TOP 10 WAYS TO PREVENT DIGITAL EYE STRAIN

​The average American is looking at a screen over 10 hours per day! It’s not just work and school. Over 85% of our free time is spent looking at screens. No wonder many of us experience Digital Eye Strain symptoms including visual disturbances, ocular discomfort, and headaches, in addition to neck, back, wrist and shoulder pain.

Every single day we have patients in our office complaining about Digital Eye Strain, so we would like to offer some tips to managing your symptoms.

1. Visit your Optometrist

Of course our #1 suggestion is to visit your eye doctor. A plan to address your individual needs is best. Keep in mind that correcting even low levels of refractive error with glasses can improve eye strain. Reading glasses, non-fatigue lenses or bifocals may be recommended, especially if you are over the age of 40. Your doctor can also detect other deficiencies in the way you use your eye muscles and offer additonal treatment options to ease your symptoms. If dry eye is diagnosed, there are several different options for treating eye dryness to explore as well.

2. Prevent Dry Eye: Be Mindful of the Blink. 

When our eyes dry out, it leads to inflammation which causes discomfort; Burning, redness, a foreign body sensation, grittiness, a general feeling that the eyes are tired, and disruptions to your vision are all symptoms of Dry Eye.  Preventing dry eye is very important to reducing Digital Eye Strain.

Blinking is important for maintaining moisture on the front surface of the eye. When you blink, your tear glands express tears which are distributed across the eye by the eyelids. The smooth tear film protects your cornea from exposure and ensures clear vision.

We know that blink rate is reduced with screen use, and that blinks are more likely to be incomplete or partial blinks. The more difficult the task (e.g. complex gaming) the more pronounced this blink dysfunction becomes.  Not only are less tears expressed, but tears will evaporate more quickly as your eyeball is exposed to the air for longer durations. Tear evaporation will be worse with a screen positioned straight ahead, vs in downgaze, due to the wider opening between the eyelids

​Be mindful of your blinks to increase the frequency of complete blinks (you want to feel your eyelids touch!) and reduce Digital Eye Strain-related Dry Eye. You can also perform blinking eye exercises periodically during screen use.

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There are several other ways to prevent Dry Eye Syndrome like staying hydrated, using humidifiers indoors, maintaining good eyelid hygiene (e.g. removing your makeup before bed), using special Lid & Lash cleansers to promote tear gland health, and incorporating more foods rich in omega-3 fatty acids in your diet. (Make sure to ask your doctor before using supplements such as fish oils). 

3. Treat Dry Eye: If you can Beat it, Treat it!

With the amount of screen use going on, it's hard to avoid dry eye altogether, and some of us are at a greater risk due to age, sex, other health issues, etc. Don't stay miserable - Ask your doctor what more you can do!

Treatment options for Dry Eye includes supplementing your natural tears with an Artifical Tear. Many of our patients have great intentions and start supplementing with over-the-counter eye drops, but often they are not using a high quality supplement and/or they are not using them enough. 

Check the labels: We recommend staying away from “redness relievers” and sticking to “eye lubricants" in the active ingredients. Generic brands often use harsher preservatives (like benzalkonium chloride/BAK) that could make symptoms worse. We like lipid-based products that won't drain from the eye too quickly. 

Dr. Gambs recommends a high quality lipid-based tear supplement several times per day. The goal here is to maintain a level of moisture on the eye that will prevent inflammation. If you use lubricating drops only in the moments when you are having dry eye symptoms, your eyes are already inflamed and the artificial tears will not be as effective as if you use them regularly.

Your eye doctor can also prescribe anti-inflammatory eye drops to reduce inflammation, or use Punctual Plugs to keep tears on the eyes longer. We recommend talking with your eye doctor about which treatment could be right for you. 

4. Adjust your lighting

There are muscles in the eye that react to changing light levels. Generally speaking, to ease the strain on these muscles, you want your screen brightness and room brightness to be similar.  A very bright screen in a dark room is going to cause eye fatigue.  It is also straining to view a very dim screen in a brightly lit room. Try to keep the brightness of the device equal to your surrounding environment.

5. Reduce Glare

Position your screens away from nearby light sources to reduce glare. You definitely don't want your screen facing a window!

If you are in the market for a new computer screen, many brands offer a matte finish to reduce glare and are much more comfortable to look at. After-market screen covers can also be added to reduce glare. 

If you wear glasses, make sure to get an anti-reflective coating added to your lenses. Without this coating, >10% of light will be reflected off of your lenses causing glare. This is reduced to <1% with anti-reflective coatings. 

Add fruits and veggies containing lutein and zeaxanthin to your diet to improve your eye's natural ability to filter glare and recover from glare exposures. 

6. Block the Blue Before Bed

Blue light is the highest energy VISIBLE light in the light spectrum. Antidotally, people do report Digital Eye Strain relief from using blue blocking spectacles with their devices. 

There are several options for blue-light filtering which will block blue light to varying degrees: 

• Yellow/amber tints (blocks the most)
• Photochromic lenses (some blue blocking while clear and increases as they darken)
• Certain lens materials block more blue light than others
• Coatings can be added to your glasses to block (usually smaller percentages of) blue light

Although heavily marketed, the hard evidence behind the idea that blue-blocking lenses aid in Digital Eye Strain leaves much to be desired with results often only showing a placebo effect, therefore we don't usually recommend blue-blockers for Digital Eye Strain. However, what we have learned is that the high energy blue light (which is similar to daylight) emitted from digital screens can reduce your melatonin levels. This will affect your circadian rhythm and make it more difficult for you fall asleep and get a good night’s rest.   Your cortisol levels rise, leading to more stress and inflammation in the body, and more fatigue in general.

