All about the 20-20-20 rule for tackling eye strain

• Long periods of close work and screen use can contribute to digital eye strain, where individuals experience symptoms of eye discomfort such as sore, tired eyes, and headaches.
• The 20-20-20 rule recommends taking a break every 20 minutes of screen use, by focusing on an object at least 20 feet away for 20 seconds.
• Adopting the 20-20-20 rule into your daily habits is a simple, cost-free way to manage eye strain, dry eye, and discomfort.
• Parents can use timers, apps, or fun activities to help children practice this rule.

In today’s digital world, young people are spending more time than ever on screens – whether for online learning, homework, or entertainment.

While technology offers many benefits, prolonged screen use can lead to digital eye strain. Screen use puts significant stress on vision and the muscles that control focusing and eye movement. Coupled with screen glare and reflections, improper posture, poor lighting, and very close viewing distances, this continuous state of focus can lead to eye fatigue over time. At the same time, our eyes tend to blink less frequently when focusing intently, which can result in dry, irritated, and uncomfortable eyes.

Another common concern is that spending too much time reading and looking at screens may disrupt healthy vision.1  In particular, this has been linked to the development and worsening of myopia (near-sightedness). For example, children exposed to screens before 3 years of age are more likely to develop myopia by pre-school.2 Teenagers and young adults aren’t safe either, especially among those engaged in high amounts of reading and laptop use such as college and university students.3 

The 20-20-20 rule is an easy-to-follow technique that encourages regular breaks during periods of screen use, reading, or intensive focus. These short breaks allow the eye muscles to relax and help restore normal blinking patterns.4 

The rule suggests that:

1. For every 20 minutes spent looking at a screen or performing close work
2. Try to look at something at least 20 feet away
3. For at least 20 seconds

An easy way to implement the 20-20-20 rule is to modify your smartphone or tablet settings. Most devices (including Apple iOS) nowadays have features that can automatically limit screen time, issue reminders to take regular breaks, and even monitor screen distance. For other devices, apps developed by scientists and optometrists such as Myopiaapp can help monitor and track digital device habits for children and teens.

One of the best ways to give back to your eyes is by replacing the time spent on screens and close work, with time outdoors. Outdoor time is beneficial for physical and mental health in children and teenagers5 , and there is strong evidence that spending 2 hours per day or more outside reduces the risk of children developing myopia.6 

For younger children, parents can turn these breaks into fun activities. For example, you can ask your child to look out the window and:

• Count how many cars, trees, or people they can see
• Try to spot objects of a certain color in the distance
• Identify birds, clouds, or buildings far away
• Play simple “I spy” games using distant objects

Heavy screen usage causes digital eye strain, which encompasses a variety of symptoms including:

• Eye irritation
• Frequent eye rubbing
• Burning sensation
• Dry eyes
• Tearing or watery eyes
• Blurred vision
• Difficulty focusing
• Tired eyes
• Headaches
• Neck or back discomfort

The 20-20-20 rule is an easy way to reduce eye strain and dry eye caused by prolonged near work or screen time, and it can improve symptoms if performed consistently.

In terms of keeping myopia at bay, a 20-second break every 20 minutes might not be enough. One study suggests that taking longer breaks of at least 5-minutes every hour may have a greater effect.7 

The 20-20-20 rule is a simple, easy-to-remember exercise to give the eyes a much-needed rest during screen use. Studies indicate that having regular breaks can be an effective strategy for reducing digital eye strain and dry eye.

Good visual habits can go a long way in protecting eye health. Besides practicing the 20-20-20 rule, ensure your child reads at an arm’s length distance (also known as the elbow rule). Try to limit leisure screen time (outside of school work) to two hours per day in school-aged children. Make sure the lighting is adequate to reduce glare, and that the text size is comfortable for reading.