Smartphone and tablet use in Australia and worldwide is reaching saturation levels and associated visual and ocular discomfort such as headaches, eyestrain, dry eyes and sore eyes are widespread. This review synthesises the available literature and considers these symptoms in the context of a binocular vision and/or ocular surface aetiology. Eye discomfort with smartphones and tablets is discussed alongside similar symptoms reported with desktop computer use. Handheld devices differ from computers in viewing position and distance, screen size and luminance, and patterns of use. Accommodation is altered with handheld device use, with increased lag and decreased amplitude. Smartphone and tablet use results in reduced fusional convergence and possibly a receded near point of convergence. This is similar to what happens with computer use. Findings related to blink rate with smartphone and tablet use are contradictory, perhaps due to the influence of task difficulty, and there is limited evidence related to blink amplitude. Reduced blink rate and amplitude are consistently reported with computer use. Use of handheld digital devices, like computers, may adversely impact tear stability. There is insufficient evidence to support the impact of handheld devices on tear volume, although this is reduced with computer use. The available literature does not conclusively link eye and visual discomfort symptoms reported with handheld digital devices, with changes in binocular vision, blinking or ocular surface. However, there is a gap in our understanding of symptoms which occur with smartphone and tablet use in the context of how these devices are used. In addition, studies are required in high users such as teenagers, and in patients with dry eye or accommodative/ binocular vision anomalies, all of whom may have a higher risk of symptoms. A better understanding of symptom aetiology can guide clinical advice to minimise adverse impacts on visual and ocular surface health and discomfort.

Viewing distances are closer and eyestrain symptoms are greater after reading from a smartphone for 60 minutes. The viewing distances measured were closer than those previously reported in the literature.

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This is a two-part survey of current literature concerning strabismic amblyopia. The aim of this review is to bring the optometric practitioner up to date on the status of scientific research into strabismic amblyopia. Part 1 in this series discusses research into strabismic amblyopia from the viewpoint of psychophysical experiments that investigate both spatial and temporal behavioural deficits accompanying strabismic amblyopia. These include deficits in contrast sensitivity, spatial localisation, fixation, ocular motility, accommodation, crowding, attention, motion perception and temporal processing. Part 2 will evaluate neural processing in regard to strabismic amblyopia. It will discuss current understanding of aspects of central processing of visual information and theories regarding neural sites and mechanisms involved in amblyopia.