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Eye strain

Eye strain

Also known as Asthenopia, Eye fatigue, Ocular fatigue, Computer Vision Syndrome, Digital Eye Strain

Overview

Eye strain is a common condition, especially in today's digital age. It is mainly characterized by discomfort, red, watery eyes, and blurred vision as if looking through a fogged-up window. 

It is a common issue that can affect anyone. Spending extended periods in front of screens puts you at risk. Other contributing factors, such as poor lighting, improper viewing distances, and insufficient blinking, also exacerbate symptoms.

Amidst COVID-19, a significant rise in digital eye strain cases was witnessed. The widespread adoption of online education and remote work has underscored the importance of proper screen practices, making it more relevant than ever.

Taking regular breaks, adjusting screen settings, and maintaining proper posture can help prevent eye strain. Individuals with persistent eye strain may require prescription glasses or other interventions to manage the discomfort effectively.

Key Facts

Usually seen in
  • All age groups
Gender affected
  • Both men and women but more common in women
Body part(s) involved
  • Eyes
Prevalence
  • India: 45.5% (2023)
Necessary health tests/imaging
  • Patient history
  • Visual acuity measurements
  • Refraction test
  • Eye muscle testing
  • Binocular vision testing
  • Slit-lamp examination
  • Testing under normal seeing conditions
  • Optional use of eye drops
Treatment
  • Corrective lenses
  • Ergonomic adjustments
  • Use of blue light filters
  • Computer-specific eyeglasses
  • Prescription glasses adjustments
  • Address underlying medical issues
  • Vision therapy
Specialists to consult
  • General physician
  • Ophthalmologist
  • Optometrist

Symptoms Of Eye strain 


It can occur when your eyes become tired from intense use or extended periods of focused activity, such as staring at a computer screen or reading for a long time. Symptoms of eye strain may include:

  • Redness and irritation in the eyes 
  • Watery or dry eyes
  • Tired, aching, or heavy eyelids.
  • Grittiness in the eyes
  • Sensitivity to light (photophobia)
  • Headache
  • Pain or strain in the back, neck, or shoulder
  • Double or blurred vision
  • Difficulty in focusing
  • The inability to keep eyes open

 

If symptoms persist or worsen, consulting with an eye care professional is advisable for a proper diagnosis and guidance on managing eye strain.

Causes Of Eye strain


One of the most common causes of eye strain is a computer and digital screen use. Eye strain results from a complex interplay of factors involving the eyes, surrounding muscles, and environmental conditions. 

Here's an overview of the key aspects:

1. Fatigue of eye muscles

  • Prolonged engagement in activities such as reading, screen time, or extended driving strains the extraocular muscles (responsible for eye movement and focus), inducing muscle fatigue. 

  • Additionally, continuous close-up tasks, like reading or computer work, demand constant adjustment and focus from the ciliary muscle (adjusts the shape of the lens in the eye to facilitate focusing on objects at different distances), leading to strain and fatigue over time.

2. Reduced blinking 

Intense concentration on screens or close tasks often results in reduced blinking. Blinking is crucial for evenly spreading tears over the cornea. Reduced blinking can cause dry eyes, contributing to eye strain.

3. Blue light exposure

Extensive use of electronic devices emitting blue light, such as computers and smartphones, can induce digital eye strain due to prolonged screen focus and exposure to this specific light wavelength.

4. Poor lighting conditions

Struggling to see in low or inadequate lighting forces the eyes to exert extra effort, resulting in eye strain.

5. Incorrect vision correction

Neglecting prescribed glasses or contact lenses, or using outdated or incorrect prescriptions, forces the eyes to work harder to focus, leading to eye strain.

6. Medical problems

Underlying eye conditions like dry eye syndrome, allergies, or uncorrected refractive errors can contribute to eye strain. Additionally, general fatigue or stress may exacerbate discomfort by reducing the eye’s ability to maintain focus.


7. Environmental factors

Humidity:  Low environmental humidity can contribute to dry eyes, increasing the likelihood of eye strain.

