Blog by Stacey R Jones, O.D.

“Normal” isn’t something American school children have experienced since March of this year.  At the height of the stay-home orders, 83% of American school children were learning remotely through online education.  Not only did I hear from concerned parents regarding the uptick in eye strain and headaches related in increased screen time, but this was a common complaint from just about any patient:  college students, adults whose work was moved to their home, older adults who were passing time by playing games or watching movies on a device.  There’s no doubt that we all need a break from our screens.  Thank goodness for summertime, sunshine and fresh air to get us outside for a break!

For students returning to school this fall in an online or hybrid setting, data suggests that most children ages 6-12 will be in front of a digital screen TWICE as much as before the COVID-19 closures.  Prolonged viewing of digital screens often makes the eyes work harder, and as a result, these unique characteristics and high visual demand make many individuals susceptible to the development of vision-related learning problems.  The following can increase discomfort and exacerbate uncorrected vision problems:  screen and/or font size, glare, definition, luminosity and contrast, viewing distance and/or angle.  Oftentimes, digital eyestrain occurs because the visual demands of the task exceed the visual abilities of the individual to comfortably perform them. Those most at risk are spending two or more continuous hours looking at a digital device.  Besides making sure that the screen position and lighting are appropriate for the student, it is important to reinforce correct posture, routine blinking, and frequent breaks.

The 20-20-20 rule is something I find myself reinforcing to patients in almost every examination.  Basically, every 20 minutes spent using a screen, you should look away at something that is 20 feet away for a total of 20 seconds.  Consider looking out a window at an object that seems far away, like a tree or a structure across the street.  It takes 20 seconds for your eyes to completely relax.  Other ways to reduce eye strain include: sitting farther away from the screen (at least arm’s length away) and move it so that you are looking slightly downward at the screen, use artificial tears when the eyes feel dry if frequent blinking is not enough, dim the screen if it seems much brighter than the light in the room and consider blue light blocking glasses with anti-reflective coating to reduce glare symptoms.

In summary, I expect that as students return to school this fall, I will continue to see patients of all ages who are struggling by the end of their school (and/or work) day with eye fatigue and headaches.  It is important to recognize the symptoms of eyestrain and work to eliminate them before they have an impact on learning.  And, of course, it is important for all children to have a comprehensive eye exam to rule out any other vision-related issues while also obtaining an ocular health examination.