What question did this study set out to answer?

This research aims to evaluate the effects of carboxymethyl cellulose on corneal parameters in young adults with dry eye disease linked to high screen exposure.

February 21, 2026Clinical Optometry0 citationsOpen Access

Changes in Corneal Epithelial Thickness and Tear Film Stability After Carboxymethyl Cellulose Use in Young Adults with High Screen Time Exposure

UBUmesh Belbase PKPrastuti Khanal ASAnup Subedi

Key Points

This research aims to evaluate the effects of carboxymethyl cellulose on corneal parameters in young adults with dry eye disease linked to high screen exposure.
Conducted a prospective, single-arm interventional study.
Enrolled 76 patients aged 20-40 years with symptomatic dry eye disease and high screen time.
Participants used preservative-free 0.5% CMC artificial tears four times daily for one month.
Measured changes in central corneal epithelial thickness and tear film stability using OCT and non-invasive tear break-up time.
One month of CMC treatment significantly increased central corneal epithelial thickness by 0.86 μm (p < 0.001).
Tear film stability improved, with NIBUT increasing by 1.37 seconds (p < 0.001).
A strong negative correlation was found between daily screen time and baseline NIBUT (r = -0.72, p < 0.001).
Older age was identified as a significant predictor of positive anatomical response to treatment (adjusted OR = 1.15, p = 0.013).

Abstract

Background: Dry eye disease (DED) is increasingly prevalent among young adults, largely driven by prolonged digital screen exposure. This study evaluated changes in ocular surface–related parameters following carboxymethyl cellulose (CMC) use in a young population with high digital screen exposure and explored baseline factors associated with anatomical change. Methods: This prospective, single-arm interventional study enrolled 76 patients (120 eyes) aged 20– 40 years with symptomatic DED and high screen time. Participants used preservative-free 0.5% CMC artificial tears four times daily for one month. Primary outcome was the change in central corneal epithelial thickness (CET) measured by Fourier-domain optical coherence tomography (OCT). Secondary outcomes included changes in non-invasive tear break-up time (NIBUT), central corneal thickness (CCT), and an analysis of predictors of anatomical improvement. Results: One month of CMC treatment was associated with the statistically significant increase in central CET (from 52.79 ± 2.86 μm to 53.65 ± 2.92 μm; Δ = +0.86 μm, p < 0.001), with significant thickening observed across all corneal zones. Tear film stability also improved significantly, with NIBUT increasing from 6.52 ± 2.14 seconds to 7.89 ± 3.13 seconds (Δ = +1.37 seconds, p < 0.001). A strong negative correlation was found between daily screen time and baseline NIBUT (r = − 0.72, p < 0.001). Binary logistic regression identified that older age within the cohort was a significant predictor of a positive anatomical response to treatment (adjusted OR = 1.15, p = 0.013). Conclusion: In young adults with screen-time-associated DED, one month of CMC may be associated with changes in corneal epithelial thickness and tear film stability. The strong correlation with screen time underscores its role as a key risk factor. Keywords: dry eye disease, carboxymethyl cellulose, corneal epithelial thickness, digital screen time, optical coherence tomography

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Cite This Study

Belbase et al. (Sun,) studied this question.

synapsesocial.com/papers/69994ba9873532290d01fc3f https://doi.org/https://doi.org/10.2147/opto.s585390

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