CHENNAI: We’ve all heard people shouting “Ho, Ho, Ha, Ha, Ha” in parks, and when we follow the sounds, we often discover it’s part of a laughter exercise. While these exercises are widely associated with health benefits, a study published in the British Medical Journal (BMJ) has taken it a step further, revealing that laughter exercises can be just as effective as standard treatments like hyaluronic acid drops in alleviating the symptoms of dry eye disease. Let’s dive deeper into the findings with insights from experts.
Dry eye, or keratoconjunctivitis sicca, is a common condition where the eyes either don’t produce enough tears or the tears don’t function properly. Dr Sushma Reddy Katukuri, consultant in Pediatric Ophthalmology at Rainbow Children’s Hospital, explains that while dry eyes are more common with age, especially in postmenopausal women, they can also be linked to systemic conditions such as rheumatoid arthritis, lupus, Sjögren’s syndrome, and thyroid disorders. Additional contributors include eyelid diseases, long-term contact lens use, and post-refractive eye surgery. In recent years, prolonged screen exposure has become another significant factor.
Dr Deepti Mehta, consultant ophthalmologist at CARE Hospitals, Hyderabad, elaborates on the study, stating, “The goal was to see if laughter exercises could match the effectiveness of artificial tears in treating symptomatic dry eye disease (DED). The randomised controlled trial involved 299 participants aged 18 to 45, all diagnosed with DED. These participants were split into two groups one performed laughter exercises while the other used artificial tears.
Both treatments were administered four times daily over eight weeks. Primary outcomes were measured using the Ocular Surface Disease Index (OSDI) scores, with secondary outcomes including tear film stability (non-invasive TBUT), corneal staining, and assessments of mental health and quality of life.”
Dr Deepti further explained that participants in the laughter group engaged in specific vocalisations and facial movements to stimulate laughter, with adherence monitored through a custom face-recognition app. At the end of 12 weeks, both groups showed significant improvement in symptoms, but the laughter group saw greater gains in OSDI scores and tear film stability.
How does laughter help soothe dry eyes?
Laughter has unique physiological effects on both the mind and body, which can help alleviate dry eye symptoms, says Dr Deepti. “Laughter is well-known for reducing stress and promoting positive emotions, both of which are linked to worsening DED symptoms. Stress especially from anxiety and depression often exacerbates physical discomfort, including dry eye.
By lowering stress levels, laughter may reduce inflammation and boost tear production, offering relief. It also stimulates the lacrimal glands, improving tear film stability and reducing dryness. Additionally, laughter relaxes muscles, contributing to overall eye comfort,” she adds, further stating that its mental health benefits can mitigate the severity of depression, which is often associated with chronic DED.”
Limitations
The study did have its limitations. Dr Deepti notes that it couldn’t be double-blinded since there’s no placebo equivalent for laughter exercises, which may have influenced the results. “Moreover, laughter therapy required more time and effort compared to the convenience of using eye drops, making it less appealing for some. While short-term outcomes were promising, the long-term effects remain unclear, and the exact biological mechanisms behind laughter’s impact on DED are not fully understood. Additionally, the study only included participants with mild to moderate DED, limiting its applicability for those with more severe cases.”