The 21st century has given way to a society increasingly dependent on a variety of digital technologies in personal, occupational, and institutional settings. Naturally, this has led to rising daily exposure to digital screens, such as desktops, smart phones, televisions, and tablets. Use of computers and display devices with a screen decreases the number of eye blinks, leading to incomplete blinking and evaporation of tears. So it’s probably not a big surprise that too much screen time can impact the vision and the health of eyes & subsequently leads to dry eye disease and rise in the prevalence of ocular complaints. Common visual symptoms include dryness and irritation, sensations of burning, asthenopia, epiphora, hyperemia, blurred vision, diplopia, glare sensitivity and transient deceptions in color perception. It affects millions of people across the globe. Therefore identifying and managing its underlying causes can help improve physical wellbeing and workplace productivity.
Dry eye (DE) is a heterogeneous, multi-factorial disease characterized by a combination of ocular surface symptoms (dryness, pain, poor, or fluctuating vision) and signs (reduced tear break-up time, decreased tear production, corneal staining) [1].
Eye dryness is a very common eye disease nowadays, occurs for roughly 90 percent of people who use computer devices daily and it affects daily activities by decreasing the quality of life due to its symptoms. In addition, it has also become an important public health problem because of the increased treatment costs [2-4].
Nearly 60% of Indians use a digital device for at least 3-4 hours a day. All that screen time can result in dryness and eye irritation. The amount of time a person spends staring at a screen can affect the eyes and worsen dry eye symptoms. But work obligations may often prohibit from limiting the time a person need to spend in front of a computer [5-8].
Normally, people blink every 10 seconds or so. When you blink, your eyes release a “tear film” that soothes and coats your eyes. But you don’t blink as often when you’re on a tablet, computer, or watching TV. According to the many studies, a person blinks up to 66 percent less frequently while using a computer. Less blinking means drier eyes [9,10].
Activities that demand intense concentration can result in eyestrain and dryness. Blinking is important because it helps spread hydrating substances like tears and mucus across your eyes. If you’re blinking less, the tears on your eyes have more time to evaporate, resulting in red and dry eyes [5,11].
The brightness of the monitor reflecting onto your eyes can also contribute to dry and tired eyes. By the end of your workday, you may find you’re squinting to see what you could previously see more easily [5,12].
Working on computers and on mobile for a long time may even change the balance of your tears. Many studies found that people who spent hours on their computers and on mobile had a lower amount of mucus in their tears & had dry eye. While the chances of getting dry eye go up with age, studies found that children who spent more time on their smartphones /tablets and less time outside had more symptoms of dry eye [5,9,10,13].
Computer vision syndrome, also referred to as digital eye strain, describes a group of eye- and vision-related problems that result from prolonged computer, tablet, e-reader and cell phone use. Signs that you may have computer vision syndrome, which is also known as digital eyestrain, include dry eyes, Decreased or blurred vision, Burning or stinging, The feeling of having something in your eyes, Sensitivity to light, Red, watery eyes, eyestrain, headaches, neck & shoulder pain and Difficulty wearing contact lenses and driving at night [13-15]. Some Steps a person can take to reduce eye dryness and strain are:
Use artificial tears drops
Using artificial tears on occasion can keep your eyes moist & lubricated. Do this several times during the day e.g. at lunch, midday and before bed [1-15].
Adjust your glasses
If you wear glasses, talk to your eye doctor about antireflective coatings or special lenses. These can help to minimize glare on your computer screen and keep your eyes feeling comfortable.
Keep screens at arm’s length
Most people hold their smart phones and small devices 8 to 12 inches from their face. That close distance slows down blink rates. It’s better to hold your device at least 20 inches from your eyes.
Make text bigger
You may lean into your computer screen if the type is too small. Bump up the size of the font, so you can comfortably read from a farther distance. If possible, switch to a larger monitor. This will usually make words and images easier to see.
Adjust the Position of computer monitor
Proper placement of the monitor on your desk can help reduce glare. Position your computer monitor about 20 to 26 inches away from your head. The monitor should be placed at such a height that you’re looking at the middle of the screen. Make sure the center of the screen is 4 to 8 inches lower than eye level and 20 to 28 inches from your eyes to reduce the surface area of your eyes that are exposed to air. This can help reduce tear evaporation that can lead to dry eyes.
Adjust glare & brightness of computer and mobiles
Use a glare filter over your computer to reduce any unwanted light that can make it difficult to see. Also note that flatter screens tend to have fewer glares. Adjust the brightness of your computer monitor as well.
