Lifestyle Medicine and Dry Eye Disease in Viet Nam: Screen Habits, Environmental Exposures, and Evidence-Based Care

Lifestyle Medicine and Dry Eye Disease in Viet Nam: Screen Habits, Environmental Exposures, and Evidence-Based Care

Primary category: Evidence & Clinical Practice

Secondary category: Lifestyle Medicine in Viet Nam

Article type: VLMA Perspective

Last reviewed: October 30, 2026

By the end of a working day, someone who spends hours at a computer may experience burning eyes, blurred vision, or a persistent feeling of dryness. The discomfort may improve after leaving the office, only to return the following day. Because the symptoms appear during screen use, it is tempting to assume that the screen is responsible.

Yet similar complaints can occur in people who spend relatively little time using digital devices. Some have problems with tear production or evaporation. Others have eyelid abnormalities, medication-related effects, or medical conditions affecting the ocular surface. In some cases, the discomfort may not be caused by dry eye disease at all.

Dry eye disease is more complex than simply having too few tears. It can interfere with visual comfort, daily activities, work, and quality of life. Although screen habits and environmental exposures may contribute to symptoms, modifying these factors alone does not necessarily resolve the underlying condition.

Evidence-based Lifestyle Medicine can support eye health by addressing relevant behaviors, workplace conditions, and other modifiable exposures. Its contribution is most useful when these measures complement appropriate ophthalmic assessment and treatment.

For healthcare professionals in Viet Nam, the challenge is to distinguish screen-related discomfort from clinically established dry eye disease, identify factors that can reasonably be modified, and determine whether an intervention produces meaningful benefits. Recent international guidance and Vietnamese research provide an opportunity to examine these questions more closely.

Understanding Dry Eye Disease Beyond the Feeling of Dryness

In 2025, the Tear Film & Ocular Surface Society published the third Dry Eye Workshop reports, commonly known as TFOS DEWS III. These reports provide an updated international framework for understanding, diagnosing, and managing dry eye disease. An executive summary subsequently appeared in the February 2026 issue of the American Journal of Ophthalmology. [1–3]

The revised definition describes dry eye as a multifactorial, symptomatic disease characterized by loss of homeostasis of the tear film and/or ocular surface. Tear film instability, increased osmolarity, ocular surface inflammation and damage, and abnormalities in ocular sensation are among the factors involved.

An important feature of this definition is that dry eye disease is symptomatic. Abnormal ocular surface findings without symptoms may represent another ocular surface condition, while discomfort without corresponding clinical findings may require investigation for alternative explanations.

The tear film is not simply a layer of water covering the eye. Its components work together to maintain a stable optical surface, support vision, and protect the underlying tissues.

Some patients have reduced aqueous tear production. Others experience excessive evaporation because of abnormalities involving the tear film's lipid layer, eyelids, or blinking patterns. Several mechanisms may coexist, and their relative contribution can vary between individuals.

Meibomian gland dysfunction is an important example. The meibomian glands, located within the eyelids, produce lipids that help limit tear evaporation. When their function is impaired, the tear film can become less stable, contributing to irritation, discomfort, and fluctuating visual quality.

Patients may describe burning, grittiness, foreign-body sensation, intermittent blurred vision, light sensitivity, or difficulty maintaining visual comfort during prolonged activities. Excessive watering can also occur as a reflex response to ocular surface irritation.

None of these symptoms, however, is specific to dry eye disease. Allergic conjunctivitis, blepharitis, contact lens complications, uncorrected refractive errors, binocular vision disorders, and other ocular conditions may produce overlapping complaints.

A history of eye discomfort is therefore a starting point for clinical assessment, not sufficient evidence for a diagnosis.

Screen Use and Dry Eye Disease Are Not the Same Problem

Digital eye strain refers to a group of visual and ocular symptoms associated with prolonged use of computers, smartphones, tablets, and other electronic displays. These symptoms can include eye fatigue, headaches, blurred vision, difficulty maintaining focus, burning, and sensations of dryness.

Dry eye disease may contribute to digital eye strain, and prolonged screen use can aggravate existing ocular surface problems. Nevertheless, the two conditions are not interchangeable.

Some symptoms are related primarily to sustained near focusing, uncorrected refractive errors, or problems with eye coordination. Others involve changes in blinking behavior and tear film stability.

During visually demanding tasks, people often blink less frequently or fail to close their eyelids completely. Incomplete blinking may interfere with the normal distribution of the tear film and contribute to increased evaporation.