Airflow: Airflow from fans, air conditioners, or heating systems may contribute to dry eyes.


Note: 
While uncomfortable, eye strain is typically a transient condition that can be alleviated with adequate rest.

Did you know?

Online office and school coupled with extended screen time during COVID lockdowns had contributed to a notable uptick in eye strain cases.


Protect your vision! Take regular breaks and try these simple exercises to relieve eye strain.

Did you know?

Risk Factors For Eye strain

Eye strain can affect anyone, but certain factors may increase the likelihood of experiencing it. Risk factors for eye strain include:


1. Excessive digital device usage

Excessive use of smartphones, tablets, computers, or other digital devices with screens can strain the eyes due to prolonged exposure to blue light and reduced blinking.

2. Extensive reading

Jobs that require extensive reading, such as editors, researchers, or writers, may increase the risk of eye strain.

Here are some workplace safety tips to protect your eyes.


3. Vision problems

Individuals with vision problems are more susceptible to eye strain, especially if they need vision correction but don't use it.

  • Farsightedness (Myopia): Difficulty seeing close objects.
  • Nearsightedness (Hyperopia): Difficulty seeing things at a distance.
  • Astigmatism: Blurred and distorted vision.


Vision problems make it challenging to focus the eyes, leading to strain. The effort to focus both eyes, especially when one has more significant issues than the other, can also contribute to eye strain.

4. Dry eyes

Insufficient eye lubrication, often caused by factors like aging, medications, or environmental conditions, can lead to discomfort and eye strain.

5. Age

As individuals age, it becomes harder to focus on close objects, which increases the risk of eye strain, particularly during prolonged near tasks.

6. Fatigue and lack of sleep

Fatigue, tiredness, stressful lifestyles, and lack of sleep can contribute to eye strain.

Take care of your vision! Invest in good eye care if prolonged screen time or poor ergonomics cause discomfort or strain.

Diagnosis Of Eye strain

The diagnosis of eye strain involves a comprehensive eye examination. The diagnostic process may include the following:

 

1. Patient history

The ophthalmologist will begin by taking a detailed patient history. They will inquire about symptoms, including the nature and duration of discomfort, activities that worsen or alleviate symptoms, and any other relevant information.

 

2. Visual acuity measurements

A basic eye test, including reading letters or characters from a chart, assesses visual acuity. This helps identify refractive errors such as nearsightedness, farsightedness, or astigmatism.

 

3. Refraction test

A refraction test helps determine the appropriate lens power to address refractive errors such as nearsightedness, farsightedness, or astigmatism. 

 

4. Eye muscle testing

This helps identify any issues with focusing or eye alignment. Evaluating how the eyes focus, move, and work together. This includes assessing the eyes' ability to change focus effectively and work in unison to obtain a clear, single image.

 

5. Binocular vision testing

Testing how well both eyes work together (binocular vision) helps identify any imbalances that could contribute to eye strain.

 

6. Slit-lamp examination

A slit-lamp examination allows the eye care professional to examine the eye structures, including the cornea, iris, and lens.

 

7. Testing under normal seeing conditions

Conducting tests without eye drops to observe how the eyes respond under typical viewing conditions. This helps identify any issues affecting the eyes' ability to focus.

 

8. Optional use of eye drops

In some cases, eye drops may be used to temporarily prevent changes in focus during testing.

Prevention Of Eye strain


Preventive measures for eye strain involve adopting good eye care habits and adjusting your work environment. Here are some preventive measures to reduce the risk of eye strain:

1. Computer Screen

  • Position the screen 20-26 inches away and slightly below eye level.
  • Clean the screen regularly to prevent glare, reflections, and contrast reduction.
  • Choose screens with tilt and swivel options for customizable positioning.
  • Use a glare filter.
  • Wear prescription glasses for optimal comfort.

 

2. Work environment

  • Ensure well-lit workspaces with balanced lighting.
  • Avoid direct glare from windows or overhead lights.
  • Arrange the workstation ergonomically for comfortable posture.
  • Upgrade to an LCD to minimize eye strain.

