SCENE + HEARD: Today's Read Digital Eye Strain—Another Pandemic Pain Point By Mary Kane Friday, March 19, 2021 8:30 AM We’ve all seen those notifications and displays on our phones tallying up our average screen time for the week. I don’t know about you, but I find it a bit jarring some weeks to see how much time I am spending on my phone. And I’m sure I’m not alone. Ever since we went into lockdown last March, we’ve all been spending way too much time not just on phones, but on electronic devices in general—including laptops, ipads and TVs. And once you add in children learning remotely on screens, you have a recipe for digital overload throughout the entire family. Here are some eye opening statistics about the rise of Digital Eye Strain (DES) and some advice from several eye doctors on how to combat the problem. According to new data from Eyesafe, a leader in screen time and blue light solutions, and LG Display, a cutting edge display company, people have been spending 13+ hours per day on screens since COVID-19 emerged—up 30 percent from last year. As a result, eye strain has become the #1 pain point for device users, with 59 percent of people experiencing symptoms of digital eye strain. When asked about watching TV or using laptops and monitors for an extended time, eye strain and vision deterioration was the Number 1 complaint for device users. To address eye health, consumer electronics manufacturers are evolving their design of PCs, monitors, and televisions. For example, in January, LG Display introduced the world’s first Eyesafe Certified television display—a 65” OLED. The display meets Eyesafe requirements for low emission of blue light, while maintaining natural color. Consumers can enjoy binge-watching their favorite shows with less worry about the potential health impacts of blue light, such as dry, irritated eyes, blurred vision, trouble sleeping and disruption in circadian rhythm. See related story. Eyesafe CEO Justin Barrett commented, “As screen time continues to increase, Eyesafe is on a mission to create the healthiest displays in the world. We partner with the leading device manufacturers on products designed for human health with reduced blue light at the source. With eye strain now the number one pain point for consumers, we have reached a tipping point and expect Eyesafe will be the standard across consumer electronics.”The ECP ViewpointA recent report from UnitedHealthcare Vision, indicated that 78 percent of employers are concerned about the impact of digital device screen time on their patient’s and employee’s eyes. As employees continue to work from home for the foreseeable future, they are spending a concerning amount of time in front of digital displays that emit potentially harmful levels of blue light. Together with Eyesafe, UnitedHealthcare Vision conducted the comprehensive survey on how ECPs are thinking about addressing the health challenges stemming from exposure to screens and blue light. The survey of ECP providers indicated that 83 percent of respondents estimate that as much as 75 percent of their patients are impacted by blue light-related symptoms. Dr. Nathan Bonilla-Warford, a pediatric optometrist at Bright Eyes Family Vision Care in New Tampa and Westchase, Florida said, “I have definitely seen an increase in the number of people of all ages with digital eye strain complaints. There have been highly-focused office workers and intense video gamers with eye strain symptoms for a long time. The difference now is that many more of the average patients we see are becoming like them due to changes from the pandemic. “It is affecting everybody. We now see kids as young as in pre-school who develop issues, such as blinking and squinting. And then we are seeing older kids who have blurry vision and adults with headaches and discomfort.” Nathan Bonilla-Warford, OD Since screen time is unlikely to go down anytime soon, it’s important that users take preventative and proactive measures to help protect their eyes and health. “We educate our patients on taking breaks from screen time, looking at distance when possible, deep blinking, and correct posture. Then we can prescribe lenses for specific functions that may include plus power, prism, and blue-light filter. If they have signs of dry eye, we manage that. If they have development accommodative spasm or other functional vision problems we will recommend vision therapy,” Warford said. Robert Weinstock, MD The Dangers of DES “Due to all of the quarantining, remote work and virtual meetings, all of that screen time has exponentially increased during the pandemic,” according to Robert Weinstock, MD, the director of cataract and refractive surgery at the Eye Institute of West Florida in Tampa Bay, Florida. In addition, Dr. Weinstock, a board certified ophthalmologist, sits on the board of Eyesafe and is a medical advisor for eye health and eye diseases for the company. “When you stare at a computer screen, an iPhone or tablet for a long period of time, it's been proved that your normal blink mechanism slows down. So that creates a strain on the eyes as things get blurry and as the tears evaporate. Research studies have shown that blue light can also cause toxicity to the surface of the eye, and blue light shines a lot of light on the retina, as well. “So we recommend taking breaks, and looking away every 30 to 40 minutes, making sure you blink your eyes and you look into the distance to give your eyes a rest. We also recommend turning down the brightness on the screen to a level that's not too low that you can't read it but not as bright. “Ideally, we want to reduce some of that blue light and we want people to reduce their screen time. We also recommend that people use artificial tears if their eyes are dry to alleviate some of the scratchy and foreign body sensation that they feel,” Weinstock said. Weinstock said there has been research in animals who were exposed to high amounts of light for long periods of time, simulating what happens in humans when they're on the screen too much. “It showed that all that light was toxic to the retina, a very important part of the back of the eye. More research would be needed to obviously vet it out and prove it further in humans but it leads us to believe that there may be some potential risks of developing diseases of the retina, such as macular degeneration or atrophy of the retina. “For younger people, it just makes sense to try to protect them, because the lenses in their eyes are very clear and they don't have cataracts yet that filter some of these light rays. So all of that high energy light is coming right through to the retina. There is some logic to protecting the eyes of younger people, because we know all these computers and devices aren’t going away. And we don't really know yet what the long term consequences are of so many years of intense light hitting the retina. And if somebody is already predisposed by genes to develop macular degeneration, this could be an environmental situation that adds to that risk.” Changing Digital Viewing Behaviors "It is incredibly difficult to get people to change their viewing habits so education must come first,” Bonilla-Warford said. “We explain all of the different types of problems that can arise from DES and how they are related. Some people, due to work or school demands, really can't reduce their time on screens, but they can blink their eyes more, close their eyes when not reading, use glasses, and change their posture. There are also apps people can use to help with some of these reminders. “Because a large percentage of my patients are children, I created this guide about reducing visual eye strain in children who are e-learning.” Warford concluded, “This is an important problem that is not going away any time soon, so we must remain vigilant. It is also an evolving area. New research and products are being developed that will help us help patients.” Dry Eye Disease Carole Burns, OD Dr. Carole Burns of Professional Vision Care in Columbus, Ohio said, “the Number One thing that we've learned is that as a result of the pandemic, younger people are getting eye strain. When we work on a computer screen or do anything up close our blink rate decreases and when we blink less, it causes a lot more eye strain. A lot of it is due to dryness. “And this is a really interesting point—dry eye disease is usually diagnosed primarily in females over the age of 50. But what we found since COVID, is dry eye is affecting everyone of all ages, including children from grade school to high school because they're doing more digital work. Prior to this, it would be extremely rare for us to ever diagnose dry eye in the younger population or even people in their 20s or 30s, but it's become much more prevalent due to COVID. “So we are now prescribing lenses that are specific to all ages, but one of the lenses that we prescribe the most is the Workspace lens by Shamir. The great thing about these computer glasses, versus old style computer glasses, is it gives you clear vision from 12 feet. So you're not stuck at just 24 inches from your computer screen. You can see clearly up to 12 feet, which allows you to relax, and still see everything in between 12 feet," Burns said.To learn more about DES and screen time check out these special reports from UnitedHeathcare and Eyesafe: the Blue Light and Screen Time Guide for Employers, the Blue Light and Screen Time Guide for Parents and Educators, and the Blue Light and Screen Time Guide for Vision Care Providers.