A study published in Scientific Reports has explored how virtual reality (VR) headset use affects tear film stability — revealing that short-term VR exposure may, contrary to popular belief, actually enhance tear film lipid layer thickness, potentially improving tear stability despite reduced blink rates.
Dry eye disease (DED) affects over a billion people globally and is closely linked to tear film instability and blink suppression during digital device use. Previous DED studies have reported mixed findings on the impact of VR headsets — some showing improved stability, others showing none — but all have been limited to pre- and post-use comparisons.
Now, researchers based at Waseda University and the Kyoto Prefectural University of Medicine, Japan, have sought to clarify these effects through time-course observation of tear film dynamics during VR use.
To do so, the researchers had 14 healthy participants play a 30-minute session of Tetris Effect: Connected while wearing a custom-modified Meta Quest 2 headset equipped with an ultra-compact interferometric camera to visualize the tear film lipid layer in real time. Tear film parameters — including interference grade, lipid spread grade, lipid spread time, maximum blink interval, and tear meniscus height — were analyzed at five-minute intervals, with corneal and periocular temperatures being recorded before and after the session.
The findings reveal a significant increase in the interference grade of the tear film lipid layer after 20 minutes of VR headset use, suggesting thickening of the lipid layer. Mean interference grade rose from 1.8 ± 0.7 at baseline to 2.6 ± 0.6 after 30 minutes. Meanwhile, corneal and upper eyelid surface temperatures increased by approximately 1.5°C and 2.1°C, respectively, indicating a localized warming effect inside the headset.
Other parameters — including lipid spread time, blink interval, and tear meniscus height — remained stable, and participants reported no significant change in subjective dry eye symptoms.
The study authors propose that the observed lipid layer thickening is linked to periocular temperature elevation, which may increase lipid fluidity and promote the incorporation of polar lipids into the nonpolar lipid layer — resulting in a more stable tear film. However, they caution that excessive lipid thickening could also indicate compositional abnormalities, underscoring the need for further investigation.
Interestingly, contact lens wearers showed a delayed lipid response, suggesting pre-existing ocular surface adaptations may influence tear dynamics during VR exposure. The team also noted that the sealed design of VR headsets could reduce evaporative loss, acting similarly to moisture chamber goggles.
The study demonstrates the feasibility of real-time, non-invasive monitoring of tear film behavior during immersive visual tasks. While findings suggest that short-term VR use might temporarily stabilize the tear film via thermal and mechanical effects, the long-term implications for patients with DED or meibomian gland dysfunction still remain unclear. As such, the authors now call for future clinical studies in pathological populations to evaluate whether this lipid layer thickening translates into improved ocular comfort, or merely reflects a compensatory physiological response.
Dry eye disease (DED) affects over a billion people globally and is closely linked to tear film instability and blink suppression during digital device use. Previous DED studies have reported mixed findings on the impact of VR headsets — some showing improved stability, others showing none — but all have been limited to pre- and post-use comparisons.
Now, researchers based at Waseda University and the Kyoto Prefectural University of Medicine, Japan, have sought to clarify these effects through time-course observation of tear film dynamics during VR use.
To do so, the researchers had 14 healthy participants play a 30-minute session of Tetris Effect: Connected while wearing a custom-modified Meta Quest 2 headset equipped with an ultra-compact interferometric camera to visualize the tear film lipid layer in real time. Tear film parameters — including interference grade, lipid spread grade, lipid spread time, maximum blink interval, and tear meniscus height — were analyzed at five-minute intervals, with corneal and periocular temperatures being recorded before and after the session.
The findings reveal a significant increase in the interference grade of the tear film lipid layer after 20 minutes of VR headset use, suggesting thickening of the lipid layer. Mean interference grade rose from 1.8 ± 0.7 at baseline to 2.6 ± 0.6 after 30 minutes. Meanwhile, corneal and upper eyelid surface temperatures increased by approximately 1.5°C and 2.1°C, respectively, indicating a localized warming effect inside the headset.
Other parameters — including lipid spread time, blink interval, and tear meniscus height — remained stable, and participants reported no significant change in subjective dry eye symptoms.
The study authors propose that the observed lipid layer thickening is linked to periocular temperature elevation, which may increase lipid fluidity and promote the incorporation of polar lipids into the nonpolar lipid layer — resulting in a more stable tear film. However, they caution that excessive lipid thickening could also indicate compositional abnormalities, underscoring the need for further investigation.
Interestingly, contact lens wearers showed a delayed lipid response, suggesting pre-existing ocular surface adaptations may influence tear dynamics during VR exposure. The team also noted that the sealed design of VR headsets could reduce evaporative loss, acting similarly to moisture chamber goggles.
The study demonstrates the feasibility of real-time, non-invasive monitoring of tear film behavior during immersive visual tasks. While findings suggest that short-term VR use might temporarily stabilize the tear film via thermal and mechanical effects, the long-term implications for patients with DED or meibomian gland dysfunction still remain unclear. As such, the authors now call for future clinical studies in pathological populations to evaluate whether this lipid layer thickening translates into improved ocular comfort, or merely reflects a compensatory physiological response.