 

3. Work habits

  • Follow the 20-20-20 rule: take a 20-second break every 20 minutes.
  • Be mindful of blinking, especially during intense screen use.
  • Schedule regular breaks to stretch and give your eyes a rest.
  • Stay hydrated to support overall eye health and reduce dry eyes.
  • Ensure prescription eyewear is up-to-date and consistently used for computer work.
  • Maintain an optimal viewing distance (about 90 cm or 35 inches) and a downward gaze angle of 10° for enhanced comfort and reduced dry eye symptoms.


Learn more about effective tips to minimize eye strain.


4. Eye exercises 

While eye exercises do not improve eyesight or reverse eye conditions, they may enhance eye comfort. You can try the following exercises:

Convergence to Pen:

  • Hold a pen at arm's length, focusing on the tip as you slowly bring it toward your nose. 
  • Strengthen eye muscles by maintaining focus. 
  • Repeat to enhance clarity and agility.

 

Jump Convergence

  • Focus on a distant object, then quickly shift to a near one. 
  • Alternate between distant and near objects rapidly to boost the flexibility and agility of your eye muscles.


Additional Tips- For the Eyecare routine

  • Soothe tired, dry eyes with a warm, damp washcloth. Keep your eyes closed for comfort.
  • Combat dryness with lubrication drops or artificial tears for instant refreshment.
  • Use an air cleaner to filter dust and a humidifier to add moisture to the air to prevent dry eyes.

    Enhance air moisture for better eye health.
  • Give your eyes a break from contact lenses. 
  • Consider different glasses, especially for computer work.
  • Quit smoking, as it can dry your eyes out.

Doctor To Visit


In the contemporary era, prolonged exposure to computers and mobile screens is a leading cause of eye pain and persistent headaches. For a precise diagnosis and effective treatment of eye strain, consider consulting specialists such as:

  • General physician
  • Ophthalmologist
  • Optometrist


General physician:
Provides initial assessment and may address minor eye strain issues; refers to specialists if necessary.

Optometrist: Conducts comprehensive eye exams, prescribes corrective lenses, and offers advice on reducing eye strain.

Ophthalmologist: Specialized eye doctor capable of diagnosing and treating a wide range of eye conditions, including severe cases of eye strain.

Learn more about different types of eye specialists

Note: Never disregard the signals your eyes are giving. Regular check-ups are crucial. If you've neglected eye exams or think they're unnecessary, heed your body's signals and see an eye specialist nearby. 

Treatment Of Eye strain


While no specific medication exists for treating eye strain, adopting various strategies can effectively manage and alleviate symptoms. Lifestyle changes, ergonomic adjustments, and specialized eyewear can make a significant difference.

1. Eye correction

If refractive errors such as hyperopia (farsightedness), myopia (nearsightedness), and astigmatism are identified, prescription or contact lens glasses may be recommended for better and more comfortable vision.


2. Ergonomic modifications

Ensure a well-designed workspace to reduce eye strain, incorporating visually appropriate monitor placement, proper lighting, and comfortable seating adjustments.

3. Use blue filter light

Use blue light filters or computer glasses with blue light-blocking coatings to minimize exposure to harmful blue light emitted by screens.

4. Computer-specific eyeglasses

Consider prescription glasses explicitly designed for screen viewing to enhance visual comfort and reduce stress during electronic use.

5. Prescription adjustments

If your current glasses are not optimal for screen work, opt for a computer-specific prescription, which may enhance strength, color, or coatings.

6. Dealing with underlying issues

If you have preexisting conditions contributing to eye strain, such as dry eye syndrome or uncorrected vision problems, work with an eye care professional to address these issues.

 

7. Vision therapy

Vision therapy may be recommended for difficulties in eye focusing or coordination.
Vision therapy, or visual training, involves activities designed to improve visual abilities. It trains the eyes and brain to work together more effectively, addressing eye movement, focusing, and teaming deficiencies.

Home-care For Eye strain


Although eye drops and other medicines are readily available, there are also many natural ways to reduce eye strain.


