[ Dr Lobsang Tsetim ]
The Covid-19 pandemic has brought unprecedented changes in human lives and behaviour. The lurking fear of spread of the disease and lockdowns have confined people at home more than ever; some working, and many not.
Laptops, tablets, smartphones, and other digital gadgets have become an indispensable part of our daily lives. Our dependence on them has increased remarkably during the Covid-19 crisis and lockdown periods. These devices help us to stay productive, enable us to access needed resources, and help reduce social isolation during a period of intense physical distancing.
The Covid-19 pandemic has led to a sharp increase in our screen time, owing to increased time spent on virtual education, working from home, entertainment consumption, online shopping, and electronic communication with friends and family. Reliance on technology and digital solutions to keep children learning, entertained and connected to the outside world has increased due to the closure of schools and strict containment measures. Most schools, too, have shifted to virtual and online classes for continuation of their students’ classes.
‘Screen time’ refers to the duration of time spent in activities that involve peering at a digital screen, including media viewing, working on a computer or tablet, electronic communication, and playing video games. Since the beginning of the Covid-19 stay-in periods, screen time in homes around the globe is at an all-time high. Internet usage is at an all-time high, and Google Classroom, social media usage and online gaming have also gone up tremendously. One survey found that the number of people working remotely with digital devices during the Covid-19 pandemic may increase by upto 30 percent.
It can also promote a sedentary lifestyle and affect sleep, so it’s not surprising that screen time has negative mental and physical health impacts. When this is all compounded by fear, distractibility, loneliness and anxiety over Covid-19, people experience a sort of ‘digital distortion’ – the distortion being that people are being flooded with negative, threatening, panic-inducing information, and that information is becoming over-represented in their mind.
Increasing screen-time due to continuous usage of smartphones, laptops, computers and other digital devices has profound effects on our eyes. It may result in a significant rise in complaints of eye issues, especially among children and young adults.
Digital eye strain
The complex eye problems related to near work which are experienced during or related to digital device usage is known as digital eye strain or computer vision syndrome. Reading a book or looking at a computer screen for long hours can contribute to eye dryness, which can also make your eyes feel tired.
When you read or look at a computer, you don’t blink as frequently. Normally we blink 12-14 times a minute, but while looking at a screen, our blink rate slows down and the eyes get dryer. According to the American Academy of Optometry, anyone who exceeds two hours of computer use a day is at a risk of computer vision syndrome. Computer vision syndrome (CVS) affects around 60 million people globally.
The American Academy of Ophthalmology noted that focusing on computer screens and digital displays can reduce a person’s blink rate by a third to half. This can cause your eyes to dry out and feel irritated, especially if you have an air conditioner that keeps your room’s humidity low. In most cases, symptoms occur because the visual demands of the task exceed the visual abilities of the individual to comfortably perform the task.
Eye strain from screen use can lead to visual disturbances and other physical discomforts, including tearing, gritty sensation, tired eyes, burning sensations, redness, blurred vision, double vision, and general eye fatigue. It can affect your vision, but it’s more of a comfort issue with long period’s device.
Eye strain and headaches can go hand in hand. For some people, eye strain can be a symptom of headache syndromes like sinusitis, tension headaches, or migraines. All of these things can change how your eyes feel.
Individuals who get migraines tend to be more visually sensitive, especially to blue light; hence, use of electronics can cause more headaches. For some people, digital eye strain isn’t caused by dry eyes, but due to accommodative eye strain, or pain from focusing on things close-up. Looking at a near target for a long period of time causes the eyes to accommodate, using muscles inside of the eyes to try and focus.
If you’re reading an email and your eyes have difficulty relaxing, you can end up with a strained feeling. This is commonly caused by fatigue, medical illnesses, certain medications (including opioids), and post traumatic stress disorders. Accommodative eye strain tends to make your vision blurry or unfocused, while dry eyes are more likely to make your eyes physically hurt.
Secondary physical issues of eye strain include stiff neck, headache, backache, and overall fatigue. The bottom line is that too much screen time, whether for work or entertainment, is bad for our health.
Eye strain also can happen when someone’s eyes have to work too hard due to an incorrect prescription. If you are under- or over-corrected, which means that you have an inaccurate prescription, it can create eye strain by causing the eyes to overwork.
The excessive use of devices not only puts a strain on the eyes but is also a risk factor for myopia (nearsightedness). In other words, students staring at screens for prolonged periods may end up wearing glasses, and if they are wearing glasses already, the power may increase rapidly.
The combination of more screen time and less outdoor time during the Covid-19 pandemic may actually harm children’s vision and put them at a higher risk of developing myopia or nearsightedness.
Causes of digital eye strain
Less blinking: When you are hooked to any electronic devices, you tend to blink less. Less blinking causes dry eyes. Blinking is the natural reflex of eyes to keep it moist. If blinking reduces to 6-8 times in a minute, then gradually, it results in dry eyes and becomes a cause for computer vision syndrome.
Improper workstation: If you have not set up your workstation in a proper way, then it could cause computer vision syndrome. ACs in offices strip the air of its moisture, thereby making the environment dry. This dryness, an improper workstation, or bad sitting posture, makes people prone to computer vision syndrome.