The effects vary according to the individual and the task being performed. Reading on a smartphone at a short viewing distance may place different demands on the visual system than working with a larger desktop monitor. Screen position, viewing distance, font size, lighting, visual correction, and the duration of uninterrupted work can also influence comfort.

For many people, digital devices are essential to their employment, education, and daily communication. Advising someone to avoid screens may be unrealistic, particularly when their work requires sustained visual concentration.

A more useful assessment considers which activities provoke symptoms, whether the person's visual correction is appropriate, what environmental conditions are present, and whether there is evidence of an underlying ocular surface disorder.

Rather than treating digital devices as the sole cause, healthcare professionals should consider how visual demands, individual susceptibility, and ocular health interact. This can help identify interventions that are both clinically relevant and practical.

What Do Recent Studies Tell Us About Screen Breaks and Blinking?

Regular breaks during prolonged near work are commonly recommended. One familiar example is the 20–20–20 rule, which encourages people to look at something approximately 20 feet away for about 20 seconds after every 20 minutes of screen use.

The approach is relatively simple and low risk. However, its effectiveness should not be overstated, particularly when discussing treatment for established dry eye disease.

A study published in Experimental Eye Research in 2025 examined different break schedules during a 40-minute reading task involving 24 young adults. Participants completed four experimental conditions on separate days: uninterrupted work, one break after 20 minutes, breaks every 10 minutes, and breaks taken according to individual preference. [6]

More frequent and self-paced breaks were associated with improvements in certain measures of digital eye strain and focusing behavior compared with uninterrupted work. Participants reported less irritation, burning, and eye strain under some break conditions. The study also identified differences in temporary changes in focusing after near work.

However, the findings were not uniform across all measures. The experiment involved a small group of young adults and a relatively short reading task. It did not establish whether any particular break schedule prevents dry eye disease or produces sustained improvement in patients with a chronic ocular surface disorder.

The 20–20–20 rule can therefore be considered a practical option for interrupting prolonged near work, rather than a universally validated treatment protocol.

Blinking behavior has also become an area of interest in research on digital device use.

A randomized study published in npj Digital Medicine in November 2025 evaluated a smartphone application designed to encourage more frequent and complete blinking. The study involved 40 young adults with dry eye disease, randomly assigned to an intervention group using the application or a control group without the intervention. [7]

After 30 days, participants using the application showed improvements in symptom scores, blinking behavior, and selected measurements of tear film stability.

Between-group analyses demonstrated statistically significant benefits for some outcomes, including the Ocular Surface Disease Index and the percentage of incomplete blinks. However, not every measurement showed a significant difference between groups. Pairwise comparisons at day 30 did not demonstrate significant between-group differences in blink rate, noninvasive tear film breakup time, or tear meniscus height.

The participants were university students with a mean age of approximately 24 years, and 37 of the 40 participants were women. These characteristics limit how confidently the findings can be applied to older adults, broader occupational groups, or the general population.

The investigators also assessed the intervention group 30 days after the application had been discontinued. Some symptom improvements remained evident, although several objective measures showed partial reversal. Because this later follow-up did not include the same controlled comparison, the findings should not be interpreted as definitive evidence of sustained effectiveness.

The study also lacked an active or sham application control, making it difficult to separate the specific effects of blinking training from possible effects of attention or expectations.

Nevertheless, the research suggests that blinking behavior can be modified and that selected patients may benefit from structured reminders or training.

In practice, periodic visual breaks and improved blinking awareness may be reasonable supportive strategies. Their value should be assessed according to the patient's symptoms, clinical findings, and ability to sustain the intervention.

An improvement in temporary screen-related discomfort should not automatically be interpreted as resolution of underlying dry eye disease.

Environmental Exposures: Looking Beyond the Screen

The conditions in which people live and work can influence ocular surface comfort.

TFOS DEWS III recognizes environmental and behavioral factors as relevant to dry eye assessment and management. Temperature, humidity, airflow, airborne particles, and occupational exposures may affect symptoms or tear film stability, although the strength of evidence varies between individual factors. [1,2]

These considerations are relevant to daily life in Viet Nam, where people may move between hot outdoor environments, air-conditioned offices, industrial workplaces, and areas affected by air pollution.

High outdoor humidity does not necessarily mean that indoor conditions support tear film stability. Air conditioning may reduce indoor humidity, while fans or ventilation systems can direct airflow toward the face and increase tear evaporation.

