Computer Vision Syndrome: What You Need to Know

Ever noticed tears rolling down freely from the corner of your eyes after staring into your device for too long? How about blurred vision, or burning sensation? These, according to Dr Tan Jin Poi – Eye Surgeon Consultant, Pantai Hospital Penang, are just a few symptoms of computer vision syndrome, also known as digital eye strain/fatigue.

The human body is a miraculous creation, an incredible self-maintaining machine that works non-stop to keep you alive. Every single thing you do and seek pleasure and comfort in – breathing, walking, running, eating, drinking, travelling, listening to music, giving and receiving hugs, family, friends – none of it would be possible without the marvel that is our body and our five senses, adding layers of enriching depth and true meaning to our very existence. Thus it’s our responsibility and, not to mention, privilege to ensure we do everything in our power to protect and care for the body, and that includes our eyes.

Since the introduction of smartphones, our eyes have had to work doubly, triply hard what with social media such as Facebook, Instagram, Tik Tok and YouTube vying for attention, not forgetting losing track of time shopping online. Like it or not, we’ve all become slaves to our devices to some extent. Even tiny tykes take to smartphones like fish to water, as though they’ve had a ton of practice while growing in mama’s belly!

Technology is definitely here to stay, that’s for sure – which is wonderful in that there are countless ways humans have and will continue to benefit from them. However, prolonged use of these life-changing devices (eg smartphones, tablets, desktops, laptops, e-readers) could lead to computer vision syndrome (CVS), also known as digital eye strain/fatigue.

What are the symptoms of computer vision syndrome (CVS)?
One may experience asthenopia, defined as non-specific symptoms such as tired eyes, eye strain, fatigue, pain in or around the eyes, headaches and blurring of vision.

Then there are dry eye symptoms such as tearing, irritated eyes and foreign body sensation in the eyes. Other symptoms include neck and shoulder pain, double vision, difficulty refocusing the eyes, dizziness, as well as reflex symptoms like nausea, twitching of facial muscles and migraine.

These symptoms are usually aggravated by long duration of digital device usage, seated too close to your computer or device screen, poor lighting conditions, glare on digital screen, or direct air exposure to the eye, for example overhead vents and direct air blowing from a fan or an air-conditioning unit.

What causes CVS?
CVS, also known as digital eye strain/fatigue, is caused by prolonged use of digital devices, eg computer, tablet, e-reader and smartphone. Viewing a digital screen is different from reading a printed page. Most of the time the letters on digital devices are not sharply defined, there is also reduced contrast of the letters to the background, while glaring and reflections on the screen may make viewing difficult and uncomfortable.

In addition, when we are engrossed on the screens of these devices, be it during work or leisure, we tend to blink less, about one-third less, which leads to the overexposure of the eyes to the air and causing them to dry out faster. Research has found that around 75 to 90 percent of the population working in front of a screen for three to nine hours daily complain of some ocular discomfort.

Other contributing factors include improper viewing distances, poor sitting posture, unsuitable spectacles and contact lens prescription for specific viewing distances, and prolonged and fixed bending or tilting postures causing muscle spasms or pain in the neck, shoulder or back. If one is unaware of existing and thus uncorrected vision problems (eg farsightedness, astigmatism, presbyopia, reduced eye focusing or eye coordination abilities), this may also lead to eye strain.

Will anti-glare screens prevent CVS?
Glare from light reflecting off walls and reflections on your computer screen can cause eye strain. So yes, it’s a good idea to install an anti-glare screen on your device display, and consider working in an environment with darker colour and matte finish walls. If you wear spectacles, consider lenses with anti-reflective (AR) coating as this can reduce glare.

Is CVS permanent?
No, many of the symptoms related to CVS are temporary, and will improve after a period of rest without any use of digital devices.

How is computer vision syndrome diagnosed?
CVS is diagnosed through a comprehensive eye examination. The patient will be asked about the symptoms experienced, the presence of general health problems, medications taken, or environmental factors that may be contributing to the symptoms related to computer use. Vision and refraction (an eye exam that measures a person’s prescription for eyeglasses or contact lenses) will be checked in order to determine the appropriate lens power needed to overcome any refractive errors such as nearsightedness, farsightedness or astigmatism.

The doctor will test how the eyes focus and how both eyes move together while focusing on seeing conditions. Medicated eye drops might be used to dilate the pupils in order to examine the inner structures of the eyes.

Will ergonomics remedy CVS?
Proper ergonomics can relieve some of the symptoms, however it must involve other kinds of management, such as placing your computer screen 20 to 30 inches (around an arm’s length) from your eyes. The top of the screen should be slightly below horizontal eye level. Most prefer to slightly view the computer with the eyes looking down. Tilt the top of the screen away from you at a 15 to 20-degree angle below eye level. Also, you need to ensure proper body positioning for computer use and a comfortable chair. Chair height should be adjusted so your feet are able to rest flat on the floor. Avoid resting your wrists on the keyboard when typing.

How can we manage CVS?
Adequate rest for the eye and its muscles is recommended to relieve eye strain.

Take frequent breaks and look at distant objects away from the computer screen. These steps allow the muscles in charge of focusing or accommodating (the ciliary muscles) to rest. During these breaks, stand up, move about and stretch your arms, legs, back, neck and shoulders to reduce tension and muscle fatigue.

Remember to consciously blink your eyes every now and then to help replenish the evaporated tear film. Artificial tears (in the form of eye drops) applied three to four times a day can help replenish the tear film when spending long hours in front of a digital screen. Change display settings to adjust the brightness, reduce flickering, select highest resolution, larger display and font size, and contrast.

It’s best to avoid direct airflow from overhead vents or air-conditioner as it can cause dry eye symptoms to worsen. It may be beneficial to consider using air humidifiers.

Follow the 20-20-20 rule, which means every 20 minutes, shift the eye focus on an object 20 feet (six metres) away for 20 seconds.

You should also have your eyes examined regularly so that any eye problems are checked and treated, ensuring even minor vision problems are properly corrected.

Finally, if CVS symptoms persist, consult an optometrist or ophthalmologist right away.

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Dr Tan Jin Poi
Eye Surgeon Consultant,
Pantai Hospital Penang