TFOS lifestyle report executive summary: A lifestyle epidemic - Ocular surface disease

Jennifer P Craig, Monica Alves, James S Wolffsohn, Laura E Downie, Nathan Efron, Anat Galor, José Alvaro P Gomes, Lyndon Jones, Maria Markoulli, Fiona Stapleton, Christopher E Starr, Amy Gallant Sullivan, Mark D P Willcox, David A Sullivan

Research output: Contribution to journalReview articlepeer-review


The Tear Film & Ocular Surface Society (TFOS) Workshop entitled 'A Lifestyle Epidemic: Ocular Surface Disease' was a global initiative undertaken to establish the direct and indirect impacts of everyday lifestyle choices and challenges on ocular surface health. This article presents an executive summary of the evidence-based conclusions and recommendations of the 10-part TFOS Lifestyle Workshop report. Lifestyle factors described within the report include contact lenses, cosmetics, digital environment, elective medications and procedures, environmental conditions, lifestyle challenges, nutrition, and societal challenges. For each topic area, the current literature was summarized and appraised in a narrative-style review and the answer to a key topic-specific question was sought using systematic review methodology. The TFOS Lifestyle Workshop report was published in its entirety in the April 2023 and July 2023 issues of The Ocular Surface journal. Links to downloadable versions of the document and supplementary material, including report translations, are available on the TFOS website:

Original languageEnglish
Pages (from-to)240-253
Number of pages14
JournalThe ocular surface
Early online date1 Sept 2023
Publication statusPublished - Oct 2023

Bibliographical note

© 2023 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (


  • Contact lenses
  • Cosmetics
  • Digital environment
  • Dry eye
  • Elective medications
  • Environmental conditions
  • Evidence quality
  • Global consensus workshop
  • Nutrition
  • Ocular surface disease
  • Public awareness
  • Societal challenges


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