For someone who notices that symptoms worsen when sitting beneath an air-conditioning vent, changing position or redirecting airflow may be a reasonable adjustment. Modifying indoor humidity may also help selected patients, particularly in unusually dry environments, although there is no single humidity target established as necessary or effective for everyone with dry eye disease.

The potential contribution of outdoor air pollution requires similarly careful interpretation.

Observational research has reported associations between certain air pollutants and ocular surface symptoms or clinical abnormalities. Nevertheless, differences in exposure assessment, study design, and individual susceptibility limit the ability to attribute dry eye disease directly to pollution exposure in a particular patient.

Tobacco smoke may also contribute to irritation and should be considered when evaluating avoidable exposures.

Occupational conditions deserve attention because not everyone has the same ability to modify their environment.

An office worker may be able to reposition a monitor or redirect an air-conditioning vent. Someone employed in manufacturing, construction, transportation, or another setting with unavoidable exposures may need workplace-level controls rather than advice directed solely at personal behavior.

Depending on the occupational risks, appropriate protective eyewear, ventilation improvements, exposure controls, and reasonable opportunities for breaks may be relevant.

Such measures should be proportionate to the identified risks and consistent with applicable occupational health and safety requirements. They should not be presented as substitutes for appropriate medical evaluation.

Recognizing the difference between what patients can reasonably change themselves and what requires support from employers or other responsible parties can make recommendations more practical and equitable.

Accurate Diagnosis Requires Symptoms and Clinical Findings

One of the most important contributions of TFOS DEWS III is its emphasis on a standardized diagnostic approach.

The updated Diagnostic Methodology report recommends the six-item Ocular Surface Disease Index, known as OSDI-6, as the screening questionnaire within its diagnostic framework. A summed score of four or higher identifies symptoms that warrant further investigation. [1]

This threshold is specific to OSDI-6 and should not be confused with the scoring system of the original, longer Ocular Surface Disease Index questionnaire.

A positive questionnaire result alone does not establish dry eye disease.

Under the TFOS DEWS III framework, diagnosis requires compatible symptoms, consideration of relevant alternative diagnoses, and objective evidence of disturbed tear film or ocular surface homeostasis.

The recommended diagnostic indicators include noninvasive tear film breakup time, tear osmolarity, and ocular surface staining.

A noninvasive tear film breakup time below 10 seconds is one possible positive sign. Defined abnormalities in tear osmolarity or ocular surface staining can also support diagnosis when the recommended criteria are met.

The report provides more specific thresholds, including tear osmolarity of at least 308 mOsm/L in either eye or an interocular difference greater than 8 mOsm/L, subject to the measurement methods and limitations described in the guidance.

One qualifying objective indicator can support confirmation of dry eye disease in a symptomatic patient after appropriate consideration of alternative causes. Clinical interpretation remains essential, however, and a limited assessment may not be sufficient to exclude every relevant ocular surface condition.

Additional investigations may help clarify the mechanisms involved. Assessment of eyelid abnormalities, meibomian gland function, blinking, tear production, and ocular surface inflammation may be appropriate according to the presentation.

Schirmer testing, for example, can provide useful information when reduced aqueous tear production is suspected, but it should not be treated as a universal stand-alone diagnostic test.

A particular challenge is that symptoms and clinical signs do not always correspond closely.

Some patients experience substantial discomfort despite relatively limited observable abnormalities. Others have significant ocular surface findings but report few symptoms.

When symptoms are present without confirmatory signs, clinicians may need to consider other explanations, including neuropathic ocular pain, refractive problems, and binocular vision disorders.

Conversely, patients with clinically important ocular surface abnormalities but no symptoms may require assessment and management of the underlying condition, even if they do not meet the revised definition of symptomatic dry eye disease.

Without appropriate diagnostic assessment, patients may receive repeated lubricating treatment or additional lifestyle advice while the actual cause of their discomfort remains unrecognized.

Accurate diagnosis is essential to selecting appropriate care and avoiding unnecessary or ineffective interventions.

What Does Research From Viet Nam Tell Us?

Research conducted in Vietnamese healthcare settings can help clarify the circumstances in which patients experience ocular discomfort and identify priorities for improving care.

In August 2026, Tạp chí Nghiên cứu Y học published a study by Trương Công Gia Thịnh and Trương Công Đức examining factors associated with dry eye symptoms among users of electronic screen devices. [4]

The investigators conducted a cross-sectional study involving 400 individuals attending a specialized eye clinic between February and August 2025. Participants completed a questionnaire that included the Ocular Surface Disease Index and information about their digital device use.