Refractive errors: You might get accommodative eye strain because of undiagnosed vision problems like farsightedness, astigmatism, or issues with focusing.
How to treat digital eye strain?
Establish good screen schedule: Reduce digital eye strain by making use of your screen time wisely. It is important to take a break from the screen at least two hours before you go to bed. Studies show that blue light emitting from screens can affect natural sleep and wakeup cycle. Try and make use of digital screens mostly for work-related purposes.
Take frequent breaks: Follow the 20-20-20 rule. Your office job or study-related projects may demand you to stay glued to the computer screen for over 10 hours. While it may seem impossible for you to cut down on the screen time, you can pursue the 20-20-20 rule. As per this rule, after every 20 minutes, take a 20-second break and focus your eyes on something at least 20 feet away. This will not only reduce eye strain but will also keep you active.
Exercise your eyes frequently: For eye convergence issues at home, do the ‘pencil pushup’ exercise. Hold a pencil directly in front of your eyes, at arm’s length, then follow it with your eyes as you draw it slowly toward your nose. You use your pencil or thumb and move it out 50 to 60 times a day from in to out, out to in, to strengthen your muscles of convergence.
Blink often: Remember to blink while watching television or doing work on any digital device. Blinking moistens the eyes to guard against dryness and irritation. Blinking happens without us having to think too much about it. However, prolonged computer work typically decreases blinking without the worker realizing it.
Use appropriate glasses: There are computer glasses specifically designed to reduce eye strain, headaches, eye fatigue, and eye soreness. Glare is the visual sensation you experience in excessive, uncontrolled brightness. Wear antiglare/antireflective blue blocker glasses regularly if you’re constantly glued to the digital screens. These eyeglasses are able to filter out blue light emitted from digital devices.
Also, don’t forget to regularly clean your computer screen. Dirt and dust buildup can cause some areas of the screen to display more brightly than others, causing your eyes to strain more when looking at it.
Adjust your screen settings: If the current settings of your laptop or desktop are causing eye strain, then adjust the screen brightness, contrast, font size and colour temperature until you find what’s best for you. It’s also important to upgrade your display if possible. The higher the resolution of your new monitor, the better off your eyes will be. Larger displays will result in less strain.
Ensure there is good lighting: Good lighting is essential at the workplace to avoid visual strain. Keep bright lighting overhead to a minimum, use blinds to prevent glare, or get a glare screen. Position the computer screen in such a way that it reduces reflections from windows or overhead lights.
When using a computer or other digital device for long periods of time, the ambient light, or light that’s around you, should be approximately half as bright as what’s normally found in an office environment.
Exercise: Stretch your neck and shoulders frequently. During break time, move your arms and legs. Walk a bit.
Get a comprehensive eye test done: If you’re witnessing recurrent headaches, watery eyes and blurred vision, then it is time for you to get a comprehensive eye examination done.
Look for alternatives: People did communicate with each other before the discovery of social media and other networking apps. So, pick up that phone and dial the person you want to talk to. Host walk and talk meetings instead of using digital devices for the same.
Drink plenty of water: Children don’t pay attention to drinking water unless they’re thirsty. Drinking water keeps the body hydrated. It not only flushes out body waste but also regulates body temperature. Most importantly, it hydrates the eyes, flushes out salt, and reduces eye strain.
Eat more greens: Include green leafy vegetables in your diet to keep your body and eyes healthy. The nutrients present in green vegetables, like lutein and zeaxanthin, carry anti-inflammatory properties and antioxidants that keep the eyes healthy.
Use artificial tears: If your eyes feel irritated or dry, ask your eye doctor about using artificial tears to help combat dry eyes.
Following are some suggested guidelines by various experts on time and curfews.
0-3 years: At this age, the brain is going through ‘the critical period’ due to the prolific growth taking place in the brain. Too much screen time during this age range can leave their still developing brains permanently damaged. If absolutely unavoidable, then for children 18 months to three years old, parents should choose only high-quality media and watch it with their child, engaging and interacting with them. Less than 18 months is a vehement no!
3-5 years: Less than one hour per day of high-quality programming is recommended, with parents watching along.
6-12 years: Two hours. This is where the negotiations begin. More than two hours is still known to cause significant alterations in mood and behaviour.
Over 12 years: Not more than three hours. There is enough data on adolescent difficult behaviour in correlation with screen or gadget use for over three years. Academic grades, sleep, mood and substances have all been found to be correlated with increased screen time.
As we plan the future of education in the age of Covid-19, schools and policymakers must consider children’s vision needs while designing new initiatives. Schools, teachers and parents can work together to incorporate eye health strategies and protect children as they learn online.
Acknowledge the reality. Use the virtual platform but ensure and engage children in healthy physical and social activities, maintaining social distance. Accept that not all screen time is equal. Whenever possible, make the screen time positive. Be clear about the start and end times. Use parental controls. There are technologies that can help you manage screen time. Encourage communication between you and your child.
Large populations are at risk of digital eye strain, especially during the Covid-19 pandemic. Hence, proper digital device usage and appropriate screen time with all precautionary measures are important to avoid this issue. (Dr Tsetim is Senior Consultant Ophthalmologist, RKMH, Itanagar.)