Brughanya Subramanian, B.Optom

M.Optom student, Sankara Nethralaya Medical & Vision Research Foundation, Chennai, India


Digital reading:

  • Computer screens, smart phones and tablets are the modes of digital reading which display text and images using pixels. Digital reading enriches content with audio and video features, making reading more interesting in addition to just words and pictures. Digital books are quicker to access by search engines. (1)

  • Digital technology allows us to have instant access to volumes of information that help us improve comprehension. The computer system is superior in many aspects such as storing, distributing and retrieving documents. Sometimes one can even read the full content of an e-book free of charge whereas, finding a traditional book involves spending money in bookstore, or ordering online. (1)
  • Digital reading is dominated by shallow forms of reading (e.g., scanning and skimming), and digital text makes us read in a shallower, less focused way. (2)
  • Birkerts(3)observes that the younger generation growing up in the digital environment is lacking the ability to read deeply and to sustain a prolonged engagement in reading.


  1. Improved speed of reading
  2. Improved skimming ability
  3. Easily accessible


  1. Eyestrain
  2. Dry eyes
  3. Computer vision syndrome
  4. Glare
  5. Distraction
  6. Change in patience as readers
  • New inventions do make our lives easier in many ways, but they can also cause worries and troubles. Focusing on pixels makes our eyes strain than if we were reading a traditional book and may cause digital eye strain. (4)
  • Digital eye strain is a condition characterised by visual disturbance and/or ocular discomfort related to the use of digital devices and resulting from a range of stresses on the ocular system, including glare, defocus, accommodation dysfunction, fixation disparity, dryness, fatigue and discomfort (refer table 1). (4)


Table 1. Depicting types, symptoms, and sources of digital eye strain (4)

Eye strain types Symptoms Findings in mild TBI
Vision-related • Frontal headache
• Sore eyes
• Heaviness
• Diplopia
• Hyperopia
• Myopia
• Presbyopia
• Accommodative anomalies
• Astigmatism
Oculomotor-related • Other symptoms like vision-related eye strain
• Diplopia
• Focusing difficulty
• Fixation disparity
• Poor convergence
Dry eye or ocular surface-related • Dryness
• Itchiness
• Irritation/scratchiness
• Redness
• Burning
• Blurred vision
• Tearing/sore eyes
• Dry eye
• Contact lens wear
• Corneal, conjunctival and/or eyelid pathology
• Reduced/poor blinking
• Environment
• General health
• Changes in medication
• Age
Extraocular or environmental factor-related • Neck/shoulder/back pain
• Glare
• Headache
• Posture
• Lighting
• Temperature/humidity
Device-related • Depends on type of digital device
• Most symptoms like vision-related eye strain
• Small screen
• Reduced working distance and font size
• Screen illumination and spectrum of light
• Screen resolution and contrast
• Reduced blink rate
• Incomplete blinks


Traditional reading with prints:

  • Paper, on the other hand, is heavily used in tasks that required certain levels of sustained attention (e.g., editing, planning, and collaboration).(1)
  • The limitation with traditional printed books is lighting. Reading in poor light makes it more difficult for the eyes to focus, thus causing eye fatigue. Reading in dim lighting also makes the reader blink less often than they normally would, leading to temporary case of dry eyes.(5)


  1. Improves concentration
  2. Can be easily used by elderly
  3. No digital eye strains


  1. Eye fatigue
  2. Minimal reading speed
  3. Less interesting than e-books which displays audios and videos

Which reading medium is best for eyes? 

  • The improved access creates a new challenge for readers as to what material they choose to read. In a world where choices and opportunities are part of our daily lives, we need to set priorities on the kind of materials we want to access [4].
  • Research finds that readers’ choices and preferences for reading medium are very diverse and contextual.(6)
  • Despite increasing popularity of digital resources, we should note that not a single type of format has ever proven adequate for all needs and ideal in all situations. (5)
  • For example, even though e-textbooks offer a number of features and functions that are not available with printed textbooks such as search ability, built-in dictionary, crossing referencing, and ease in copy and paste; it is somewhat surprising that e-textbooks have not been embraced as whole-heartedly anticipated.
  • According to the National Association of College Stores, digital versions make up no more than 3% of recent textbook sales.(7).
  • E-book devices can support expansive skimming but have not yet crossed the critical hurdle of supporting the intertwined reading and note-taking. (8)


Figure 1: Picture depicting ergonomic book holder and the right way to read. (Image courtesy:

Tips to avoid digital eye strain or computer vision syndrome:

  1. Follow 20/20/20 rule while reading; look at something 20 feet away for 20 seconds every 20 minutes.
  2. Read under good lighting conditions to avoid eye fatigue.
  3. Using ergonomic book holder for reading (refer figure 1).
  4. Maintaining a proper sitting posture while reading or working on computer (refer figure 2).


Figure 2: Picture depicting proper sitting posture while using computer. (Image courtesy:

  1. Use higher pixels with good screen resolution when reading on digital materials.
  2. Practice voluntary blinking while reading.
  3. Sit facing the light source while reading to avoid glare.
  4. Take frequent breaks in-between to avoid strain injuries like neck pain and back pain.
  5. Switch to night mode display to reduce blue light.
  6. Refrain from digital reading or any gadgets for 2hours before bedtime for improving melatonin productions which stimulates good sleep.



1) Sellen, A. J., & Harper, R. (2002). The myth of the paperless office.

2) Mangen, A. (2008). Hypertext fiction reading: haptics and immersion. Journal of research in reading31(4), 404-419.

3) Birkerts, S. (1994). The Gutenberg Elegies: The Fate of Reading in an Electronic Age. Boston.

4) Coles‐Brennan, C., Sulley, A., & Young, G. (2019). Management of digital eye strain. Clinical and Experimental Optometry102(1), 18-29.

5) Cull, B. W. (2011). Reading revolutions: Online digital text and implications for reading in academe. First Monday.

6) Liu, Z., & Luo, L. (2011). A comparative study of digital library use: Factors, perceived influences, and satisfaction. The Journal of Academic Librarianship37(3), 230-236.

7) Foderaro, L. W. (2010). In a digital age, students still cling to paper textbooks. The New York Times19.

8) MacFadyen, H. (2011). The reader’s devices: The affordances of ebook readers.

9) Liu, Z. (2008). Paper to digital: Documents in the information age. ABC-CLIO.