The study reported that 81.5% of participants had an Ocular Surface Disease Index score above 12, while 57.3% had scores classified as moderate or severe.

Smartphones were the most commonly reported device category, accounting for 52.0% of the study's device classification. The average reported viewing distance was approximately 34.6 centimeters.

Longer daily screen exposure and the use of certain device categories were associated with greater symptom severity in the study's statistical analyses.

These findings provide locally relevant information about ocular complaints among people seeking eye care, but they should not be interpreted as evidence of national disease prevalence.

The participants came from a particular eye clinic rather than a representative sample of the Vietnamese population. The study relied on questionnaire-based symptom assessment and did not establish clinically confirmed dry eye disease according to the complete TFOS DEWS III diagnostic framework.

Its cross-sectional design also cannot determine whether screen exposure caused the reported symptoms. Other factors, including visual correction, occupational conditions, preexisting ocular disease, medication use, and individual susceptibility, may have contributed.

The reported 81.5% should therefore be understood as the proportion of participants whose symptom scores exceeded the questionnaire threshold. It is not a national prevalence estimate for clinically confirmed dry eye disease.

A separate study published in the Vietnam Medical Journal in August 2026 examined 50 patients, representing 100 eyes, who had already been diagnosed with meibomian gland dysfunction at the National Eye Hospital in Ha Noi. The data were collected between June and December 2024. [5]

Unlike the screen-related symptom study, this investigation focused on a selected group with an established eyelid gland disorder. The researchers evaluated symptoms, tear film breakup time, eyelid findings, and meibomian gland morphology.

The participants had a mean age of approximately 57 years, and 90% were women. The mean Ocular Surface Disease Index score was 48.1, indicating substantial symptom burden within the selected group. The average tear film breakup time was approximately 4.9 seconds, and abnormalities involving the meibomian glands were documented.

These findings illustrate the clinical importance of eyelid gland dysfunction in patients with ocular surface complaints. However, the study was descriptive and involved individuals already diagnosed with the condition. It cannot establish the prevalence of meibomian gland dysfunction in the wider population or demonstrate that the same clinical patterns apply across Vietnamese healthcare settings.

Taken together, the two studies offer complementary insights. The first highlights the frequency of ocular symptoms among selected patients using digital devices. The second demonstrates that clinically important ocular surface complaints may involve identifiable abnormalities in eyelid gland function.

Neither study establishes that screen use is the sole or principal cause of dry eye disease in Viet Nam.

Further Vietnamese research would benefit from standardized diagnostic definitions, more representative populations, appropriate control of confounding factors, and prospective evaluation of interventions relevant to local working and environmental conditions.

Matching Supportive Interventions to the Underlying Problem

Once the clinical condition has been appropriately assessed, management should reflect the factors contributing to that patient's symptoms and ocular surface abnormalities.

For someone whose discomfort worsens during prolonged screen use, adjustments to viewing habits, screen position, work breaks, and blinking awareness may offer useful support.

For another person with significant meibomian gland dysfunction, appropriate eyelid care and targeted treatment may be more important than reducing screen exposure alone.

Patients with reduced aqueous tear production, ocular inflammation, contact lens-related complications, or associated systemic conditions may require different approaches.

TFOS DEWS III emphasizes treatment selection according to the underlying mechanisms rather than assuming that one intervention is suitable for every patient. [2]

Medication history also deserves attention. Certain antihistamines, antidepressants, isotretinoin, and other systemic or ocular medicines may contribute to symptoms or affect ocular surface health.

Identifying a possible medication-related factor does not mean that treatment should be stopped. The indication for the medicine, potential alternatives, and risks associated with changing therapy must be assessed by appropriately qualified healthcare professionals.

Systemic medical conditions may also be relevant. Persistent ocular dryness accompanied by substantial dry mouth or other suggestive symptoms may warrant assessment for Sjögren disease or another underlying disorder rather than repeated advice about screen habits.

These examples illustrate why individualized assessment matters. A supportive intervention should address a plausible and clinically relevant contributor, and its usefulness should be evaluated rather than assumed.

When Lifestyle Changes Are Not Enough

Although behavioral and environmental modifications can support ocular comfort, established dry eye disease may require additional treatment.

Lubricating eye drops and other tear supplements remain important components of care. Their selection depends on the patient's symptoms, tear film abnormalities, ocular surface findings, frequency of use, and tolerance.

