Understanding Digital Eye Strain

Author: Jerry D’Aversa, OD

Now, more than ever before, people of all ages are spending extended hours staring at digital screens. Due to the COVID-19 pandemic, many people are experiencing nonstop screen time for work and/or school, and it doesn’t stop there—people often unwind and relax after work or school by staring at their phones or the TV.

Extended hours of computer work can lead to a specific form of asthenopia (the medical term for eye strain) described as computer vision syndrome. The symptoms of computer vision syndrome include double vision, blurry vision, dry and/or irritated eyes, and asthenopia. Many people also report a pressure sensation around the eyes while working on the computer, which eventually leads to a headache. Symptoms of digital eye strain tend to worsen with a more strenuous task.

The good news is that most symptoms are temporary and resolve naturally once you rest your eyes. Unfortunately, a large group of the workforce will continue to rely on their computers for most responsibilities as the pandemic continues, and screen technology will continue to be relied upon heavily in everyday life.

Specific causes of digital eye strain and appropriate treatment can be categorized into the following two groups: 

Dry Eye Component 

Research has shown that we blink significantly less while staring at a digital screen. The problem with this is that we rely on blinking to uniformly disperse the tear film on the surface of our eyes. When our blink rate decreases, our tear film isn’t dispersed as frequently. This leads to tear evaporation, which in turn can cause persistent irritation or a burning sensation of the eyes. A uniform tear film is also important because it provides optical clarity. 

Whether at home or at work, your environment can exacerbate this problem if you’re in a room with dry air. Dry eyes tend to worsen in the winter months due to heating systems being on full force. Dry eyes will also worsen if you have a fan or vent pointed in the direction of your workspace. 

Treatment

• Remember to blink often. It sounds like it should be reflexive, but reminding yourself to blink will help keep your vision clear and eyes comfortable.
• Keep a bottle of artificial tears near your computer. Lubricating your eyes throughout the day will provide prolonged relief as you’re working.
• Give yourself a break from contact lenses. Extended use of contacts can lead to significantly dry eyes and reduced oxygen to the cornea. 
• Avoid fans or heaters in your workspace that point directly toward your face. 
• Purchase a humidifier for your workplace to keep the air moist.
• Don’t forget to drink water to stay hydrated.

Accommodative Component

We rely on our eyes’ accommodative or “focusing” system to provide clear vision at a specific focal distance while working. When on the computer, this is typically arm’s length; however, many of us find ourselves slowly inching closer and closer to our digital device as the day goes on. This is especially true if we aren’t wearing the correct glasses or contact lens prescription. Extended hours of close work can strain this focusing system, causing visual blur. Accommodative issues not only cause blurring at near vision but also may lead to distance-vision blur. Many people report seeing significant halos and glare from oncoming streetlights when driving home from work. This is called transient myopia. 

Treatment

• Take breaks (20/20/20 rule): Every 20 minutes take a 20-second break from the computer to view something in the distance about 20 feet away. This allows for our accommodative system to reset and relax from the strenuous near task.
• Computer vision glasses: If the 20/20/20 rule isn’t providing relief, glasses can be designed to provide optical clarity specifically at computer distance. Glasses designed for computer distance allow your accommodative system to take a break while you clearly view your computer screen. It’s important to understand that these glasses work best if used throughout the entire task. Keep in mind that computer vision glasses are different than blue-light blocking glasses. More research must be performed to assess the true benefit of blue-blocking glasses. 
• Limit screen time directly before bed: Although there’s no strong evidence of damage to the eyes from digital screen blue light, research has shown that prolonged blue light exposure before bed may lead to circadian rhythm changes. Many phones and computers have a built-in nighttime option to limit blue-light emission.
• Incorporate near vision correction into your glasses or contact lenses: Around the age of forty, our accommodative system gradually loses the ability to focus clearly at close distances.  Switching to progressive or bifocal glasses greatly improves near vision clarity. Contact lenses can also be specially designed to improve near vision with multifocal technology. 
• Keep your screen at an appropriate distance: Typically, arm’s length from your eyes (around 30 inches) is most comfortable. 

Additional Tips

• Reduce the glare emitted from your computer by lowering the brightness or purchasing a filter for your screen. 
• Increase the contrast of the text on the screen compared to the background. 
• Try to limit slouching to reduce neck and back stiffness.

Summary

It’s important to discuss any potential symptoms of digital eye strain with your eye doctor. I like to remind my patients that treatment for digital eye strain will not provide spontaneous relief—it’s a marathon, not a sprint. Implementing just a few changes, such as using ocular lubrication or utilizing the appropriate glasses prescription can keep you on your A-game while you’re on the computer.

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