by Deepthika Jeyaraman
The start of the digital revolution in the 20th century marked the exponential rise in the use of devices such as smart phones, computers, etc. This massive increase in the demand for technology was attributed to many factors such as the shift away from labour intensive jobs, the population boom, and the increase in the diversity of lifestyle such as the various fields of work and the variety of entertainment sources, which boosted the need to increase the efficiency of storing data and also executing them in a timely fashion.
However, the downside of this shift was the ‘gift’ of a more comfortable life! A more sedentary one with very little physical activity unless an active effort is made to do some! The usage of devices such as computers, hand-held phones which can be used in the dark meant that people who had to restrict themselves to work in daylight or bad lighting at night in the past, could now work or seek entertainment for longer periods of time. They had crossed the barrier of ‘blindness’ at night! Moreover, the usually small size of devices with the small font being used, meant that it became more comfortable to view them by positioning them nearer to the eye than recommended. However, this has some serious implications for our health!
Digital eye strain is the physical eye discomfort felt by many individuals after two or more hours in front of a digital screen. Nearly 9 out of 10 adults use more than 2 hours of the computer, with about 3 out of 4 people look at their phones before going to sleep. This was also shown to be more prevalent in the working age group and relatively more women experience the symptoms of back and neck pain compared to men.
Not to mention, the 60 or older age group showed an increase of about 30% in the past 15 years, but younger adults and children use these technology relatively more than older adults. About 60% adults use digital devices for more than 5 hours in USA and about 70% use more than 2 devices with women more likely to complain of the side effects of prolonged exposure. This picture shows the path our generation is walking along: A future made with the price paid by our health!
The most common symptoms associated with digital eye strain are eyestrain, headache, blurred vision, dry eyes, and neck, and shoulder pain.  A combination of factors including the proximity at which we view digital screens, the frequency and length of time of this use, physical responses to screen habits, and exposure to high-energy visible (HEV) or blue light lead to the cumulative effect on a threshold type of model for digital eye strain.  The major risk of this strain is the increased risk of blindness due to macular degeneration, cataracts, etc. 
A study by Brien A. Holden, published in the journal Ophthalmology showed that 4758 million people will be suffering from myopia by 2050. This is essentially 49.8% of the global population! This has several implications on the planning of health services, as it has a huge demand placed on it. Moreover, it was noted that the economic burden of uncorrected refractive error, largely caused by myopia, was estimated to be US$202 billion per annum in the USA. This places a substantive argument for the need to improve the eye care awareness provided to people and enable ways by which people can access these services, mainly in developing countries which has a significantly higher percentage of the of the global population. The data was included from 145 studies covering 2.1 million participants which gives the results more validity!
This is just one of the studies that has shown the damage that’s possible without any means of protection. Another study had previously also shown that LEDs and some other lighting devices used in devices such as laptops and cell phones have white light with the diodes having peak emission in the blue light range of the electromagnetic spectrum. This high intensity light on exposure caused photoreceptor damage and also the retinal pigment epithelium cells due to the accumulation of reactive oxygen species. It was also shown in another study that a one-off 5-minute exposure didn’t do much damage but a series of 5 minute exposure did cause significant photoreceptor damage. It was also noted that the time between exposures had a cumulative effect on the damage caused. Moreover, the aging population in many developed countries pose increasing concern for it was observed that the damage increased with age!
The ever increasing rise in the usage of digital devices necessitates the need to improve the awareness surrounding the ill effects of it. One shouldn’t forget the effects on health elsewhere! Usage of more than 1 device at a time causes fall in productivity due to less attention being put on it.  For example, a child using smart phones for entertainment while studying makes the learning process less efficient. The usage of devices before going to sleep causes sleep dysregulation and increases the activity of the brain which makes falling asleep more difficult. This poses further problems to the circadian rhythm. The bad posture usually assumed while using these devices give way to excess pressure on certain joints causing pain and discomfort, particularly in the back and neck.  A more common form of musculoskeletal problem is called Repetitive Strain Injury (RSI) which is damage to the fingers, wrists and other parts of the body due to repeated movements over a long period of time. The list goes on!
Hence, empowerment of people in protecting their health is paramount! Limit the usage to 1 device at a time unless necessary and also avoiding looking at digital devices before going to bed would be advised. Instead reading a book or listening to music that is soothing would help in getting a good sleep. A fully adjustable chair, foot rests, screens that can tilt and turn to a position that avoids awkward movements should help in avoiding poor posture.
The optical industry took to developing computer eyewear which are new lens technology that cuts glare, blocks out blue light from penetrating our eyes and prevents vision fatigue when staring at digital devices. The lenses and filters are customized to reduce blurriness and pixilation, decrease brightness and minimize glare during prolonged use of devices. The type of lens and filter can be adjusted based on level or type of activity. Looking at devices in correct angles (just below eye level) and distance can decrease the stress placed on joints, hence reducing pain and discomfort.[1,5] It is ideal to sit an arm’s-length away from the computer screen, and to help out your vision by making the text larger rather than sitting very close to the computer which could cause more neck and back problems. It is also best to position your screen so that it is directly in front of your face and slightly below eye level. This keeps eyes at a relaxed position that promotes more frequent blinking. Keeping the room not overly lit overhead can help in decreasing the strain placed on our eyes.  Follow the 20-20-20 rule to avoid dry, tired eyes: Every 20 minutes, take a 20-second break and look at something 20 feet away. This would promote blinking! Moreover, drinking at least 1.2L of fluid would help is preventing dry eyes. Eating a good diet is also very crucial, including garlic broccoli, fatty fish, carrot, eggs, and apricots.
One must appreciate the growth in economy and the changes in lifestyle due to the advent of the digital revolution. However, it is important that as a global community, we work together to stem the rise in the ill effects of over usage of digital technology which is currently on the rise and may cause half the world’s population to be suffering from myopia!
- Digital Eye Strain Report 2016. The Vision Council. [Internet]. 2016 [cited 8 July 2016]. Available from: http://www.thevisioncouncil.org/digital-eye-strain-report-2016
- Computer Eye Strain. Eye Health. Specsavers UK [Internet]. 2016. [Cited 8 July 2016]. Available from: https://www.specsavers.co.uk/eye-health/computer-eye-strain-symptoms-and-solutions
- Holden B, Fricke T, Wilson D, Jong M, Naidoo K, Sankaridurg P et al. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology. 2016; 123(5):1036-1042.
- Gianluca Tosini K. Effects of blue light on the circadian system and eye physiology. Molecular Vision [Internet]. 2016 [cited 8 July 2016]; 22:61. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4734149/
- 5. BBC – GCSE Bite size: Possible dangers and solutions [Internet]. Bbc.co.uk. 2016 [cited 8 July 2016]. Available from: http://www.bbc.co.uk/schools/gcsebitesize/ict/implications/3healthandsafetyrev3.shtml
- Digital Eye Strain | Computer Eye Strain | Vision Direct UK [Internet]. Visiondirect.co.uk. 2016 [cited 8 July 2016]. Available from: http://www.visiondirect.co.uk/do-you-have-digital-eye-strain-infographic