- lifestyle report
TFOS Lifestyle: Impact of the digital environment on the ocular surface
James S. Wolffsohn a,f,*, Gareth Lingham b, Laura E. Downie c, Byki Huntjens d, Takenori Inomata e, Saleel Jivraj a, Emmanuel Kobia-Acquah b, Alex Muntz f, Karim Mohamed-Noriega g, Sotiris Plainis h,a, Michael Read i, Rony R. Sayegh j, Sumeer Singh c, Tor P. Utheim k, Jennifer P. Craig f,a
a College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK, b Centre for Eye Research Ireland, Technological University Dublin, Dublin, Ireland, c Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia, d Division of Optometry and Visual Sciences, City, University of London, EC1V 0HB, UK, e Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan, f Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
g Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo Le´on (UANL). Monterrey, 64460, Mexico, h Laboratory of Optics and Vision, School of Medicine, University of Crete, Greece, i Division of Pharmacy and Optometry, The University of Manchester, Manchester, UKm j Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA, k Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
ARTICLE INFO
Keywords:
Digital environment
Digital eye strain
Computer vision syndrome
Visual fatigue
Digital display
Management
Systematic review
Blinking
Nutrition
Blue-light
ABSTRACT
Eye strain when performing tasks reliant on a digital environment can cause discomfort, affecting productivity and quality of life. Digital eye strain (the preferred terminology) was defined as “the development or exacerbation of recurrent ocular symptoms and/or signs related specifically to digital device screen viewing”. Digital eye strain prevalence of up to 97% has been reported, due to no previously agreed definition/diagnostic criteria and limitations of current questionnaires which fail to differentiate such symptoms from those arising from nondigital tasks. Objective signs such as blink rate or critical flicker frequency changes are not ‘diagnostic’ of digital eye strain nor validated as sensitive. The mechanisms attributed to ocular surface disease exacerbation are mainly reduced blink rate and completeness, partial/uncorrected refractive error and/or underlying binocular vision anomalies, together with the cognitive demand of the task and differences in position, size, brightness and glare compared to an equivalent non-digital task. In general, interventions are not well established; patients experiencing digital eye strain should be provided with a full refractive correction for the appropriate working distances. Improving blinking, optimizing the work environment and encouraging regular breaks may help. Based on current, best evidence, blue-light blocking interventions do not appear to be an effective management strategy. More and larger clinical trials are needed to assess artificial tear effectiveness for relieving digital eye strain, particularly comparing different constituents; a systematic review within the report identified use of secretagogues and warm compress/humidity goggles/ambient humidifiers as promising strategies, along with nutritional supplementation (such as omega-3 fatty acid supplementation and berry extracts).
read full article