posted on Sep 02, 2019

and how to be smart about it

Digital Eye Distress

by Arash Razavi

Most probably you have already heard a thing or two about Computer Vision Syndrome (CVS). Or, if you haven’t experienced some random eye aches or blurred vision yourself, you will probably find a colleague or friend who is dealing with these symptoms.

Generally speaking, CVS is associated with the use of digital screens like desktops, laptops, graphic tablets, and smartphones. A more recent term for CVS is ‘Digital Eye Strain (DES)’. It is more comprehensive since we usually fail to regard portable devices such as smartphones and tablets as computers [1].

In fact, DES is the leading occupational hazard of the 21st century and its symptoms affect nearly 70 per cent of all computer users (based on overall self-reported symptom prevalence), both vocational and avocational [2]. It should not appear as a surprise that digital artists are no exception. DES symptoms reported by the users are [2-4]:

  • external ocular symptoms: dryness, irritation and burning
  • internal ocular symptoms: strain and ache
  • visual symptoms: blurred and double vision
  • musculoskeletal symptoms: neck and shoulder pain (topic for another article)

While symptoms are usually transient, the condition can cause significant discomfort on a regular basis. The substantial consequences of this are reduced productivity at work, increased error rate, reduced job satisfaction, and impaired visual abilities [3, 6], among which the reduced productivity is a clamouring consequence for creative professionals. The problem is that in many cases of DES manifestation, the users have to restrict their daily screen exposure, meaning less time on a graphic tablet per day.

So a question might be to ask what the contributing factors to DES are. In fact, a combination of individual and environmental factors is at play. For instance, individuals with preexisting conditions (correction spectacle/lenses) are more susceptible to experience the symptoms [3]; but then when they use screens with amped-up brightness in an environment with poor lighting, the strain increases significantly.

Another major contributing factor of DES is the daily exposure time [5]. According to recent studies, two-third of the adults spend more than five hours per day in front of computer devices (including smartphones and graphic tablets). These reports demonstrate a direct relationship between screen exposure time and the intensity and/or symptoms count(s) among the users [7]. The surveys have shown that most of these users also fail to take frequent breaks from staring at screens. That is the classic case of strain: injury caused by continuous stress and pressure. Therefore continuous exposure with no rest time promotes the symptoms viciously. With this concern, have you ever heard of the 20-20 rule?

The next contributing factor is the blue light emitted from digital screens (again all devices included). Although the light from a screen might appear as white, the wavelength of peak emission from today modern screens is in the blue light range [8]. Many recent studies have reported the hazardous effects of this wavelength range (400 to 490 nm) to both the cornea and the retina. The damage is caused by induced phototoxicity and oxidative stress [10-13]. Obviously, when coupled with long screen time, the hazards are more at play. Nevertheless, the blue light emission is still a threat to the eye compartments even during shorter screen exposure time [9].

So far, this article has been focused on ‘bad news.’ Indeed, DES can influence one’s artistic productivity in malicious manners, but the ‘good news’ is that it may be possible to keep the hazards at bay if we are willing to put a conscious effort into it. Here are some friendly suggestions to effectively prevent/reduce the syndrome:

  • 20-20 rule: it is strongly suggested for every 20 minutes spent on screen, one should take a minimum 20-second break to venture behind the screen a bit, looking at an object in the distance, outside of the window into the neighbours’ yard, or a drifting cloud perhaps. Avoid rubbing your eyes and blink frequently. You may want to put an alarm as a reminder every 20-30 minutes. There are even some apps and chrome extensions for that like Protect Your Vision and eyeCare. The importance of this simple yet effective action cannot be emphasized enough.
  • Let your personal distance from the screens be respected: 25 inches/64 cm (an arm’s length away) and look slightly downward at the screen.
  • In the case of dry eyes, artificial tears can help. If it happens often then definitely visit a specialist. Also, if possible try to avoid dry places to work in. If there is no way out, then consider using a humidifier with noise-cancelling headphones if you are noise-sensitive.
  • Avoid contrast at all costs! (Well, this might be the only place to tell this an artist). The screen should not be much lighter than the environment. It is helpful to get used to working on low brightness while doing some admin or surfing mindlessly.