Bask in the early morning sunlight

Begin your day by standing in sunlight without glasses or contacts. Gently close your eyes and face the sun, allowing warm sunlight to soothe and relax your eyes.

Gently massage the area around the eyes

Use gentle circular motions to massage the area around your eyes, relieving tension and promoting relaxation.

Cold water splash

Splash cold water on your closed eyes to reduce puffiness and refresh tired eyes.

Maintain contact lens hygiene

Maintain contact lens hygiene by changing them regularly and following proper cleaning rituals. 

Here are some of the common mistakes that contact lens wearers make!


Protect your eyes from direct sunlight

Shield your eyes from direct sunlight and bright screens to prevent strain and discomfort.

Get adequate sleep

Ensure you get sufficient sleep to promote overall eye health and reduce fatigue.

Enhance your sleep quality with our curated products designed for better sleep.


Focus on your diet

Nutrients like vitamin A, C and E, lutein, zeaxanthin, omega-3, zinc, etc., are required for optimum eye health.

Learn more about nutrient-rich foods for healthy eyes!


In addition to incorporating food into your diet, consider including supplements. Explore various supplements to enhance your nutritional intake.

Complications Of Eye strain


Eye strain can lead to various complications if not addressed or managed correctly.

Some potential complications include:


1. Sleep disruption

Exposure to blue light emitted from screens, especially in the evening, may interfere with the natural sleep-wake cycle, making it difficult to fall asleep.


2. Increased risk of myopia

Long hours of work, such as staring at a screen, may contribute to the progression of myopia (nearsightedness) in some individuals.

3. Reduced productivity

Eye strain can affect overall work efficiency and productivity due to discomfort and visual challenges.

4. Neck and shoulder pain

Poor ergonomics and prolonged screen use can contribute to neck and shoulder pain, as the muscles are strained while maintaining a fixed position.

Note: Proper ergonomics avoids eye strain and prevents musculoskeletal problems and fatigue, impacting your health.

Learn more about the adverse effects of inadequate ergonomics.

5. Light sensitivity

Increased sensitivity to light, known as photophobia, may develop, causing discomfort in well-lit environments.

6. Headaches

Due to increased muscle tension around the eyes and forehead, prolonged eye strain may contribute to frequent headaches, especially tension headaches.

7. Difficulty focusing

Prolonged eye strain can affect the ability to focus, making it harder to concentrate on tasks and decreasing productivity.

Did you know?

Since the COVID-19 pandemic began, virtual classes and remote work have increased screen time, impacting eye health. Notably, new-onset myopia and accelerated progression of existing myopia have been observed.

Did you know?

Alternative Therapies For Eye Strain


A few alternative therapies may offer some relief for eye strain. However, it's important to note that these remedies are not substitutes for professional medical advice.

I. Herbal remedies

  • Eyebright (Euphrasia): It is often used in herbal eye drops or eyewashes. It is believed to reduce inflammation and soothe irritated eyes.

    Usage: Typically, use a few drops in each eye, avoiding direct contact with the dropper.

  • Chamomile: Chamomile has anti-inflammatory properties that may help reduce eye irritation. 

    Usage: Soak a clean cloth or cotton ball in the cooled chamomile tea, then place it over closed eyes for 15-20 minutes. Repeat as needed.

  • Rose Water (Gulabjal): It is known for its soothing properties and may help relieve eye strain.

    Usage: Apply a few drops directly to each eye or use it as a compress by soaking a cotton ball in rose water and placing it on closed eyes.

  • Ginkgo Biloba: It is known to improve blood flow to the eyes, potentially reducing eye strain.

    Usage: You can consume ginkgo biloba supplements.

  • Bilberry: Rich in antioxidants, bilberry may support eye health and reduce eye strain.

    Usage: Bilberry supplements or extracts are available for oral consumption.

  • Muli (Radish green leaves):  It helps by relieving the burning sensation and itching in the eyes.

    Usage: You can use fresh leaves of radish to make juice. Consuming this juice is considered good for eye health. 

