Digital eye strain: prevalence, measurement and amelioration

Digital device usage has increased substantially in recent years across all age groups, so that extensive daily use for both social and professional purposes is now normal. Digital eye strain (DES), also known as computer vision syndrome, encompasses a range of ocular and visual symptoms, and estimates suggest its prevalence may be 50% or more among computer users. Symptoms fall into two main categories: those linked to accommodative or binocular vision stress, and external symptoms linked to dry eye. Although symptoms are typically transient, they may be frequent and persistent, and have an economic impact when vocational computer users are affected. DES may be identified and measured using one of several available questionnaires, or objective evaluations of parameters such as critical flicker-fusion frequency, blink rate and completeness, accommodative function and pupil characteristics may be used to provide indices of visual fatigue. Correlations between objective and subjective measures are not always apparent. A range of management approaches exist for DES including correction of refractive error and/or presbyopia, management of dry eye, incorporating regular screen breaks and consideration of vergence and accommodative problems. Recently, several authors have explored the putative role of blue light-filtering spectacle lenses on treating DES, with mixed results. Given the high prevalence of DES and near-universal use of digital devices, it is essential that eye care practitioners are able to provide advice and management options based on quality research evidence.