Mina Massaro-Giordano, MD
A seemingly endless cycle of switching between your phone, computer, and TV has created a sort of digital permanence where a screen is always within reach. Though most of us require this type of access for work, school, and entertainment, constant screen time can have repercussions on your eye health, possibly leading to something called Computer Vision Syndrome.
At Penn Medicine’s Scheie Eye Institute, this is a common conversation topic between ophthalmologists and patients. “I’ve seen a huge amount of patients experiencing symptoms that are attributed to the amount of time they spend on some sort of visual device,” says Mina Massaro-Giordano, MD, a professor of Clinical Ophthalmology and co-director of the Penn Dry Eye & Ocular Surface Center. “If you push your eyes too hard, they’ll fire back.”
A Rise in Screen Time—and Eye Health Challenges
In 2020, Americans in their early twenties used their phones an average of 28.5 hours per week—an increase from 25.9 hours per week in 2018. Massaro-Giordano points to the COVID-19 pandemic as a contributing factor to the rise in screen time—when most of the world had to shift to remote work and education. She also attributes increased access to digital devices to this rise in screen use, particularly among younger people. “Twenty years ago, we didn’t have all these devices,” she says. “There is so much more available to us now.”
Massaro-Giordano often sees patients reporting signs of Computer, or Digital, Vision Syndrome, also known as trigeminal dysphoria—a condition that describes a range of symptoms such as burning, irritation, dryness, and fatigue of the eye after prolonged computer use.
Some of these symptoms can be caused by the lack of blinking while staring at a screen. “Normally, you should blink at least 20 times every minute,” she says. “But when looking at a computer screen, and focused on your work, you tend to blink one-third of the time less than you normally would, which creates that dryness and can lead to more problems.”
Ergonomics and your environment can also play a role in eye strain. The eyes may have to work harder if there are external factors affecting vision, such as having to hunch over to be closer to a device, squinting to see through a glare from the light hitting a screen, or if there is a fan or wind blowing into the eyes. “Environment is critical,” says Massaro-Giordano. “Trying to push through what’s causing discomfort is just going to create more harm. You must be cognizant of your surroundings and what you’re exposing your eyes to.”
In severe cases, one may experience an accommodative spasm—when the eyes are fixed in a state of focus and unable to relax. “It’s like a charley horse of the eye muscle. It creates a lot of pain,” she says.
The good news: There is no evidence that this will lead to permanent damage. However, Massaro-Giordano encourages practicing proper eye hygiene to avoid this pain and discomfort in your life.
Solutions to Eye Strain
Massaro-Giordano offers a simple solution: Take a break. Just as your muscles need to rest after an intense workout, your eyes need to relax after prolonged computer use, she says.
While working on your computer, she encourages the 20-20-20 rule: taking a break every 20 minutes, and having your eyes focus on another object 20 feet away for 20 seconds. Eye exercises, such as pencil push-ups—forcing your eyes to focus on a point, like a pencil, and bringing that point closer and closer to the nose until the eyes are relaxed on the point—can also serve as a break and help avoid a fixed state of focus on a screen.
If experiencing constant eye strain, Massaro-Giordano recommends scheduling an appointment with an ophthalmologist for a full eye exam. At the Scheie Eye Institute, ophthalmologists offer treatment for signs of Computer Vision Syndrome, determining if a patient is in need of a prescription or specialized lenses to alleviate eye tension.
“Patients may think they have 20/20 vision,” she says, “but for many patients, their eyes may be working very hard to get to that 20/20, which can cause strain.”
Even if a patient has 20/20 vision, or already has their correct eye prescription, eye strain can be caused by ocular misalignment—when the eyes may not work in unison, focusing at different times, which can sometimes produce double vision.
“It’s like going to a 3-D movie without the glasses,” says Massaro-Giordano. “Your eyes are fighting to figure out how to get something into focus.”
For cases like this, Massaro-Giordano prescribes prism glasses—specialized lenses that alter the way light enters both eyes to produce a single, clear image.
In addition, Massaro-Giordano will walk through recommended techniques for screen use, calling attention to her patients’ workspaces. Poor posture at a desk results in poor eye placement on a computer screen, she says. When using a computer, an individual should have their back straight against a chair, shoulders relaxed, with feet planted on the ground. They should be sitting 25 to 30 inches away from a computer with the screen placed 3 to 4 inches below eye level.
Preparing Your Eyes for the Future of Screens
Using your eyes in a digital world is only going to become more complicated as new technology is developed, says Massaro-Giordano. Virtual reality (VR) headsets, for example, could create too much visual stimulation and lead to eye fatigue, as the VR screen encompasses your entire field of vision. For those with glasses, like any other device, the VR headset could cause eye strain if not used with the correct prescription. It could also force your eyes to work harder to see the VR surroundings if the headset is not placed comfortably over your glasses.
“Now, more than ever, it’s important to practice good eye hygiene,” says Massaro-Giordano. “Having annual appointments, getting the right prescription, and making simple adjustments to your workspace can help protect your eyes and change your quality of life.”
Scheie Eye Institute Director and Chair of Ophthalmology at Penn, Bennie H. Jeng, MD, recently shared more tips on how to take good care of your eyes. Read more on Today.com.