Digital eye strain symptoms to watch for

• Digital eye strain describes a group of eye and vision-related symptoms (and sometimes bodily symptoms) that occur during or after using an electronic device, such as eye fatigue, blurred vision, and headaches.
• Individuals of all ages can struggle with viewing digital devices for extended periods, as they place intensive work demands on our eyes and visual system. However, digital device use in children has additional risks as it has been associated with myopia.
• Digital eye strain is best managed by addressing any underlying eye problems with an eye care professional, as well as managing viewing habits when engaging with screen-based devices.

Digital eye strain (DES), also known as computer vision syndrome (CVS), is a broad term used to describe a range of eye, vision, and sometimes physical, problems linked to the prolonged use of digital electronic devices.1 Among the most common symptoms are blurred vision, tired eyes, and headaches, which can significantly impact mental well-being and lead to stress, discomfort, and loss of productivity.2

DES can affect people of all ages and demographics, as long as they engage with some form of digital device. Children and teenagers are at risk of DES as they spend many hours interacting with electronic devices for learning, leisure (e.g. video games, social media), and communication (e.g. sending and receiving messages). When children spend more time at home and less time outdoors, screen time tends to increase substantially. Research has shown that during periods of home confinement, such as during the COVID-19 lockdowns, screen time can more than double.3,4

Symptoms of DES can be separated into three categories: eye-related, vision-related, and symptoms affecting areas beyond the eyes (e.g. headache).5 It is common for multiple symptoms to occur at the same time, and symptoms can vary between individuals.

Eye-related symptoms include:

• Tired eyes
• Sensitivity to bright light
• Dryness
• Eye redness
• Watering or tearing of the eyes
• Burning sensation in the eyes
• Eye pain
• Itching
• Irritation or foreign body sensation

Vision-related symptoms include:

• Blurred vision
• Difficulty refocusing from one distance to another
• Double vision

Symptoms beyond the eye include:

• Headache
• Neck pain
• Shoulder pain
• Back pain

In 2023, it was estimated overall that about 2 in every 3 people worldwide are affected by DES.5 

With the recent COVID-19 pandemic, DES became an emerging health concern in part due to the lifestyle shift towards the indoor environment. As several countries declared nationwide lockdowns, this led to a boom in remote work and online learning, and a subsequent increase in screen time on digital devices.

The pandemic appears to have amplified the issue of DES particularly in children. Before COVID-19, about 20% were estimated to be affected by eye strain from digital device use – increasing to 60% by the end of the pandemic.1,7

Compared to most everyday visual activities, viewing screen-based electronic devices often make the eyes work harder and can affect our normal viewing behaviours.1

Screen-based tasks require continuous focus, in an attempt to see pixelated targets clearly. Unlike reading printed text, our eyes need to move constantly to maintain focus, as the objects displayed on the screen are often constantly changing. In addition, shorter viewing distances, longer periods of viewing, glare, and reflections can cause eye strain. 

It is well-known that the eyes tend to blink far less often while concentrating on a computer screen – on average, about 3–6 times slower than usual.9 Blinking is an important function that helps promote a healthy, moist eye surface.10 Reduced blinking increases the likelihood of symptoms like blurred vision, eye redness, irritation, and burning that occur if the eyes become too dry.

The environment in which we use digital devices can play a major role. Even for those with excellent vision, poor viewing angles and viewing distances contribute to eye strain.2 A poor seating position and/or posture may require a person to tilt their head at an odd angle, causing strain on the neck, shoulder, or back.

Digital eye strain has multiple potential causes and often overlaps with other eye conditions. If you recognise symptoms of digital eye strain in your child, it is recommended to visit your eye care professional for a comprehensive eye examination. 

An eye examination assesses various aspects of the eyes, including vision, focusing ability, eye coordination, and eye health – helping to identify the underlying causes of DES so that they may be managed appropriately. For example, uncorrected vision can be managed through prescription glasses, and dry eyes can be managed with lubricating eyedrops.11 Research suggests that blue-light filtering lenses are not effective for relieving symptoms of digital eye strain.12

Another way to manage digital eye strain is to manage viewing habits during screen time. For example, if your child is often using an iPhone or iPad, try enabling the ‘Screen Distance’ setting. 

Below are three easy rules to follow for the indoor environment:

1. The elbow rule: keep an elbow-to-hand distance away from books and screens to avoid them being too close to the eyes.
2. The 20-20-20 rule: take regular breaks from reading to reduce demand on the visual system: every 20 minutes of screen use, by focusing on an object at least 20 feet away for 20 seconds.
3. The two-hour rule: try to limit leisure screen time (outside of school work) to two hours per day in school-aged children.