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Is there such a thing as digital dry eye?


Person suffering from digital eye strain

The experts agree – the answer is YES!


We know a lot more about the impact of digital use on our eyes because of the big jump in digital activities during lockdown. A web-based study of 233 volunteers was conducted via an e-survey which showed an acceleration of ocular symptoms linked with a rise in digital time. Many classic dry eye symptoms were reported such as blurred vision, watery, tired, red and dry eyes, the incidence was reported by 64–90% of computer users after prolonged use. But long before this study researchers were aware that long periods of concentration at screens produce ocular strain, the phrase CVS (computer vision syndrome) or digital eye strain was being increasingly used.


How do screens cause these symptoms?

An important part of the way our eyes are kept moist and protected is the regular blinking process. Studies report a normal relaxed blink rate of about 12-15 blinks per minute with the interval between blinks somewhere between every 2-10 seconds. However, when we look at a screen something happens to the rate at which we blink our eyes. It is not a conscious thing we can control but as we concentrate our blink rate slows. This reduced blink rate means that less tears are released and spread across the eye as part of the natural ocular hydration process. Fewer tears result can result in dry spots on the surface of the eye where the sensitive cornea is exposed hence the dry eye symptoms.


An interesting study looked into the difference in blink reduction between reading on a screen compared to a paper copy. This study showed that both slowed your blink rate to a similar level but the computer work also reduced the quality of the blink – they detected a higher number of incomplete blinks when working at a computer screen. Another study suggested that it is perhaps this increase in incomplete blinks which could be resulting in the associated increase in dry eye symptoms.


It is not just work related


Kids playing with mobiles phones increases chances for digital eye strain

Screens have increasingly become part of our leisure time as well as our work. Dry Eye Zone has heard that dry eye signs and symptoms are increasingly being seen in younger people – including school children as a result of long periods looking at phones or playing computer games. A paper published by the journal Nature commented on the ubiquitous use of digital devices among children, with two-thirds of UK children owning a smart phone. The amount of time being spent is far in excess of the WHO (World Health Organisation) recommendation of 2-hours a day. This study showed that just one hour of smartphone gaming led to increased symptoms of dryness, discomfort, and tiredness in children. Just like the findings in adult studies the blink rate decreased and interblink interval increased . What was surprising is that these changes were seen after just 60 seconds of gaming on a smartphone!


It is not all bad news

The good news is that according to the American Academy of Ophthalmology (AAO) digital use will not cause permanent damage to the surface of the eye. And you need not worry about blue light as according to the AAO blue light does not cause digital eye strain.


Some helpful tips from Dry Eye Zone

But long hours of digital work are a reality for many millions of people in the UK and the world over. Dry Eye Zone would recommend some very simple actions to minimise the impact of screen work on your eyes:


  1. Take regular breaks using the 20:20:20 principle. This gives your eyes a rest and a chance to replenish themselves by simply looking away from your screen every 20 minutes and focusing on an object 20 feet away for at least 20 seconds.

  2. Because we know that screen work will make our eyes dry don’t wait for those tell-tale feelings of tired, dry, sore eyes to start. Instead use hydrating eye drops before the symptoms start which will help feel your eyes moisturised as your work.

  3. Interesting a recent large-population study showed that although drinking plenty of water is good for our general well bring it is unlikely to protect you from dry eye – so keep those dry eye drops within easy reach.

  4. Reduce the amount of glare from your screen by turning down the brightness. This can feel more relaxing to the eye. You can also make sure your screen is positioned away from light sources which will cause glare on the screen.

  5. Avoiding keeping your eyes wide open as you work will help slow the rate of tear loss from your eyes. You can do this by angling your screen or adjusting your seat so you are looking slightly downwards

  6. Don’t make your eyes work harder than they have to – increase the print size on your screen a little to make things easier to read at a glance

  7. Your natural blink rate will be slowing so try and force regular ‘big blinks’ to help replenish your natural tears

  8. If possible turn down the air-conditioning or heating. A humidifier would also be a big help


It is important to make sure that any visual correction you might need, either by way of glasses or contact lenses, takes into account the fact that you will be spending long periods of time at a computer screen. Make sure you mention this to your eye care professional during your routing eye examination


If you are experiencing digital dry eye symptoms then you should ask the advice of your eye care professional. Why not book your next eye examination with an independent optician today.


Sources:

Usgaonkar U, Shet Parkar SR, Shetty A. Impact of the use of digital devices on eyes during the lockdown period of COVID-19 pandemic. Indian J Ophthalmol. 2021 Jul;69(7):1901-1906. doi: 10.4103/ijo.IJO_3500_20. PMID: 34146054; PMCID: PMC8374748.


Article by Daniel Porter reviewed by Dr Odalys Mendoza. Digital Devices and Your Eyes. American Academy of Ophthalmology. Oct. 27, 2022 https://www.aao.org/eye-health/tips-prevention/digital-devices-your-eyes


Chu CA, Rosenfield M, Portello JK. Blink patterns: reading from a computer screen versus hard copy. Optom Vis Sci. 2014 Mar;91(3):297-302. doi: 10.1097/OPX.0000000000000157. PMID: 24413278.


Jaiswal S, Asper L, Long J, Lee A, Harrison K, Golebiowski B. Ocular and visual discomfort associated with smartphones, tablets and computers: what we do and do not know. Clin Exp Optom. 2019 Sep;102(5):463-477. doi: 10.1111/cxo.12851. Epub 2019 Jan 21. PMID: 30663136.


Portello JK, Rosenfield M, Chu CA. Blink rate, incomplete blinks and computer vision syndrome. Optom Vis Sci. 2013 May;90(5):482-7. doi: 10.1097/OPX.0b013e31828f09a7. PMID: 23538437.


Abusharha AA. Changes in blink rate and ocular symptoms during different reading tasks. Clin Optom (Auckl). 2017 Nov 20;9:133-138. doi: 10.2147/OPTO.S142718. PMID: 30214369; PMCID: PMC6118863.


Loh K, Redd S. Understanding and preventing computer vision syndrome. Malays Fam Physician. 2008 Dec 31;3(3):128-30. PMID: 25606136; PMCID: PMC4170366.


Chidi-Egboka, N.C., Jalbert, I. & Golebiowski, B. Smartphone gaming induces dry eye symptoms and reduces blinking in school-aged children. Eye 37, 1342–1349 (2023). https://doi.org/10.1038/s41433-022-02122-2


Rideout VJ, Robb MB. The common-sense census: Media use by tweens and teens. Common Sense Media. p. https://www.commonsensemedia.org/research/the-common-sense-census-media-use-by-tweens-and-teens. 2019. Accessed 10 February 20.


Nguyen L, Magno MS, Utheim TP, Jansonius NM, Hammond CJ, Vehof J. The relationship between habitual water intake and dry eye disease. Acta Ophthalmol. 2023 Feb;101(1):65-73. doi: 10.1111/aos.15227. Epub 2022 Aug 8. PMID: 35941821; PMCID: PMC10087849.



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