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Refer this article as: Adamopoulos, D. et al., Digital Eye Strain in the USA: overview by The Vision Council, Points de Vue, International Review of Ophthalmic Optics, N72, Autumn 2015

Digital Eye Strain in the USA: overview by The Vision Council*

Date of publication :
09/2015

With its annual survey, Hindsight is 20/20/20: Protect Your Eyes from Digital Devices [1], The Vision Council monitors usage trends related to digital displays and their impact, as regards both eye strain and exposure to blue light. The report’s 2015 edition highlights the growing pervasiveness of digital displays in the United States and the stakes in raising awareness of the actors involved in the visual health sector like the general public.

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* The Vision Council Serving as the global voice for vision care products and services, The Vision Council represents the manufacturers and suppliers of the optical industry. The Council positions its members to be successful in a competitive marketplace through education, advocacy, consumer outreach, strategic relationship building and industry forums.

“ From the moment people get up until the time they go to bed again – including when they are eating, exercising and reading – they are using one digital device after another and thus exposing themselves to risks related to prolonged exposure to light emitted by screens ” M. Daley

Digital eye strain is more than a reality; it is a public health priority in the United States. This is the warning published by The Vision Council*, which has just released its latest survey on this issue: Hindsight is 20/20/20: Protect Your Eyes from Digital Devices [1]. The document is based on an analysis of 9,749 questionnaires completed by a representative sample of adult U.S. residents. Its aim is to determine the broad outlines of behavioral changes with respect to digital displays, be they smartphones, tablets, computers, laptops or other electronic devices, such as game consoles. This state of play confirms the trend that has emerged in recent years: “From the moment people get up until the time they go to bed again – including when they are eating, exercising and reading – they are using one digital device after another and thus exposing themselves to risks related to prolonged exposure to light emitted by screens,” sums up Mike Daley, chief executive officer of the Vision Council. In concrete terms, more than 95% of American adults spend at least two hours a day in front of a screen and almost three out of ten spend over nine hours. Even though people working on computers are the most concerned by a potential “overdose”, the study stresses that one child out of four is exposed to screens over three hours a day. These constantly increasing figures can be explained by both new societal patterns (i.e. a decrease in physical activity, an increase in passive consumption and paperless contacts, etc.) and options made possible through innovation. “Digital technologies offer ever increasing options and opportunities to simplify consumers’ daily lives. This growing trend is not likely to be reversed any time soon. Nor are the related ophthalmic problems,” Daley predicts.

Screens as a source of eye strain

“ A questionnaire handed out prior to a consultation can help to clarify at what distance each screen is being used, how the office is organized, the most common postural positions assumed and so on, and this information can then serve as a basis for discussing problems and possible solutions ” E. Hildreth

The main effect of prolonged exposure (greater than two hours per day) to light emitted by screens is digital eye strain. Described as a passing discomfort, it manifests itself in different forms with symptoms such as red, dry or irritated eyes, blurred vision, pain in the neck, shoulders or back, headache, etc. “We blink 18 times a minute on average. However, staring at a screen for an extended period can result in less frequent blinking that could dry or even irritate the eyes [2], Erin Hildreth reminds us. The Vision Council’s marketing and communication manager relates that a recent study [3] concluded that employees working all day on a computer could present physiological changes of the lacrimal system similar to those found in dry eye syndrome. “This is not surprising when one considers that the work environment is often characterized by multiple or split screens, small fonts, poor posture and LED or fluorescent lighting.”

activities associated with digital device

The blue light paradox

In addition to eye strain, overexposure to digital displays is linked to the issue of blue light. Eye doctor and medical advisor to the Vision Council, Dora Adamopoulos, recalls that “a great deal of research is currently underway to determine its precise impact on the eyes and vision. One thing is certain: the blue-violet spectrum (415-455 nm) is particularly harmful [4]. It penetrates deeply and causes photochemical reactions likely to damage retinal cells, with a cumulative effect. The retina cannot be replaced; its alteration therefore leaves the eye vulnerable to harmful light and environmental factors, thereby increasing the risk of early development of ophthalmic disorders, such as AMD.” However, blue light is not an enemy that must be fought at all costs. The blue-turquoise spectrum participates in the regulation of natural circadian rhythms (i.e. sleep-wake cycles) among other things, and stimulates the pupillary reflex and such cognitive functions as alertness, memory and emotion regulation. “Blue light is both unavoidable and indispensable. So it is important to understand its repercussions on the organism and vision, and be familiar with the tools and recommendations for minimizing exposure, particularly from digital displays,” the expert advises.

Digital Eye Strain in the USA
Digital Eye Strain in the USA
Source : 2014 Vision Watch data

Digital childhood and myopia

Prevention and protection are equally important for both adults and young people, who now use computers and smartphones in all aspects of their schooling and social life. The latest Digital Eye Strain report points to intensive screen use and a lack of data on the medium-term consequences. “The phenomenon is recent, so it is impossible to foresee the impact of emitted light on children’s eyes. But in our opinion, myopia is one the main risks that must be evaluated,” Erin Hildreth hypothesized. “The causes of myopia are related to a combination of genetic and environmental factors, and since the pervasiveness of digital devices stimulates ocular accommodation at very close reading distance, this could well be part of the problem.” The Vision Council therefore calls for vigilance and a complete eye exam every year to ensure the best possible development of children's eyes. “A professional can evaluate symptoms or visual disorders resulting from the use of digital devices and suggest solutions and make recommendations,” she affirms. However, this approach comes up against one of the main findings of the study: the majority of parents are not worried about the effect of the digital environment on their offspring. 15% of respondents place no limits on the amount of time spent in front of screens, and 30% are not concerned about the potentially harmful impact of digital devices on the development of the visual system.