Ideally, you should discontinue screen use an hour or more before bed. If you must use your devices before bed, we recommend blue-blocking spectacles (a true yellow tint would be best), an app on your device that adds a blue light filter to your screen (e.g. "nightime mode", "eye comfort shield" - your screen will tint yellowish), or simply reducing your screen brightness to limit the amount of light exposure and the effects on your circadian rhythm. 

Blue-blockers have their place, but how much do we need to worry about retinal damage due to our screens emitting high energy light?

At this time, the American Academy of Ophthalmology does not recommend any blue blocking eyewear for screen use because, frankly, there just isn't compelling evidence that the amount of high energy light exposure we get from our screens is enough to cause eye damage. 

In fact, being outdoors on a sunny day dramatically increases your exposure to high energy light (up to 100,000×!) compared to your computer screens. This is why we recommend sunglasses when outdoors to protect your eyes. Your sunglasses should block all UVB and UVA light up to 400nm. The brown and more amber tints will block more of the visible blue light (vs a gray tint which blocks all visible light wavelengths more uniformly).

Finally, reduce your high energy light exposure risk in all lighting situations by adding Lutein and Zeaxanthin in the diet. These eye-specific carotenoids will improve your eye's natural ability to neutralize high energy light in the retinal tissue, improve your glare recovery, and slow the progression of macular degeneration.

7. Increase your working distance

It is common with handheld devices to slowing bring your phone or tablet closer and closer to your eyes as the duration of use increases. The closer the screen is to your eyes, the harder your focusing muscle has to work. Try pulling the screen away from your face to reduce strain.

8. Limit Multitasking

Multitasking often requires you to focus your eyes at many different distances. When you are constantly changing your focus from your computer screen to closer objects like your phone or tablet it is more taxing on your visual system. Limiting this, if possible, can reduce the likelihood of experiencing eye strain.

9. Take Frequent Breaks & Engage in Physical Movement

After about 20 minutes, we will start to experience deficits in the ability to focus the lens and pull the eyes in.  We will see more difficulty in changing focus.  A reduction in blink frequency will cause the eyes to become dry and inflamed. 

We recommend a break after about 20 minutes of screen use. Going outside, gazing out a window, or looking down a long hallway will relax your focusing muscles. Closing your eyes will also relax your eye muscles, while protecting the cornea from exposure. And don't forget about those blinking exercises! 

Screen time affects your eyes as well as the rest of your body. Our stationary body positions and the high demands we place on those muscles lead to back, neck, shoulder, and wrist pain, headaches and more.  Physically moving your body is a great way to give your eyes and body a break from screens. Take a walk, do some jumping jacks or stretches. 

10. A Healthy Diet with Fruits & Vegetables
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​Incorporating more foods with the following nutritional content will aid in Digital Eye Strain Symptoms.​

Omega-3 polyunsaturated fatty acids

​Some foods that contain Omega-3 include:
Salmon, mackerel, tuna,  grass-fed beef, eggs, avocado, flaxseed, walnuts

Dry eye is one of the most common ocular complaints reported by individuals experiencing digital eye strain due to poor tear expression and tear evaporation from disrupted blinking patterns which leads to inflammation. Increasing Omega-3 intake has been linked to decreased inflammation, increased tear production, and reduction in tear evaporation, which will improve dry eye symptoms.

Ask your doctors before taking supplements, as there are some contraindications such as blood thinners. You also want to make sure you are getting a high quality supplement as they are not all created equal! A good supplement has:

• EPA/DHA 3:1
• a re-esterified triglyceride based formulation for fewer G.I. side effects and better absorption
• 2000mg/day

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 Anthocyanins

You will find Anthocyanins in your red, blue, and purple pigmented fruits and vegetables, such as: Berries, cherries, red grapes, pomegranates, red cabbage, red onions, red radishes, purple cauliflower, purple corn,  eggplant, black beans, wine

These antioxidants are anti-inflammatory and improve your micro-circulation.
The ability to focus and control the eye movements gets harder after long periods of demand on the eye muscles. Anthocyanins have been associated with improvements in the ability to focus the eyes. It is thought that the improvement in the circulation of the small muscles of the eye actually correspond to a better ability to focus the eyes and a better response from the pupils in adjusting to light levels.

Xanthophylls: Lutein and Zeaxanthin

You will find these xanthphylls in the dark green (best), orange and yellow pigmented foods like: spinach,  kale,  corn, carrots,bell peppers, egg yolks,  pumpkin/squash, broccoli, cantelope, zucchini 

These two carotenoids are highly concentrated in the eye, specifically the central retina. They act as a filter by absorbing high energy scattered light and neutralizing free radicals to prevent oxidative damage and inflammation in our retinal tissue. They are the ultimate blue-blockers!

At proper concentrations, these carotenoids will decrease light sensitivity, reduce glare, speed up visual recovery from glare exposures, and improve contrast sensitivity leading to faster reading speeds, better visual adaptation to bright light conditions (like LED displays), and overall improved visual performance.  Not surprisingly, increasing intake of these nutrients also correlate with decreased cortisol levels, less physiological stress, less anxiety and better sleep patterns. Lutein and Zeaxanthin are also found in the brain and have been associated with increased visual neuro-processing speed, improved attention, improved memory and generally enhanced cognitive function.  

Supplements are also available. Dr. Gambs prescribes supplements regularly as they are known to slow the progression of eye diseases like macular degeneration.  
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To summarize, here are the TOP 10 WAYS to reduce Digital Eye Strain:
1. Visiting your Optometrist 
2. Blinking exercises 
3. Artificial Tears
4. Matching screen brightness to room brightness
5. Anti-reflectives for screens and glasses
6. Blue-blockers before bed
7. Increase your working distance
8. Limit Multitasking 
9. Frequent breaks with physical movement
10. A healthy diet with fruits and veggies