 

II. Acupuncture

Acupuncture may help relieve eye strain symptoms by relaxing the nervous system and muscles, but its definitive effectiveness lacks strong scientific support. 
Consultation with an eye care professional is advisable before considering acupuncture for eye-related issues.

 

Living With Eye strain

Eye strain, the persistent discomfort associated with prolonged visual focus, casts a significant shadow over various aspects of our lives. Its impact resonates from our careers and academic pursuits to our physical and mental well-being, demanding tailored solutions for sustainable relief.

 

1. Reduced productivity

Tasks requiring laser-sharp vision, like reading, computer work, or intense screen time, become battlegrounds when eye strain joins the fray. Productivity takes a direct hit, leaving us feeling frustrated and inefficient.

Coping Strategy: Implement the 20-20-20 rule, take breaks, and ensure an ergonomic workspace.

2. Beyond physical symptoms:  Eye strain's reach extends beyond physical discomfort. It can trigger headaches and fatigue and even contribute to stress and a general feeling of being unwell.

Coping Strategy:

  • Practice stress-reduction techniques, prioritize sleep, and consider mindfulness activities.

  • Address ergonomic concerns, stay hydrated, and consider herbal remedies for relief.

3. Professional and academic impact: When concentrating feels like a chore due to eye strain, our performance at work or school suffers. Difficulty focusing can hinder job performance and negatively impact academic achievement.

Coping Strategy: Ensure regular eye check-ups and follow eye care recommendations.

4. Compromised safety: Impaired vision caused by eye strain poses a serious safety risk, especially during activities like driving or operating machinery. Both individual and community safety are at stake.

Coping strategies:

  • Prioritize regular eye check-ups to address vision concerns promptly.

  • Avoid driving or operating machinery during peak eye strain periods.

5. Dependency on medications: Some individuals may resort to over-the-counter medications for temporary relief, leading to a dependency on drugs to manage eye strain symptoms.


Coping strategies: 

  • Explore non-medical alternatives like acupuncture, warm compresses, or vision therapy with guidance from an ophthalmologist.

  • Gradually reduce reliance on over-the-counter medications under the guidance of a healthcare professional.

Frequently Asked Questions

References

  1. Tandon R, Singh A, Dhasmana R, Arora V, Pandey DK, Khurana AK, et al. Prevalence and risk factor assessment of digital eye strain among children using online education during the COVID-19 pandemic in India. Indian J Ophthalmol. 2021 Jan;69(1):140-4. cited 2024 Feb 5]. Available from: External Link
  2. Chirumbolo S, Suppiej A, Bottaro G, Tasso A, Zanconato S, Malacarne M, et al. Prevalence and risk factors of computer vision syndrome among school children: a cross-sectional study in northern Italy. Int J Ophthalmol. 2020 Dec 18;13(12):1915-20. cited 2024 Feb 5]. Available from: External Link
  3. Sherwin JC, Reacher MH, Keogh RH, Khawaja AP, Mackey DA, Foster PJ. The association between time spent outdoors and myopia in children and adolescents: a systematic review and meta-analysis. Ophthalmology. 2012 May;119(10):2141-51. cited 2024 Feb 5]. Available from: External Link
  4. Hopkins Medicine. Eye Strain. [Internet]. [cited 2024 Feb 5]. Available from: External Link
  5. Cheng H-M, Chang D-S, Yoo B-W, et al. The relationship between smartphone addiction and symptoms of depression, anxiety, and attention-deficit/hyperactivity in South Korean adolescents. BMC Psychiatry. 2021;21(1):218. [cited 2024 Feb 5]. Available from: External Link
  6. Choi SW, Kim DJ, Choi JS, et al. Comparison of risk and protective factors associated with smartphone addiction and Internet addiction. J Behav Addict. 2015;4(4):308-314. [cited 2024 Feb 5]. Available from: External Link
  7. An Overview of Herbal Traditional Eye Care Practices and the Development of Eye Health Promotion Strategies in Cameroon [Internet]. [cited 2024 April 15]. Available from: External Link
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