Effects of suppression of blinking on quality of vision in borderline cases of evaporative dry eye

Purpose: To study the effects of suppression of blinking on quality of vision in borderline cases of evaporative dry eye. Methods: Ocular higher-order aberrations (HOAs) were measured sequentially for 30 seconds in 10 eyes with a short tear film breakup time (TBUT; 3.0 +/- 0.6 seconds) without ocular surface staining or tear deficiency. During measurements, the subjects suppressed blinking to every 10 seconds, which is more than double the TBUT. The aberration data were analyzed for comalike and spherical-like aberrations and total HOAs to the sixth-order Zernike polynomials. Results: Sequential changes in total HOAs in subjects with a short TBUT showed a sawtooth pattern with a marked upward curve that increased after blinking. From 5 to 9 seconds after blinking, the total HOAs were significantly higher than immediately after blinking (P < 0.001). Conclusions: Serial HOA measurements showed that optical quality might deteriorate in subjects with a short TBUT by suppressed blinking, such as when gazing at a video display terminal, even with sufficient tear volume.