For patients requiring frequent lubrication, preservative-related irritation may be a consideration, and preservative-free formulations may be preferable in selected circumstances.

Meibomian gland dysfunction may benefit from appropriate warm compresses, eyelid hygiene, and other targeted interventions.

More specialized procedures, including thermal treatments and light-based technologies, may be considered for selected patients. However, the evidence supporting different procedures varies, and technological sophistication does not automatically establish better clinical outcomes.

Patients with significant ocular surface inflammation may require prescription anti-inflammatory or immunomodulatory treatment. Depending on the diagnosis and clinical circumstances, treatment may include topical immunomodulatory medicines, carefully supervised short courses of corticosteroids, and other specialist interventions.

Topical corticosteroids should not be self-prescribed for unexplained ocular discomfort. Inappropriate use can increase intraocular pressure, complicate infections, and create other ocular risks.

Similarly, over-the-counter products marketed primarily to reduce redness should not automatically be regarded as appropriate dry eye treatments.

Treatment decisions need to consider the diagnosis, expected benefits, potential adverse effects, monitoring requirements, and feasibility of follow-up.

The availability of multiple treatment options does not mean that every patient needs several interventions. The appropriate approach should address the individual's clinical needs with a reasonable balance of benefit, safety, and treatment burden.

Supplements, Blue-Light Glasses, and Commercial Claims

Patients with persistent eye discomfort may encounter a wide range of products promoted as solutions for dryness or digital eye strain.

These include nutritional supplements, blue-light-filtering spectacles, specialized eye drops, and devices marketed to improve ocular comfort. Some products may have legitimate applications, but claims about effectiveness should be evaluated against the available clinical evidence.

Omega-3 fatty acid supplements provide an important example.

The Dry Eye Assessment and Management trial, published in The New England Journal of Medicine in 2018, enrolled 535 participants with moderate-to-severe dry eye disease. Participants were randomly assigned to receive high-dose omega-3 supplementation or placebo over 12 months. [8]

Although symptoms improved in both groups, the investigators found no statistically significant advantage of omega-3 supplementation over placebo for the primary outcome or several important clinical signs.

Other studies have produced different results, and TFOS DEWS III reviews nutritional approaches among possible supportive interventions. However, differences in study populations, formulations, doses, and outcome measures limit conclusions about consistent benefits.

Current evidence does not justify presenting omega-3 supplements as a universally effective treatment for dry eye disease.

Appropriate nutrition remains important for general health, but the benefits of a balanced diet should not be confused with proof that a particular supplement can correct an ocular surface disorder.

Blue-light-filtering glasses are another frequently promoted product.

A Cochrane systematic review published in 2023 evaluated blue-light-filtering spectacle lenses compared with ordinary lenses. It included 17 randomized controlled trials involving 619 participants. [9]

The review found that blue-light-filtering lenses may provide little or no short-term benefit for computer-related visual fatigue compared with non-blue-light-filtering lenses.

Evidence concerning other outcomes, including sleep, was uncertain. The review did not establish that these products treat dry eye disease.

For someone experiencing discomfort during screen use, assessment of visual correction, workplace ergonomics, tear film stability, and other potential causes may be more useful than assuming that blue-light exposure is responsible.

Healthcare professionals can help patients make informed choices by explaining what a product has been shown to achieve, what remains uncertain, and whether the intervention is relevant to their condition.

This is particularly important when commercial promotion creates expectations that are not supported by clinical evidence.

Recognizing Symptoms That Require Prompt Eye Assessment

Not every complaint described as dry eyes is a minor or uncomplicated ocular surface problem.

Significant eye pain, pronounced redness, marked light sensitivity, sudden visual changes, or symptoms predominantly affecting one eye may indicate conditions requiring urgent evaluation.

Contact lens wearers deserve particular attention.

Someone using contact lenses who develops a painful red eye, reduced vision, discharge, or light sensitivity may have infectious keratitis or another corneal complication.

These symptoms warrant urgent eye assessment. Contact lens use should be stopped pending appropriate clinical advice rather than continuing wear or relying on lubricating drops alone.

New or worsening symptoms after eye surgery or injury may also require prompt evaluation. Chemical exposure to the eye is an emergency requiring immediate appropriate irrigation and emergency medical care.

Delays in recognizing corneal infection, significant ocular injury, or other serious conditions can threaten vision.

Lifestyle counseling should never delay necessary medical assessment or be used to explain away concerning symptoms simply because the patient spends considerable time using digital devices.

