Expert advice for reducing digital eye strain

Dr Deborah Lee, Dr Fox Online Pharmacy, shares her expert advice on reducing digital eye strain…

It took me quite a while to realise I was suffering from digital eye strain (DES). However, I’m not alone – studies suggest around 50% of the population are in the same boat. We’re all paying the price for living life online and glued to our smartphones!

DES – the symptoms

DES can cause a whole range of unpleasant symptoms. These include;

• Headaches 
• Blurred, or double vision
• Dry eyes, or weepy eyes
• Burning sensation in the eyes
• Eyes feel sore, tired, hard to keep them open
• Red eyes
• Photophobia – increased sensitivity to light
• Neck and shoulder pain

My worst symptom is photophobia, pain in my eyes from looking at the light. Although I get many of the other symptoms on this list too. This seems an impossible problem, as I can’t do my job with my eyes closed! I had to find a solution!

Dry eye

One major risk factor for DES is the medical condition of dry eye. This is also incredibly common. In one 2016 meta-analysis, 49.5% of office workers were known to have dry eye. 

Your eye produces tears from the lacrimal glands. It also produces an oily substance called meibum. Both these fluids are spread across the front of the eye – the cornea – when you blink. This protects the cornea and stops it from drying out. 

Funnily enough, research shows that for some reason, when you stare at a computer screen, you blink less often. In one 1991 study, the natural blink rate of 18.4 blinks per minute, went right down to 3.5 blinks per minute, when undertaking a computer task. 

If you have dry eyes and use a digital screen for long periods, this is likely to exacerbate the problem and lead to symptoms of DES.

Some of the causes of dry eye are listed below:

• The side effect of medication  – such as antihistamines, antihypertensive agents, decongestants, diuretics, nonsteroidal anti-inflammatories (NSAIDs), and some antidepressants. 
• Certain eye drops – such as glaucoma drops or drops containing preservatives.
• Eye allergies – such as allergy to pollen, house dust, or cigarette smoke.
• Prolonged use of contact lenses.
• Chronic eye infections – such as herpes.
• Menopause – hormone deficiency, or as a side effect of HRT.
• Auto-immune conditions – such as  Sjogren syndrome, or in association with other autoimmune conditions such as rheumatoid arthritis, or thyroid disease.

Top tips to reduce DES

1. Adjust your work station

• Sit correctly at your computer – Check you are sitting about an arm’s length from the screen, with your eyes level with the top of the screen or looking slightly down at it.
• Enlarge the computer text – This avoids you having to squint.
• Reduce the glare – Turn down the brightness of the screen.
• Follow the 20/20/20 rule – Every 20 minutes, look away from the screen and focus on something 20 feet away, for 20 seconds. This frees up your eye muscles and allows them to relax temporarily.

2. Have an eye test – see an Optician

The NHS recommends an eye check-up every 2-years.  You may be entitled to a free NHS sight test. The optician will also tell you if you have characteristic findings of dry eye. 

For more information, The Royal Society of Ophthalmology – Understanding Dry Eye

3. See a Pharmacist

• For dry eyes, the pharmacist will recommend eye drops, ointment, or gel. One option is to use ointment at night and drops during the day.

• Keep your computer room well-humidified. Try simply placing a dish of water on a window ledge or a shelf close to your computer.

• Fans and air conditioning units make the air dry which can worsen dry eyes.

4. Look after your eyes

• Stop smoking – Smoking is high-risk for the development of macular degeneration. Contact NHS Smokefree, where you can find free, helpful advice and support about stopping smoking.

• Wear sunglasses to protect your eyes from U/V light – Always protect your eyes from U/V light by wearing CE approved sunglasses. You should never look directly at the sun. U/V exposure may be related to cataract formation. 

• Omega-3 supplements –  You might want to think about taking omega-3 supplements. One 2015 randomised controlled trial compared dry eye symptoms in two groups of volunteers. One group took two capsules per day of omega-3 fatty acids – each capsule contained 180 mg of eicosapentaenoic acid and 120 mg of 120mg docosahexaenoic acid. The other group took a placebo. After 3-months, the omega-3 group had significantly improved dry eye symptoms compared to the placebo group.

5. Anti-blue light devices 

Recently, fines have been issued for over-zealous advertising, encouraging customers to purchase anti-blue light lenses. Scientists have argued that most digital screens only emit a small amount of blue light, and that there is no substantive evidence that blue light damages the retina.

However, a recent 2019 systematic review, which included 15 studies, reported  that blue light suppresses the production of melatonin, and can affect Circadian rhythms. If you, like me, tend to work on your computer in the evenings, and then get into bed and can’t sleep, this could be a contributory factor. Insomnia may well exacerbate symptoms of DES.

6. See your GP

If you’ve tried everything and still have symptoms, see your GP. Your eyes are vital for good health. 

For more information

• Patient – Is your office hurting your eyes?

• Moorfields Private Eye Hospital – 10 steps for digital eye strain relief

• BMJ Open Ophthalmology, April 2018 – Digital eye strain: prevalence, measurement, and amelioration