Ocular and visual discomfort associated with smartphones, tablets and computers: what we do and do not know

Abstract

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.

Prevalence of dry eye in college students at Uparwara community in Raipur

“…3 Prolonged usage of handheld digital devices, like smart phones, computers, may adversely impact tear stability and this can lead do adverse complications such as dry eye. 5 Literature from Asian countries like Japan studies reported that nearly (18.6%) of the females and (30%) of the males reported dry eyes following computer use. In contrast, to observed symptoms of dry eyes in (10.1%) of male and (21.5%) of female Japanese workers using VDTs at office work.…”

The Impact of Internet and Videogaming Addiction on Adolescent Vision: A Review of the Literature

“…The issues that were reported were related either to with prolonged nearterm adaptation (i.e., blurred vision at close range, difficulty in focusing, and copious headache after screen use) and those related to dry eye syndrome (irritation/burning sensation, ocular fatigue, discomfort, photosensitivity), while symptoms due to poor posture and prolonged physical immobilization in front of the screen (such as neck pain, tension headache, and other atypical musculoskeletal pain) are also very common. Preexisting vision problems (hyperopia / myopia, astigmatism, and adaptive disorders) can contribute to the appearance of the syndrome if they are not adequately addressed or have not yet been diagnosed (9,10).…”

The pitfalls of the traditional office ergonomics model in the current mobile work environment: Is visual ergonomics health literacy the remedy?

“…There is very little literature reporting the effect of digital device use on the vision and ocular health of children and teenagers [39], despite reports that children as young as 2 years use digital devices [40]. Associations have been reported between smartphone/computer use and dry eye in children [41] (see section 2.7 below).…”

“…There also appears to be an association with hours of smartphone / computer use and dry eye in children [41] but this work only reports total hours use per day, not continuous use. The impact of intermittent device use and multiple device use on visual comfort and ocular health and the maximum recommended use time requires further investigation [21,39].…”