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Comment by pmoriarty | Hacker News Reader

"He recommended I use a hot compress at least once a week for 10 minutes and to look away from the screen in a method called the 20-20-20-20 rule. Every 20 minutes take 20 seconds to look at an object at least 20 feet away and blink 20 times."

Is there any evidence that this treatment actually works?

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I can give only anecdotal evidence. I do this reasonably regularly. It's mainly to combat meibomian gland dysfunction and works by heating up the oils in and around the glands so that the dry build-up clears, and the glands can function a bit more normally. They should be releasing oil throughout the day to keep the surface of your eye from drying out.

I think you need to be careful not to overdo compresses, and associated massage, as the glands are also delicate and you can damage them, but for me it results in much more comfortable eyes and better vision when I do it semi regularly.

I've been doing this on and off for decades now, thanks to blepharitis and the associated gland dysfunction you mention. The fact that I stare at a screen all day certainly doesn't help and I've had to stop wearing contact lenses even though my prescription is quite strong and any sort of glasses screw up my peripheral vision.

The downside to the compress (other than the one you mentioned) is the simple fact that I can't always just nuke my little eye-pad thing and lean back for 10 minutes several times per day at work. Even when I'm able to do it a few times per day as my eye doctors have suggested, any relief is relatively short-lived and doesn't treat anything long-term.

It sucks because my eyes almost always feel irritated or dry and no manner of lubricating drops, antibiotic drops, or hot compresses have helped. I've tried a few less tested but ultimately harmless things like fish oil supplements (since they're cheap and effects seem to range from unnoticeable to possible systemic benefits in the long term).

My takeaway has been that there's really no "cure" for blepharitis or chronic inflammation and meibomian gland dysfunction. All you can really do is minimize the things that exacerbate it and deal with it.

I was diagnosed with blepharitis two years ago. Amusing (not really...) little story:

Usually, for me, it occurs in just one eye. I haven't had it for months, but I do religiously clean my eyes every day now. The last time it happened in both eyes, and I ended up on the floor holding my eyes in the most intense pain I've experienced in a while.

My partner took it upon herself to fry up some onions. She hadn't friend them for more than a year before. A minor screaming fit at her for being so incredibly stupid and ignorant for doing that (I couldn't even take my hands away from my eyes for a day after she did that) and I thought she'd never do it again.

23 hours.

She did it again, and claimed that it never occurred to her that it would hurt me again.

I feel mine started through squinting. My layman's theory is that this introduced tension to the muscles in the area, and around the glands, which inhibited them over a long period of time. It is much better now for me, but like you I can't follow the care instructions to the degree I should. I find a very gentle massage of that area after heat really helps, and I also try to relax the muscles around my eyes and being aware of them becoming tense whenever possible.

Like you say though, it seems to be something you manage rather than cure.

Well no cure aside maybe not looking at a backlight. I really wish there were marketed displays without a backlight. There's got to be a way.

I've been wanting this for ages. And more simply, I want brightness controls that go all the way down to zero.

On my system, I can run this:

  # echo 100 > /sys/class/backlight/intel_backlight/brightness

This sets the backlight brightness. I'm not sure what the units are, but it can go all the way to 0. If I shine a very bright light at the screen (like sunlight), it is readable at 0.

Seems like there could be a Kickstarter. I'd want a high resolution external eink display as a secondary monitor. The refresh rate would be hell, but it'd be okay for text work.

There's the Dasung Paperlike e-ink monitor:

https://www.indiegogo.com/projects/paperlike-world-s-first-e...

However, it's only 13.3" in size and, as you noted, it is limited by the refresh rate of e-ink.

This is still pretty appealing - I could stand to put static or near-static text there. I'd probably want to add it to my current pair of monitors, though, instead of subbing one out.

That's about what I'd expect it to run too. The poorly written marketing material kinda ruins my confidence though.

I've been wanting something like this for ages. Even as a small-scale secondary monitor, it'd be great to toss static text like tickets or APIs onto an eink display.

Oh yes! At least Kobo readers are Linux and you can SSH in. You could even install another distro I believe. Some ugly hack could be rendering the display content on your machine and just sent the image over.

https://github.com/koreader/koreader uses Lua so maybe one could add some bidirectional or at least PC->Reader flow of data.

edit: VNC! https://www.joachim-breitner.de/blog/660-Using_my_Kobo_eBook...

https://www.indiegogo.com/projects/paperlike-world-s-first-e...

Yeah, there's clinical backing for at least some of it.

The 20 seconds, 20 feet part is closely matched to eye exercises for people with certain types of nearsightedness or eyestrain. One example for nearsightedness is "close, middle, far" practice, where you cycle your focus across three visually-adjacent objects at different depths, which forces quick refocusing without saccades.

This has been pretty consistently shown to help strengthen muscles and improve refocusing speed. I haven't seen CVS-specific results, but for now I'll trust that treatment for older syndromes is a good start.

I find that soaking my face for 20-30 seconds in very cold water multiple times each day seems remarkably helpful. Plus it gets me away from my laptop for a few minutes. It's also the last thing I do before I go to bed and the first thing I do when I wake up.

The initial thinking was that I could do this to help reduce swelling (tired, puffy eyes). No idea if that works, but it sure is refreshing.

Cold water on the face stimulates the vagus nerve. :)

https://en.wikipedia.org/wiki/Vagus_nerve#Vagus_nerve_stimul...

I can only provide anecdotal evidence, and I was not officially diagnosed with it, but I definitely have plenty of the issues listed. Since I adopted the Pomodoro Technique (25min work, 5min break), I have noticed that a lot of my symptoms have subsided. My biggest issues were headaches and blurry vision.

Doing things outside helps me. Which makes sense, the whole point is to ease work for the ciliary muscles and allow them to fully relax. That happens by de-flexing the lens...which happens at a focal distance of 'infinity.'

(I'm a layperson, hopefully all of my terms were correct.)

Time outdoors is my best cure for this. It seems to be some combination of doing less active, narrow-target focusing, and having the option to look longer distances. 20 feet is doable indoors, but focusing 500 feet away is often out of the question.

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