Measuring Outcomes That Matter to Patients

An effective dry eye management plan should include a way to determine whether treatment is producing meaningful improvement.

Patient-reported symptoms are important because discomfort, fluctuating vision, and difficulty completing daily activities often drive patients to seek care.

Validated instruments such as the Ocular Surface Disease Index can help quantify symptom burden and monitor changes over time. However, different questionnaire versions use different scoring systems, and their results should not be treated as directly interchangeable without appropriate interpretation.

Clinical findings provide complementary information. Tear film stability, ocular surface staining, eyelid abnormalities, and other relevant measurements can help evaluate disease activity and response to treatment.

Symptoms and clinical signs do not always improve at the same rate.

Someone may report greater comfort after workplace adjustments while continuing to show abnormal tear film findings. Another patient may demonstrate improvement in objective measurements but still experience troublesome discomfort.

Follow-up should therefore consider more than a single symptom score or clinical measurement.

Visual functioning, work-related difficulties, contact lens tolerance when relevant, and the burden of ongoing treatment may all influence the patient's experience.

For someone working at a computer throughout the day, meaningful improvement may involve being able to complete essential tasks with fewer interruptions. For another patient, the priority may be greater comfort during reading, driving, or other valued activities.

Frequent eye drop administration, treatment costs, repeated appointments, and complex care routines may also affect whether a treatment plan is sustainable.

When symptoms persist despite reasonable initial measures, clinicians should reconsider the diagnosis, possible contributing conditions, treatment response, and whether specialist assessment is needed.

The purpose of outcome measurement is not simply to demonstrate a lower symptom score. It is to establish whether care is improving ocular health, visual functioning, and quality of life.

Making Evidence-Based Dry Eye Care Practical in Viet Nam

International recommendations provide a valuable scientific foundation, but their application needs to reflect the realities of healthcare delivery in Viet Nam.

Patients with ocular discomfort may initially seek advice from general medical services, pharmacies, optical businesses, or specialized ophthalmology clinics. Access to ophthalmic professionals, diagnostic instruments, and treatment options may differ between settings.

Not every patient requires advanced imaging or every specialized tear film investigation. However, the absence of particular equipment should not lead to unsupported diagnostic certainty based solely on symptoms.

Initial assessment should consider the presenting complaints, relevant exposures, medication history, contact lens use, visual demands, and warning signs that may require urgent referral.

Patients with persistent symptoms or suspected ocular surface disease should have access to appropriately qualified professionals who can perform the necessary examination and determine whether further investigation or treatment is required.

At the workplace level, opportunities for improvement may include screen ergonomics, appropriate lighting, reduced direct airflow toward the eyes, and reasonable opportunities for breaks.

These measures may be useful for employees whose work requires prolonged visual concentration, particularly when they have limited control over their daily working conditions. Nevertheless, workplace adjustments should not be marketed as guaranteed methods for preventing or treating dry eye disease.

Healthcare organizations can also consider how patients move between initial consultations, specialist assessment, treatment, and follow-up.

Consistent documentation of symptoms and clinical findings, recognition of patients requiring urgent assessment, and appropriate monitoring of treatment response can help improve care.

These activities do not necessarily require a separate Lifestyle Medicine service. They can be integrated into existing healthcare pathways through appropriate collaboration among ophthalmologists, primary care professionals, occupational health teams, and other relevant practitioners.

The broader opportunity is to make ocular surface care more accessible, consistent, and responsive to patient needs without reducing complex eye conditions to a simple problem of screen time.

Professional and Legal Responsibilities in Viet Nam

The distinction between general health education and regulated clinical practice is particularly important when discussing eye disease.

In Viet Nam, medical examination, diagnosis, treatment, prescribing, and related clinical activities are governed by the Law on Medical Examination and Treatment No. 15/2023/QH15, as amended, and applicable implementing regulations. [10]

Consolidated Document No. 26/VBHN-VPQH, issued on February 26, 2026, provides an updated consolidated reference to the law. Relevant requirements concerning professional scopes of practice are also addressed in Circular No. 32/2023/TT-BYT, as amended, including applicable amendments under Circular No. 25/2026/TT-BYT. [11,12]

Healthcare professionals must act within their qualifications, competence, professional licenses, and legally authorized scopes of practice.

General education concerning screen habits, environmental exposures, or healthy behaviors does not independently authorize an individual to diagnose dry eye disease, prescribe ophthalmic medication, perform specialized eye examinations, or determine that medical treatment is unnecessary.

