Technology has evolved to give us the world at our fingertips. The possibilities are endless with mini-computers in our pockets. But with younger and younger populations getting their hands on smartphones, tablets, computers, and more for both school and entertainment, what kind of consequences can be expected? Some eye care practices have noticed these younger demographics coming in with symptoms of digital eye strain, occasional dry eye, and nearsightedness.

A Change in Lifestyle

Over the years, the amount of time spent on digital devices has grown immensely. The time spent with these media tools has increased by nearly 85% from 1999 to 2009. In recent years, that time has increased another 82% - spending about 9 hours a day staring at screens. “[Symptoms of occasional dry eye and digital eye strain are] becoming a widespread problem as more people spend hours each day looking at computers, cell phones, iPads, tablets, and other electronic devices,” says Sarah Hinkley, spokeswoman for the American Optometric Association. But can technology be to blame for the increase in symptom sufferers? Several studies and surveys have found that increased digital device use was associated with headaches, eye strain, dryness, and eye fatigue. Another independent survey found that 92% of US adults and 70% of children experience vision-related screen time symptoms, even after only 2 hours of device use.

How Technology Affects Young Patients' Health

Increased device use affects the eyes in more ways than occasional dryness. Tanya Goodin, founder of digital detox specialists, Time to Log Off, says, "We've known for a while that overuse of screens is affecting eyesight through a range of symptoms categorized as 'digital eye strain'." Blue light often accompanies the digital eye strain conversation, along with ways to protect against excess exposure like screen filters and eye health nutraceuticals. But device overuse has recently been linked to an increase in nearsightedness, though more research is needed to prove the correlation. Beyond the impact on eye health, some are becoming concerned with the physical development of children, saying that excessive computer use may stunt progression in motor skills and coordination. While this concern requires more evidence, certain cognitive effects have been consistently linked with too much screen time, including:

• Depression
• Anxiety
• Boredom
• Loss of imagination
• Shorter attention spans (easily distracted from other important tasks like schoolwork, chores, etc.)

What Causes Screen Time Eye Symptoms?

Several aspects are thought to cause the eye discomfort surrounding digital screens:

1. Proximity to the eyes – most screens sit fairly close to our faces, making it a more exaggerated movement to scan the whole screen.
2. Blue light – this short wavelength of light scatters easier than any other wavelengths, making it more difficult for our eyes to focus on.
3. Incomplete blinking – A 2013 study found that the quality of blinks effects tear film stability more than the number of blinks.

What Can You Do?

Maria Pribis, OD, expresses her concern for future patients. “In my opinion, if smartphone overuse in young people isn’t contained somehow, we may be faced with a future [occasional] dry eye epidemic to go along with myopia.” Beyond nearsightedness and dryness, tired eyes and eye strain can cause a host of other concerns for parents and patients alike. While young patients may be fairly complaint-free, screen time usage is unlikely to change, and the long-term implications of holding an artificial light source so close to young, underdeveloped eyes necessitates education and action. There are a few things you can suggest to your patients to help them relieve their symptoms.

1. Encourage Regular Eye Exams

This is an obvious solution. Regular eye exams have a better chance of detecting changes in a patient’s eye health before it becomes a glaring problem. Most of the time, younger patients assume that their vision is “normal,” so routine checkups can help indicate if further action should be taken.

2. Identify At-Risk Patients

Look for:

• Complaints of burning, irritation, blurry vision, etc.
• Amount of time on digital devices (computers, smartphones, tablets, etc.)
• Make-up applied inside the lash margin (foundation, eyeliner, mascara, etc.)
• Medications that could contribute to discomfort

3. Relay These Helpful Tips

1. Limit screen time an hour before bed.
2. Limit single screen sessions to two hours.
3. Set up an optimal work environment (little to no glare on the screen, screen is about 15 degrees below eye level, surrounding lighting is the appropriate brightness, etc.)
4. Take frequent breaks and change postures, activities, etc.
5. Use the 20-20-20 rule (every 20 minutes, look at something 20 feet away for 20 seconds.)

4. Offer Nutritional Protection

EyePromise ^® now offers a chewable eye health nutraceutical for children ages 4-17 to help protect their eyes from the ill effects of screen time. Developed by a group of MDs and ODs, EyePromise Screen Shield™ Teen is formulated with all-natural zeaxanthin and lutein to help protect young eyes whose macular pigment is not fully formed. Most children don't get the vegetable servings they need daily. In fact, the National Health and Nutrition Examination Survey (NHANES) reported that only 10.7% of U.S. children between the ages of 6–11 ate dark green vegetables in a given day in 2009–2010, resulting in an average intake of zeaxanthin and lutein that was three times lower than adults. With these carotenoids being important nutrients for brain development, this simple, one-a-day formula is a great way to help support children's eye and overall health. Continued education and firm instructions will help patients understand their eye health and be more compliant with recommendations. For many patients, supplementation is a simple, noninvasive addition to their routines that can give them natural protection. Learn more about Screen Shield Teen.  

Sources:

1. Ani. “Children Glued to Smartphones Show Symptoms of Dry-Eye Disease.” http://www.deccanchronicle.com/, Deccan Chronicle, 8 Jan. 2017, www.deccanchronicle.com/lifestyle/health-and-wellbeing/080117/children-glued-to-smartphones-show-symptoms-of-dry-eye-disease.html.
2. Hauser, Whitney. “Dry Eye: A Young Person's Disease?” Review of Optometry, Jobson Medical Information LLC, 15 Feb. 2017, www.reviewofoptometry.com/article/dry-eye-a-young-persons-disease.
3. Heiting, Gary, and Larry K. Wan. “Children, Computer Vision Syndrome, Digital Eye Strain.” All About Vision, AAV Media, LLC., Aug. 2017, www.allaboutvision.com/cvs/children-computer-vision-syndrome.htm.
4. Hellmich, Nanci. “Digital Device Use Leads to Eye Strain, Even in Kids.” USA Today, Gannett Satellite Information Network, 25 Jan. 2014, www.usatoday.com/story/news/nation/2014/01/25/digital-eye-strain/4491611/.
5. Pribis, Maria. “Smartphone Overuse & Eye Health Risks in Teenagers.” Review of Optometry, Jobson Medical Information LLC, 15 Feb. 2017, www.reviewofoptometry.com/wo/editorial/article/smartphone-overuse-and-eye-health-risks-in-teenagers/.
6. Saint, Sarah E et al. “The Macular Carotenoids are Associated with Cognitive Function in Preadolescent Children.” Nutrients vol. 10,2 193. 10 Feb. 2018, doi:10.3390/nu10020193
7. Stringham, James M et al. “Macular Carotenoid Supplementation Improves Visual Performance, Sleep Quality, and Adverse Physical Symptoms in Those with High Screen Time Exposure.” Foods (Basel, Switzerland) vol. 6,7 47. 29 Jun. 2017, doi:10.3390/foods6070047
8. Renzi-Hammond, Lisa M et al. “Effects of a Lutein and Zeaxanthin Intervention on Cognitive Function: A Randomized, Double-Masked, Placebo-Controlled Trial of Younger Healthy Adults.” Nutrients vol. 9,11 1246. 14 Nov. 2017, doi:10.3390/nu9111246