Think and act “awareness”

“ We have a duty to explain to consumers that they do not have to live with discomfort or pain while using digital devices. Custom glasses, with or without corrective lenses, can alleviate or prevent short-term symptoms and protect against long-term damage. ” D. Adamopoulos

This finding of disregard for risk highlights one of the major challenges of the Vision Council’s action: public awareness. Its CEO confirmed this focus: “For us, education is the key. The transmission of information about the nature of digital eye strain, including risks related to exposure to digital displays and especially how to fight them, should be a major focus for mobilizing our sector.” To optimally publicize the issue, The Vision Council is diversifying its strategy and seeking to strengthen its communication in schools and during ‘key’ events: film releases, TV marathon broadcasts, new technology launches, or international trade fairs, including the celebrated CES (Consumer Electronics Showcase), an unmissable event for new technology fans. This is a good way to reach a large number of users and instill in them a desire to safeguard their eye health. And to facilitate the assimilation of prevention, the organization is relying on its flagship slogan: “20-20-20”. Every 20 minutes, look 20 feet in front of you (approximately 6 meters) for 20 seconds. This rule is easy for both adults and children to remember and use. “The Think About Your Eyes campaign (http://www.thinkaboutyoureyes.com/) is also a great way to inform people about the benefits of an annual ophthalmic examination,” adds Daley, who sees in consumers’ appetite for connected information an excellent opportunity to use these media, including websites and social networks, and connect with other industry players about the importance of eye health in the digital environment.

Vision professionals and new preventive measures

Eye care professionals have a big responsibility – and a good opportunity – to lead the fight against the deleterious effects of digital displays. In addition to the development of new health and technical solutions, Erin Hildreth encourages “ophthalmologists, optometrists and opticians to adopt simple and pragmatic measures to help their patients in their everyday activities.” Some ideas and recommendations include: promoting continuing education and keeping abreast of the latest findings in this area; taking an interest in public opinion and consumer perceptions; taking charge of consultations by systematically interviewing patients about their use of digital devices and finding out not only what type of devices are being used, but also how they are used and for how long. “A questionnaire handed out prior to a consultation can help to clarify at what distance each screen is being used, how the office is organized, the most common postural positions assumed and so on, and this information can then serve as a basis for discussing problems and possible solutions,” she suggested. This should be accompanied by some key preventive recommendations.

The importance of prevention

Advances in ophthalmic optics have already made possible a wide range of options for lenses capable of reducing glare and filtering out blue light. These two indispensable options to optimize visual comfort while using digital displays should encourage opticians to add them to prescriptions to more closely meet their clients’ needs. “Many manufacturers also offer multifocal lenses for people who need to relieve eye strain and correct both near and far vision,” Dora Adamopoulos added. The medical advisor feels that “the optical/ophthalmic industry must continue to engage in research and development for new products, but also educate the community of vision care professionals and the general public. We have a duty to explain to consumers that they do not have to live with discomfort or pain while using digital devices. Custom glasses, with or without corrective lenses, can alleviate or prevent short-term symptoms and protect against long-term damage.It is more important than ever to disseminate this message, inasmuch as scientific advances are increasingly confirming the link between digital displays, eye strain, age-related eye diseases and the importance of prevention and protection. “The new digital era is more stressful on our eyes and we must all adapt accordingly, professionals and users alike. The optical/ophthalmic industry has already identified the major issues raised by digital devices and during the last several years, we have witnessed a boom in innovation capable of reducing disorders related to the light emitted by screens. These products and technologies do much more than protect our eyes: they improve the quality and precision of our vision,” Mike Daley concluded.

time spent in front of digital devices
Source: The Vision Council reports on digital eye strain, 2012 & 2013

Some key figures

  • In 2015, 69% of American adults use a smartphone and 42.5% a tablet or e-book reader on a daily basis, versus 45% and 26% respectively in 2012.
  • 60.8% spend more than five hours a day in front of a screen. • 31.9% do not make any effort to reduce symptoms of digital eye strain.
  • 72.5% are not aware of the potential damage caused by overexposure to blue light and do not know that digital displays emit blue light.
  • 22% of parents say that they are concerned by the impact of digital device use on their children’s vision.
  • 30.6% of the same parents allow children to use digital devices for over three hours daily despite their concern.

Key Takeaways

• Americans (both adults and children) are spending more and more time in front of digital displays on all types of devices.
• Disorders and risks related to light-emitting screens (i.e. eye strain and retinal pathologies) are either unrecognized or underestimated by the general public, the majority of whom neglect prevention and protection.
• Simple solutions exist to fight against digital eye strain and overexposure to blue light.
• The Vision Council recommends following the 20-20- 20 rule (every 20 minutes, take a 20 second break while looking 20 feet away) and using ophthalmic lenses designed for screen use.
• Vision care professionals all have a role to play in terms of advocacy, awareness-raising and counseling.

References

01. Hindsight is 20/20/20: Protect Your Eyes from Digital Devices, The Vision Council, USA
02. Optometry and Vision Science. “Effect of Visual Display Unit Use on Blink Rate and Tear Stability.” November 1991.
03. JAMA Ophthalmology. “Alteration of Tear Mucin 5AC in Office Workers Using Visual Display Terminals.” June 2014.
04. Arnault, E., Barrau, C. et al. Phototoxic action spectrum on a retinal pigment epithelium model of Age-related Macular Degeneration exposed to sunlight normalized conditions. PlosOne, 2013; http://journals.plos.org/plosone/article?id=10.1371/journal.p
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Refer this article as: Adamopoulos, D. et al., Digital Eye Strain in the USA: overview by The Vision Council, Points de Vue, International Review of Ophthalmic Optics, N72, Autumn 2015

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