International clinical guidelines and professional certification programs can support knowledge and competency development. They do not independently establish legal authority to provide medical services in Viet Nam.

The protection of patient information is another important responsibility.

Ophthalmic photographs, medical histories, treatment records, investigation results, and other clinical information may contain personal or sensitive health data.

The Law on Personal Data Protection No. 91/2025/QH15 and Government Decree No. 356/2025/NĐ-CP, both effective January 1, 2026, establish relevant requirements concerning personal data processing and protection. [13,14]

Healthcare organizations and professional educational activities using identifiable patient information must consider the applicable legal basis, confidentiality obligations, necessary permissions, security safeguards, and other relevant requirements.

Educational resources should respect patient privacy and clearly distinguish scientific information from individualized clinical recommendations.

Implications for the Vietnam Lifestyle Medicine Alliance

Dry eye disease provides an opportunity to examine how lifestyle-related factors can influence a clinical condition without assuming that behavioral interventions are sufficient to treat it.

Digital device use, blinking behavior, workplace conditions, and environmental exposures may influence ocular comfort. Modifying these factors can support selected patients, but no single behavioral intervention has been established as effective for every form of dry eye disease.

For the Vietnam Lifestyle Medicine Alliance (VLMA), an appropriate contribution is to strengthen professional understanding of these issues through evidence-based education, critical appraisal of research, and scientific knowledge exchange.

Educational resources could examine the distinction between digital eye strain and clinically established dry eye disease, the influence of environmental exposures, the interpretation of symptom questionnaires, and the evidence supporting commonly recommended behavioral interventions.

The Vietnamese studies published in 2026 also provide opportunities to discuss research design, diagnostic definitions, selection bias, and the difference between statistical association and causation.

Collaboration with qualified ophthalmologists and other relevant healthcare professionals would help ensure that educational materials remain clinically accurate and appropriately connected to established eye care.

VLMA is a physician-led professional platform operated by Vietnam Lifestyle Medicine Alliance Company Limited. Its activities focus on evidence-based professional education, capability development, scientific knowledge exchange, and responsible collaboration.

VLMA does not independently diagnose dry eye disease, prescribe ophthalmic treatment, perform specialized eye examinations, or operate as a licensed eye care facility.

Its contribution is to support better professional understanding and the responsible interpretation of scientific evidence within legally authorized healthcare services.

Better Eye Care Begins With Understanding the Cause

Dry eye symptoms are familiar to many people who spend long periods using digital devices. Yet the presence of discomfort during screen use does not necessarily establish dry eye disease, and reducing screen exposure does not guarantee recovery.

The TFOS DEWS III reports provide an updated framework for connecting symptoms, clinical findings, underlying mechanisms, and appropriate treatment. Recent Vietnamese research adds useful local observations while also demonstrating the importance of distinguishing questionnaire-based symptoms from confirmed diagnoses and associations from causal relationships.

For healthcare professionals, the opportunity is to identify patients who may benefit from practical changes in daily habits and working conditions while recognizing those who require targeted treatment or further ophthalmic assessment.

An effective approach should consider the individual's ocular health, visual demands, environmental exposures, associated conditions, and ability to follow a treatment plan.

Better dry eye care is not simply about spending less time looking at screens. It is about understanding the cause of discomfort, protecting ocular surface health, and combining appropriate medical treatment with realistic, evidence-based changes that improve daily functioning and quality of life.

Selected References

1. Wolffsohn JS, Benítez-Del-Castillo JM, Loya-Garcia D, et al. TFOS DEWS III: Diagnostic Methodology. American Journal of Ophthalmology. 2025;279:387–450. Published online May 30, 2025. DOI: 10.1016/j.ajo.2025.05.033.

2. Jones L, Craig JP, Markoulli M, et al. TFOS DEWS III: Management and Therapy. American Journal of Ophthalmology. 2025;279:289–386. Published online June 2, 2025. DOI: 10.1016/j.ajo.2025.05.039.

3. Perez VL, Chen W, Craig JP, et al. TFOS DEWS III: Executive Summary. American Journal of Ophthalmology. 2026;282:135–145. Published online September 24, 2025. DOI: 10.1016/j.ajo.2025.09.035.

4. Trương Công Gia Thịnh, Trương Công Đức. Một số yếu tố liên quan đến triệu chứng khô mắt ở người dùng thiết bị màn hình điện tử. Tạp chí Nghiên cứu Y học. 2026;204(7):876–885. DOI: 10.52852/tcncyh.v204i7.5409.

