Introduction
Digital eye strain (DES), also known as computer vision syndrome or ocular asthenopia, is a common condition affecting many individuals in the digital age. It encompasses a range of visual and ocular symptoms arising from prolonged use of digital devices such as computers, tablets, and smartphones. The prevalence of DES varies widely, with studies reporting rates from 25% to 93%, and a significant increase observed during the COVID-19 pandemic.
The Digital Revolution and Its Impact
The digital revolution began in the 1980s, bringing numerous advantages such as prompt communication, extensive information availability, and reduced paper usage. However, these benefits come with drawbacks, particularly in the form of digital eye strain. The American Optometric Association defines DES as a cluster of ocular and vision-related problems linked to prolonged usage of digital screens.
Pathophysiology of Digital Eye Strain
DES is multifactorial, involving:
- Reduced contrast level: Letters on digital screens often lack the contrast of print on paper.
- Screen glare and reflections: These can strain the eyes.
- Viewing distance and angle: Incorrect positioning exacerbates strain.
- Poor lighting conditions: Inadequate lighting can contribute to DES.
- Improper posture: Leads to musculoskeletal issues.
- Infrequent blinking: Reduces tear production, leading to dry eyes.
Symptoms of Digital Eye Strain
Symptoms of DES can be broadly categorized into three groups:
- Ocular Surface-Related Symptoms:
- Irritation/Burning eyes
- Dry eyes
- Eye strain
- Headache
- Tired eyes
- Sensitivity to bright light
- Eye discomfort
- Accommodation or Vergence-Related Symptoms:
- Blurred near or distance vision
- Difficulty refocusing
- Double vision (diplopia)
- Extraocular Symptoms:
- Musculoskeletal issues like neck pain, back pain, and shoulder pain
- Headaches
In children, additional symptoms include myopia progression, recent onset esotropia, and vergence abnormalities. Children may not always express discomfort but might exhibit behaviors such as forced blinking, screen avoidance, or eye rubbing.
Mechanisms Behind Digital Eye Strain
DES symptoms arise from three main mechanisms:
- Extraocular Mechanisms:
- Musculoskeletal issues due to improper posture, screen placement, and furniture setup.
- Accommodative Mechanisms:
- Blurred vision, double vision, and difficulty in changing focus. Blue light exposure’s impact remains debatable, but concerns persist about its potential effects on visual health.
- Ocular Surface Mechanisms:
- Dryness, redness, and a gritty sensation in the eyes due to reduced blink rate and incomplete blinking.
The Problem
The Vision Council reported in 2016 that two-thirds of adults aged 30-49 in the USA spend five or more hours on digital devices daily. The COVID-19 pandemic exacerbated this, leading to increased myopia progression, particularly in children aged 6-8 years.
Key issues include:
- Decreased blink rate causing dry eyes
- Continuous focusing leading to fatigue
- Improper posture and inadequate lighting
- Increased screen time as a modifiable risk factor for myopia progression
Recommendations to Alleviate DES
To mitigate the effects of DES, consider the following:
- Limit Screen Time:
- Reduce daily screen time to less than four hours.
- Ergonomic Practices:
- Ensure proper ambient lighting.
- Position digital devices correctly.
- Adjust image parameters (resolution, text size, contrast, luminance).
- Take frequent breaks using the 20/20/20 rule (every 20 minutes, look at something 20 feet away for 20 seconds).
- Proper Sitting Posture:
- Sit upright at a desk with screens approximately 20 inches from the eyes.
- Position the screen below eye level.
- Adjust Lighting:
- Avoid environments with illumination over 1000 lx.
- Use anti-glare screens and adjust screen brightness to match the surrounding workspace.
- Frequent Blinking:
- Encourage regular blinking to maintain eye moisture.
- Screen Time Tracking:
- Use applications to monitor and limit screen time.
- Refractive Error Correction:
- Use glasses with anti-reflective coating if necessary.
- Public Education:
- Raise awareness about the effects of excessive screen time and promote healthier lifestyle practices.
- Parental Guidance:
- Encourage outdoor activities and limit children’s screen time.
- Technological Innovations:
- Utilize high-resolution screens with anti-reflective coatings and blue-light blocking glasses.
Conclusion
Digital eye strain is a significant concern in today’s technology-driven world. By adopting ergonomic practices, limiting screen time, and ensuring proper eye care, we can alleviate the symptoms and promote better eye health for both adults and children.
References
- American Optometric Association. Computer vision syndrome. 2017.
- Sheppard et al., 2018. Digital eye strain: prevalence, measurement and amelioration.
- Usgaonkar et al., 2021. Impact of the use of digital devices on eyes during the lockdown period of COVID-19 pandemic.
- American Academy of Ophthalmology. Tips for computer usage.
- Kaur et al., 2022. Digital Eye Strain – A Comprehensive Review.
- Mohan et al., 2022. Impact of online classes and home confinement on myopia progression in children during COVID-19 pandemic.
- Blehm et al., 2005. Computer vision syndrome: a review.
- Mohan et al., 2021. Acute acquired comitant esotropia in children associated with excessive online classes during COVID-19 pandemic.
- Mohan et al., 2021. Binocular accommodation and vergence dysfunction in children attending online classes during COVID-19 pandemic.
- The Vision Council, 2016. Eyes overexposed: The digital device dilemma.
- Kumari et al., 2022. Myopia progression during the COVID-19 pandemic.
- Wang et al., 2021. Progression of myopia in school-aged children after COVID-19 home confinement.
- Wang et al., 2021. Survey on the progression of myopia in children and adolescents in Chongqing during COVID-19 pandemic.
- Auffret et al., 2022. Stress oculaire induit par les écrans.
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- LeBlanc et al., 2012. Systematic review of sedentary behaviour and health indicators in the early years.
- Holden et al., 2016. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050.
- Demirayak et al., 2022. Digital eye strain and its associated factors in children during the COVID-19 pandemic.
- Mylona et al., 2023. Spotlight on Digital Eye Strain.