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Laughter: Comic Relief for Dry Eyes?


 

TOPLINE:

Laughter exercise practiced four times a day was noninferior to 0.1% sodium hyaluronic acid in alleviating the symptoms of dry eye disease and improved tear film stability and the function of the meibomian gland, researchers found.

METHODOLOGY:

  • Researchers aimed to assess the effectiveness and safety of laughter exercise in patients with symptomatic dry eye disease by conducting a two-arm clinical trial at the largest ophthalmic center in southern China.
  • They included 299 patients aged 18-45 years (74% women) with symptomatic dry eye disease who were randomly assigned to receive either laughter exercise or eye drops with 0.1% sodium hyaluronic acid four times daily for 8 weeks.
  • All the participants were required to have an ocular surface disease index score, a measure of symptoms related to dry eye disease, between 18 and 80 points and a fluorescein tear film breakup time of no more than 8 seconds.
  • Participants in the laughter exercise group watched an instructional video and were requested to repeat the phrases “Hee hee hee, hah hah hah, cheese cheese cheese, cheek cheek cheek, hah hah hah hah hah hah” 30 times per 5-minute session.
  • The primary outcome was the mean change in the ocular surface disease index score from baseline to 8 weeks.

TAKEAWAY:

  • At 8 weeks, the ocular surface disease index score reduced by 10.50 points (95% CI, −13.1 to −7.82) in the laughter exercise group and by 8.83 points (95% CI, −11.7 to −6.02) in the group prescribed eye drops.
  • At 12 weeks, patients in the laughter exercise group showed a significantly greater reduction in the ocular surface disease index score than those in the group prescribed eye drops (mean between-group difference, −4.08 points; P = .024).
  • Laughter exercise also led to a more significant improvement in the noninvasive tear breakup time than the use of eye drops (mean between-group difference, 2.30 sec; P < .001).
  • No adverse events were reported in either of the groups during the study period.

IN PRACTICE:

“As a safe, environmentally friendly, and low-cost intervention, laughter exercise could serve as a first-line, home-based treatment for people with symptomatic dry eye disease and limited corneal staining,” the authors of the study reported.

SOURCE:

This study was led by Jing Li from the State Key Laboratory of Ophthalmology at the Zhongshan Ophthalmic Center in Sun Yat-sen University in Guangzhou, China, and was published online on September 11, 2024, in The BMJ.

LIMITATIONS:

The study lacked a double-blinded design. The laughter exercise required a greater time investment than the application of eye drops, which may affect adherence in the long run.

DISCLOSURES:

This study was supported by grants from the National Natural Science Foundation of China and High-level Hospital Construction Project. The authors declared receiving support from the funding agencies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.

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