5. Trần Thị Hương Trà, Nguyễn Thị Thu Thủy, Trần Khánh Sâm, Lê Bách. Đặc điểm dịch tễ và lâm sàng của rối loạn chức năng tuyến Meibomian tại Bệnh viện Mắt Trung ương. Tạp chí Y học Việt Nam. 2026;561(3). DOI: 10.51298/vmj.v561i3.18631.

6. Redondo B, Jiménez R, Vera J, Rosenfield M. The Impact of Break Schedules on Digital Eye Strain Symptoms and Ocular Accommodation During Prolonged Near Work. Experimental Eye Research. 2025;258:110463. DOI: 10.1016/j.exer.2025.110463.

7. Xu Z, Shen J, Jiang M, et al. A Smartphone-Based Blink Training Application for Alleviating Dry Eye Signs and Symptoms. npj Digital Medicine. 2025;8:703. DOI: 10.1038/s41746-025-02053-8.

8. Dry Eye Assessment and Management Study Research Group. n−3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease. The New England Journal of Medicine. 2018;378:1681–1690. DOI: 10.1056/NEJMoa1709691.

9. Singh S, Keller PR, Busija L, et al. Blue-Light Filtering Spectacle Lenses for Visual Performance, Sleep, and Macular Health in Adults. Cochrane Database of Systematic Reviews. 2023;(8). DOI: 10.1002/14651858.CD013244.pub2.

10. National Assembly of Viet Nam. Law on Medical Examination and Treatment No. 15/2023/QH15. January 9, 2023, as amended.

11. Office of the National Assembly of Viet Nam. Consolidated Document No. 26/VBHN-VPQH: Law on Medical Examination and Treatment. February 26, 2026.

12. Ministry of Health of Viet Nam. Circular No. 32/2023/TT-BYT, as amended, including by Circular No. 25/2026/TT-BYT dated June 30, 2026.

13. National Assembly of Viet Nam. Law on Personal Data Protection No. 91/2025/QH15. June 26, 2025. Effective January 1, 2026.

14. Government of Viet Nam. Decree No. 356/2025/NĐ-CP Detailing Selected Provisions and Implementation Measures of the Law on Personal Data Protection. December 31, 2025. Effective January 1, 2026.

Editorial and Professional Scope Note

This article presents an educational and professional perspective of the Vietnam Lifestyle Medicine Alliance (VLMA) on the potential contribution and limitations of evidence-based Lifestyle Medicine in dry eye disease and related ocular discomfort. It reflects scientific and regulatory information reviewed through October 30, 2026.

The article is intended for professional information, education, and scientific knowledge exchange. It does not constitute a clinical practice guideline, individualized medical advice, an ophthalmic diagnostic or treatment protocol, a medication recommendation, an occupational health standard, or an authoritative interpretation of Vietnamese law.

VLMA is a physician-led professional platform operated by Vietnam Lifestyle Medicine Alliance Company Limited. VLMA is not a licensed medical examination or treatment facility, ophthalmology clinic, medical licensing authority, or healthcare accreditation organization. It does not independently diagnose dry eye disease, perform specialized ocular investigations, prescribe or modify ophthalmic treatments, or manage ocular complications.

Clinical assessment, diagnosis, prescribing, procedures, specialist referral, and follow-up must be undertaken by appropriately qualified and legally authorized healthcare professionals and facilities within their applicable scopes of practice and in accordance with relevant Vietnamese requirements.

International guidelines and research publications are discussed for educational purposes. Their inclusion does not imply that they automatically have regulatory force in Viet Nam, that particular products or procedures have Vietnamese regulatory approval, or that VLMA has formally adopted, delivered, validated, endorsed, or certified any clinical intervention described in this article.

The evidence supporting behavioral interventions, digital applications, supplements, devices, and ophthalmic treatments varies according to study design, patient population, clinical outcomes, and follow-up duration. Findings from individual studies should not be interpreted as proof of universal effectiveness.

Lifestyle-related interventions must not delay or replace appropriate ophthalmic assessment, necessary treatment, specialist referral, or emergency care. Patients with significant eye pain, sudden visual changes, pronounced redness, light sensitivity, or suspected contact lens-related complications should receive timely medical evaluation.

Any illustrative patient situations are hypothetical and do not represent actual VLMA clinical activities or identifiable patients.