Vision Expo 2026: Ocular surface dryness for a new generation

In Lisa M. Hornick’s, OD, MBA, FAAO, Vision Expo 2026 presentation “Young and Bothered – Ocular Surface Dryness for a New Generation“, the rising prevalence and future implications of (DED) in Gen Z (roughly aged 14–29) is framed through their lifestyle, health behaviors, and the role of eye care professionals in prevention and education.

Hornick described Gen Z as true digital natives who are “always on” their devices—using screens for school, work, entertainment, and social connection. This constant, break-free screen exposure is identified as a major contributor to dry eye symptoms. Beyond screens, several lifestyle factors common in this age group further exacerbate ocular surface issues: heavy use of cosmetics, especially lash services (with Gen Z representing about 50% of the lash industry); poor diet characterized by ultra-processed and fast foods; and inadequate or poor-quality sleep. Additionally, they fall into the primary age range for refractive surgery (20–40 years), which can worsen dryness, and some have skin conditions like rosacea and Demodex blepharitis that further affect the ocular surface.

A central theme is that many Gen Z patients do not recognize dry eye as a disease. They normalize their symptoms—like needing to stop work by mid-afternoon due to discomfort—as just part of using screens, rather than a treatable condition. This creates a substantial education gap. Hornick emphasized the need for re-education in the exam chair: explaining what DED is, what signs and symptoms to watch for, and stressing that it is not normal to be thinking about one’s eyes all day.

Hornick also highlighted how 40% of Gen Z’s medical information comes from social media, which poses a serious risk of misinformation when content is created by non-experts. Consequently, optometrists are encouraged to maintain an active digital and social media presence to provide accurate, evidence-based information. In Hornick’s own practice, they use AI tools and rely on a dedicated “dry eye champion” staff member who manages social media, answers patient questions, and handles prior authorizations.

Preventive care is heavily emphasized. Gen Z is praised for valuing self-care routines (skin, hair, dental hygiene), and Hornick argued that eye care should be embedded into these daily habits. Recommended routine components include lid hygiene with foam cleansers or wipes, consistent eye makeup removal, warm compresses, artificial tears, and prescription medications when indicated. Hornick warns that DED is chronic and progressive; without early intervention, the structural damage—especially to the meibomian glands—can become largely irreversible.

To this end, Hornick urges clinicians to perform baseline meibography in younger dry eye patients so that gland structure can be tracked over time. This allows earlier and more targeted interventions before significant atrophy occurs. The future “10-year landscape” is portrayed as potentially much worse if current patterns continue, with reduced work productivity and even job loss due to severe symptoms. Some patients already report being unable to complete their workday past mid-afternoon or having to leave their jobs entirely because of disabling dryness.

Overall, Hornick underscored that early prevention, proactive education, and strong digital engagement by eye care professionals are critical to protecting Gen Z’s long-term eye health, work productivity, and quality of life.