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Eye irritation has been defined as “the magnitude of any stinging, scratching, burning, or other irritating sensation from the eye”. It is a common problem experienced by people of all ages. Related eye symptoms and signs of irritation are e.g. discomfort, dryness, excess tearing, itching, grating, sandy sensation, smarting, ocular fatigue, pain, scratchiness, soreness, redness, swollen eyelids, and tiredness, etc. These eye symptoms are reported with intensities from severe to less severe. It has been suggested that these eye symptoms are related to different causal mechanisms.
Several suspected causal factors in our environment have been studied so far. One hypothesis is that indoor air pollution may cause eye and airway irritation. Eye irritation depends somewhat on destabilization of the outer-eye tear film, in which the formation of dry spots results in such ocular discomfort as dryness. Occupational factors are also likely to influence the perception of eye irritation. Some of these are lighting (glare and poor contrast), gaze position, a limited number of breaks, and a constant function of accommodation, musculoskeletal burden, and impairment of the visual nervous system. Another factor that may be related is work stress. In addition, psychological factors have been found in multivariate analyses to be associated with an increase in eye irritation among VDU users. Other risk factors, such as chemical toxins/irritants, e.g. Amines, Formaldehyde, Acetaldehyde, Acrolein, N-decane, VOCs; Ozone, Pesticides and preservatives, Allergens, etc might cause eye irritation as well.
Certain volatile organic compounds that are both chemically reactive and airway irritants may cause eye irritation as well. Personal factors (e.g., use of contact lenses, eye make-up, and certain medications) may also affect destabilization of the tear film and possibly result in more eye symptoms. Nevertheless, if airborne particles alone should destabilize the tear film and cause eye irritation, their content of surface-active compounds must be high. An integrated physiological risk model with blink frequency, destabilization, and break-up of the eye tear film as inseparable phenomena may explain eye irritation among office workers in terms of occupational, climate, and eye-related physiological risk factors.
There are two major measures of eye irritation. One is blink frequency which can be observed by human behavior. The other measures are break up time, tear flow, hyperemia (redness, swelling), tear fluid cytology, and epithelial damage (vital stains) etc, which are human beings’ physiological reactions. Blink frequency is defined as the number of blinks per minute and it is associated with eye irritation. Blink frequencies are individual with mean frequencies of < 2-3 to 20-30 blinks/minute, and they depend on environmental factors including the use of contact lenses. Dehydration, mental activities, work conditions, room temperature, relative humidity, and illumination all influence blink frequency. Break-up time (BUT) is another major measure of eye irritation and tear film stability. It is defined as the time interval (in seconds) between blinking and rupture. BUT is considered to reflect the stability of the tear film as well. In normal persons, the break-up time exceeds the interval between blinks, and, therefore, the tear film is maintained. Studies have shown that blink frequency is correlated negatively with break-up time. This phenomenon indicates that perceived eye irritation is associated with an increase in blink frequency since the cornea and conjunctiva both have sensitive nerve endings that belong to the first trigeminal branch. Other evaluating methods, such as hyperemia, cytology etc have increasingly been used to assess eye irritation.