  • To reduce the blue light exposure dose, turn on the Night Shift (iOS, macOS) or Night Light (Windows) option:
  • 24/7 for smartphones, that means even during the daylight
  • during admin time, billing clients, writing emails and motivation letters
  • when working behind a graphic tablet, especially when the colour fidelity is not an issue, for example when you are sculpting or doing B/W sketches…
  • Also, the blue light-filtering spectacles/lenses are expected to reduce phototoxicity up to 20% without degrading visual performance [8]. However, there is a lack of long-term and unsponsored study up to this point to the knowledge of the author. Until there is an update on that front, it is suggested to consider it only as a supplementary aid for eye protection.

In a recent observational study, clinical researchers noted that most of the users—especially the younger generation—were aware of DES and its complications, but they also found that there was a gap in practice [5]. Well, it is up to us to fill the gap between knowledge and practice. DES might only reduce the quality of life for avocational users, but unfortunately, it can also be damaging to the career of vocational artists.

If we are smart about it, though, each small effort will count. At the end of the day, it is the accumulative effect of small precautionary actions that reduces the hazards of DES in the long run. To bring the message home, let’s consider the eyes as an asset—an essential one. The same old rule applies: with a conscious effort, they need to be taken care of.

Illustration by Arash Razavi


1- Computer vision syndrome (a.k.a. digital eye strain). Optometry in Practice 2016 Volume 17 Issue 1 1 – 10. Mark Rosenfield

2- A clinical study on” computer vision syndrome” and its management with Triphala eye drops and Saptamrita Lauha. Gangamma M, Rajagopala M. AYU. 2010;31(2):236.

3- Computer vision syndrome, BMC Research Notes. among computer office workers in a developing country: an evaluation of prevalence and risk factors. P. Ranasinghe1* , W. S. Wathurapatha1, Y. S. Perera2, D. A. Lamabadusuriya2, S. Kulatunga2, N. Jayawardana2 and P. Katulanda3

4- Computer vision syndrome: A review Work. 2015;52(2):303-14. Gowrisankaran S, Sheedy JE.

5- Knowledge, awareness and practice of CVS in digital device users. Shweta Chauhan, Renu Dhasmana, Anuradha Raj

6- Computer vision syndrome. Wimalasundera S.. Galle Medical Journal. 2006;11(1):25–29

7- Computer Vision Syndrome and Associated Factors among Computer Users in Debre Tabor Town, Northwest Ethiopia. J Environ Public Health. 2018; Awrajaw Dessie, 1 Fentahun Adane, 2 Ansha Nega, 3 Sintayehu Daba Wami, 1 and Daniel Haile Chercos 1

8- Digital eye strain: prevalence, measurement and amelioration. Sheppard AL1, Wolffsohn JS1. BMJ Open Ophthalmol. 2018 Apr 16;3(1):e000146. Visual Fatigue Induced by Viewing a Tablet Computer with a High-resolution Display. Kim DJ1, Lim CY2, Gu N3, Park CY4. Korean J Ophthalmol. 2017 Oct;31(5):388-393.

9-Visual Fatigue Induced by Viewing a Tablet Computer with a High- resolution Display. Korean J Ophthalmol 2017;31(5):388-393. Dong Ju Kim1, Chi-Yeon Lim2, Namyi Gu3, Choul Yong  Park1

10- Effects of blue light on the circadian system and eye physiology. Tosini G, Ferguson I, Tsubota K. Mol Vis 2016;22: 61-72.

11- Blue light-induced oxidative stress in human corneal epithelial cells: protective ef- fects of ethanol extracts of various medicinal plant mix- tures. Lee JB, Kim SH, Lee SC, et al. Invest Ophthalmol Vis Sci 2014;55:4119-27.

12- Blue light injures corneal epithelial cells in the mitotic phase in vitro. Niwano Y, Kanno T, Iwasawa A, et al. Br J Ophthalmol 2014;98:990-2.


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Gilbert Jonathan (Sep 06, 2019)

Very Helpful :)