Shed the right light
It’s best if your computer monitor is away from the window. This reduces the glare from outside light sources that can further irritate and dry your eyes. Close the blinds or curtains. Switching out overhead fluorescent lights in favor of lamps can help to reduce overhead glare that can make it difficult for your eyes to focus. Adjusting light to a lower wattage or even a softer filter can help to relax the eyes. If you do use a lamp on your desk, ensure it isn’t pointed directly at your face. Instead, the light should be pointed downward, toward papers on your desk. If those things don't help, get a screen glare filter. It can lessen the amount of light reflected from the screen.
Eye exercises
Eyes exercises can help to reduce strain and fatigue on the eye muscles.
Follow the 20/20/20 rule
Take a 20-second break from your digital device every 20 minutes and look at something 20 feet away. Set an alarm on your smart phone as a reminder.
Adjust air quality or use a humidifier
The air quality in the environment also plays a role in eyestrain and dryness. Humidifier adds moisture to dry indoor air so your eyes won’t dry out as quickly. If necessary, move away from fans and vents that blow air toward your eyes and face. Also, avoid smoking or being exposed to secondhand smoke that can irritate your eyes.
Supplements
Some supplements like omega-3 fatty acids and bilberry extract may help improve your dry eye and eyestrain symptoms.
Take a break
If you work at a computer all day, it’s important to take frequent breaks. Every hour or two, take a few minutes to get up, go for a short walk, and stretch your arms and legs. Not only can getting away from your computer reduce eyestrain and dryness, but it can also help reduce any neck or back pain you may experience from sitting at a computer. so, your overall health will benefit.
Don’t stare
Make an effort to blink frequently, especially when you’re using a screen for a long stretch.
Stay hydrated
Dehydration can make chronic dry eye symptoms worse. And if you’re staring at a computer screen for an extended period of time on top of that, not drinking enough water can make your eyes feel even worse. Stay hydrated by drinking at least eight glasses of water throughout each day.
Don’t smoke
If you smoke, you now have another reason to quit. Cigarette smoke irritates dry eyes even more.
Get enough sleep
Take a sleep about 6 to 8 hours a night.
Mehra, D. et al. "digital screen use and dry eye: a review." Asia-Pacific Journal of Ophthalmology (Phila), vol. 9, 2020, pp. 491–497.
Akkaya, S. et al. "Effects of Long-Term Computer Use on Eye Dryness." Northern Clinics of Istanbul, vol. 5, no. 4, 2018, pp. 319–322.
Mayo Clinic. Mayoclinic.org, https://www.mayoclinic.org/diseases-conditions/dry-eyes/symptoms-causes/syc-20371863.
WebMD. Webmd.com, https://www.webmd.com/eye-health/computer-vision-syndrome. Accessed 13 Nov. 2021.
Healthline. Healthline.com, https://www.healthline.com/health/shut-the-lid-on-chronic-dry-eye/computer-use. Accessed 14 Nov. 2021.
Bahkir, F.A., and S.S. Grandee. "Impact of the COVID-19 Lockdown on Digital Device-Related Ocular Health." Indian Journal of Ophthalmology, vol. 68, no. 11, 2020, pp. 2378–2383.
Sheppard, A.L. and J.S. Wolffsohn. "Digital eye strain: prevalence, measurement, and amelioration." BMJ Open Ophthalmology, vol. 3, no. 1, 2018, e000146.
Chu, Christina, et al. "A Comparison of symptoms after viewing text on a computer screen and paper." Ophthalmic and Physiological Optics, vol. 31, no. 1, Jan. 2011, pp. 29–32.
WebMD. Webmd.com, https://www.webmd.com/eye-health/dry-eye-screen-use. Accessed 14 Nov. 2021.
WebMD. Webmd.com, https://www.webmd.com/eye-health/evaporative-dry-eye. Accessed 15 Nov. 2021.
Dry Eye Directory. Dryeyedirectory.com, https://dryeyedirectory.com/dry-eye-treatment/. Accessed 15 Nov. 2021.
All About Vision. Allaboutvision.com, https:// www. allaboutvision. com/cvs/irritated.htm. Accessed 16 Nov. 2021.
American Optometric Association. Aoa.org, https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/dry-eye?sso=y. Accessed 16 Nov. 2021.
Medical News Today. Medicalnewstoday.com, https://www.medicalnewstoday.com/articles/computer-vision-syndrome. Accessed 17 Nov. 2021.
NC Eyes. Nceyes.org, https://www.nceyes.org/digital-eye-strain. Accessed 17 Nov. 2021.
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