Pritam Dutta, M.Optom, FAAO

Assistant Professor, Ridley College of Optometry, Assam, India



In the digital age, technology has altered every aspect of our lives, from healthcare to education. However, every action has an equal and opposite response, and the digital revolution is no exception. usage. According to the American Optometric Association, digital eye strain is a collection of ocular and vision-related issues caused by extended use of gadgets.(1) During the COVID-19 epidemic, internet service usage surged from 40% to 100% compared to pre-lockdown levels, resulting in an increase in symptoms of digital eye strain among the majority of people.(2) The term “Digital eye strain” (DES) has been used interchangeably with ocular asthenopia caused by digital gadgets, computer vision syndrome, eye strain after computer or mobile usage.(3,4)

Associated mechanisms

Decreased contrast level of letters compared to the background of digital screens, screen glare and reflections, incorrect distance and angle of viewing digital screens, inadequate lighting conditions, incorrect posture during usage, and seldom blinking of eyes are some multifactorial contributing factors.(5) The three potential mechanism associated in causing DES includes ocular surface, accommodation and extraocular mechanism.(6) [Figure 1] Despite the similarities in symptoms between handheld devices and computers, there are likely to be significant distinctions in the etiology of these symptoms. Smartphones and tablets are small mobile devices in comparison to computers, which have a bigger vertically oriented display with an external keyboard and mouse. (10) The visual demands differ in both the devices and so as the outcome. [Figure 2] [Table 1] Summarises the variations in ocular parameters involved using both these devices.(10)

Figure 1: Three potential mechanism associated in causing DES includes ocular surface, accommodation and extraocular mechanism.

Managing digital eye strain

In today’s digital-centric environment, where screens dominate both work and leisure, managing digital eye strain is critical. The importance is in protecting ocular health, increasing productivity, and avoiding discomfort caused by prolonged screen exposure.

Figure 2:  Summarising the visual demands and the outcome in the devices.

Adopting good screen habits is the key for efficiently managing digital eye strain. [Table 2] This includes following the 20-20-20 rule (look at something 20 feet away for 20 seconds every 20 minutes), maintaining correct posture, adjusting screen settings, wearing blue light filters or glasses, and getting regular eye exams. In a nutshell managing digital eye strain is an investment in long-term eye health, productivity, and overall well-being in the digital age, not just temporary respite from discomfort. [Table 3]



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Table 1: Summary of widespread variations of ocular parameters after smartphone and computer usage (10)

Parameters Impact after smartphone usage Impact after computer usage

  • lag of accommodation
  • Amplitude of accommodation
  • Keratoconus
  • Facility of accommodation
  • Increases
  • Decreases
  • Decreases and no change reported
  • Increases
  • Decreases
  • Increases/decreases and no changes reported

  • Fusional vergence
  • Near point of convergence
  • Phoria status
  • Positive fusional vergence decreases
  • Reduced
  • Exophoria
  • Positive fusional vergence decreases
  • Reduced
  • Exophoria

  • Blink rate
  • Blink amplitude
  • Increased or decreased or no change reported
  • Decreased
  • Decreased
Tear film

  • Volume
  • Stability
  • Composition
  • Increases
  • Decreases
  • Decreases
  • Decreases
  • Increased osmolarity and inflammatory mediators, decreased mucin

Table 2: Management options for Digital Eye Strain

Management options
Proper ergonomics (11) -includes the use of optimal lighting, careful orientation of the digital device, altering image parameters (resolution, text size, contrast, brightness), and taking breaks
-Sitting upright at a desk by maintaining a distance of 20 inches from the screen
-screening viewing distance must be 15-20º below eye level
Refractive correction (12,13) -Computer glasses have been shown to reduce symptoms by providing proper correction for the viewing distances and angles required at the computer workstation
-Assessments performed at individual’s working distance to decide appropriate correction
Managing DES associated dryness (14) -Use of lubricating eye drops for relieving symptoms
-Contact lens related dry eye: management through appropriate selection of lens material, care and maintenance of the lens, rewetting systems, and consideration of the environmental factors
Improvising blink rate (15) -using computer applications that has visual/audible prompts of blinking uniformly
-anti-reflection film over the computer screen
Filtered lens (16) -using of blue light filtered lens, precision spectral filters may provide relief from DES symptoms

Table 3: Outcomes of managing Digital Eye Strain effectively

1. Preserving Visual Health -Excessive screen time can cause dry eyes, eye tiredness, blurred vision, and headaches. Managing digital eye strain aids in the prevention of these disorders and the maintenance of long-term eye health
2. Improving Productivity -Tired eyes can have a negative impact on productivity. When the eyes become weary or strained, it becomes difficult to concentrate, resulting in decreased efficiency and production. Individuals can retain focus and productivity while performing screen-intensive jobs by controlling eye strain
3. Avoiding Discomfort -Digital eye strain is more than simply a nuisance; it can cause significant discomfort. Poor posture can cause symptoms such as eye irritation, burning sensations, and even neck or shoulder pain. Managing eye strain aids in the reduction of these discomforts and promotes general well-being
4. Improving Sleep Quality -Because of the blue light emitted by screens, prolonged exposure to screens, particularly before bedtime, can alter sleep patterns. Managing digital eye strain entails limiting screen time before bed, which helps with sleep quality
5. Promoting Eye Safety -Adopting behaviors that safeguard eye safety is an important part of managing digital eye strain. This involves adjusting screen settings such as brightness and contrast, taking frequent breaks, using suitable lighting, and ensuring ergonomic workstation configurations to decrease eye and body strain
6. Long-term Vision Care – Although the effects of digital eye strain may appear slight at first, their cumulative influence over time can be severe. Proactively managing it helps to preserve vision in the long run, lowering the risk of acquiring more serious eye diseases later in life.

Figure legends

Fig 1: Associated mechanisms of Digital Eye Strain

Fig 2: Association and type of symptom with digital devices