Digital Eye Strain: Investigation and Optometric Management

Abstract

Digital eye strain (DES) is a condition encompassing visual and ocular symptoms that may arise due to the prolonged use of digital devices. The 2023 Tear Film Ocular Surface Lifestyle report defined DES as “the development or exacerbation of recurrent ocular symptoms and / or signs related specifically to digital device screen viewing”. Studies vary as to the prevalence of DES with some reporting values as low as 10 % and some reporting values over 90 %. This programme of research was centred around the identification and management of DES with a focus on Ireland and the UK. The attitudes of optometrists to DES were investigated. Optometrists considered DES to be a significant issue and one that they felt confident in dealing with. Optometrists typically underestimated the prevalence of DES (median at 25 %) compared to previous reports in the literature. Advising on frequent breaks, ocular lubricants and workstation / device set up were the most important management considerations. There were mixed views on specialist spectacle lenses for DES, particularly ‘blue filtering’ designs, although a significant proportion (34.7 %) did indicate that they recommended these. DES in working age adults in Ireland and the UK was examined for the first time. Using the Computer Vision Syndrome Questionnaire (CVS-Q), 62.6 % of participants were classified as DES sufferers. There was a very weak correlation between hours of device use and having CVS-Q ≥6 (rs=0.155, rs 2=0.024, p=0.001). Fewer than 10 % reported that symptoms were so bad that they affected their work. Given the increase in digital device use in older adults (≥60 years), this programme of research examined the syndrome in this age cohort for the first time. In a cohort drawn from community optometry practice, significant daily durations of device use were found (median 4 hours) and 51.6 % were found to have DES. There was a strong correlation (rs=0.81, rs 2=0.6561, p<0.00001) between dry eye symptoms and DES. The test-retest repeatability of the CVS-Q in an older population was found to be good and a minimum clinically important difference of 1.96 was determined.