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Writer's pictureDr. Chiu

Using Digital Devices: Do You Know About the 20-20-20 Rule for Your Eyes?

A modern day ailment: digital eye strain


According to a recent survey by the American Optometric Association, the average American spends seven hours a day on a computer or handheld device.

While smartphones, tablets and computers are a part of our work, home, and school environments, they are leading to a host of vision problems experienced by users.

Prolonged usage of these devices may lead to:


§ Eyestrain

§ Headaches

§ Fatigue

§ Burning or tired eyes

§ Loss of focus

§ Blurred vision

§ Double vision

§ Neck and shoulder pain


Before smartphones, tablets and other handheld devices, most Americans dealt with issues related to just their computer screens. Fortunately, the larger size and ability to adjust the work environment allowed the eyes to view the screen like a newspaper, book, or magazine. Handheld devices do not offer the same advantages.

Most devices have smaller displays. Research shows that users hold these devices closer to the eyes in an attempt to see the small print better, thereby placing greater strain on the eyes. Also, because these displays are used on the go, controlling the environment becomes more problematic.

Computer Vision Syndrome (CVS)


Prolonged use of handheld devices is contributing to an increase in Computer Vision Syndrome (CVS). The American Optometric Association (AOA) defines this as “the complex of eye and vision problems related to near work that are experienced during or related to computer use.”



computer vision syndrome to avoid
Computer work hygiene to avoid eye strains


Computer use requires specific vision skills that place extra demands on the visual system and contribute to eye and vision discomfort. These skills include:


§ Ocular mobility – the ability of the eyes to move in various positions.

§ Accommodation – the ability of the eyes to focus clearly at various distances.

§ Vergence – the ability to move the eyes in (convergence) or out (divergence).

Part of the problem with handheld device screens is that the small characters are not as well-formed (fewer pixels) as on print or even larger computer screens, making it more difficult to see.

Users can adjust the height, angle, type size and lighting on desktop or laptop computer screens to ease eyestrain. Handheld devices pose more challenges. The tiny type and screens that fade out in bright sunlight add to the problems associated with the smaller, handheld mobile device.

CVS is not restricted to adults. Children are spending more time in front of computers and using handheld devices. They can experience CVS, too.


Ease the strain


No one expects people to simply stop using their smartphones, tablets and other handheld devices, but there are steps you can take to ease eyestrain.


§ Rest your eyes: Remember the 20-20-20 rule. At least every 20 minutes take a 20-second break and view something 20 feet away. The AOA further recommends that users take a 15-minute break for every two hours they spend on their computers or handheld devices.


§ Increase font size: The smaller screens on handheld devices usually favor tiny type that forces squinting. Bringing the screen closer to the eyes may make reading easier, but it also taxes the visual system. Instead, increase the font size so the device can be seen at a more comfortable distance.

§ Adjust screen brightness: Most handheld devices allow users to adjust both the screen resolution and contrast. Better resolution offers greater clarity and usually more comfort. The contrast between the characters on the screen and the background makes a difference. Adjust screen brightness to a comfortable intensity, neither too bright nor too dim. Avoid using in bright light, which reduces contrast.


§ Reduce glare: Handheld mobile devices present challenges in lighting conditions. Make sure lighting is not directly behind or in front of the head. Overhead lighting is best for viewing, but handheld devices are often viewed on the run. Reducing glare may make a bigger difference than increasing type size.


§ Lower eye level: Like viewing a computer screen, handheld devices are easier to view when placed below eye level.


§ Remember to blink: People tend to blink less frequently when viewing a computer screen or handheld device. Remember to blink as a natural way to help prevent dryness and irritation.

§ Eye drops: Many computer users, especially those who wear contact lenses, may benefit by using eye drops to moisten their eyes. Ask your doctor of optometry to prescribe the right eye drop for you.


§ Nutrition and supplements: Studies have shown how nutrition and supplements can improve vision. It’s been found that the Omega 3s in flaxseed and fish oil supplements improve long-term eye lubrication.


§ Clean the screen: Handheld device screens get especially dirty with fingerprints, dust and smears. Clean the screen daily for easier viewing.


§ Special computer lenses: Reading and prescription glasses may not be the answer when viewing computer or handheld devices. For most people bifocals are not adjusted for this distance or angle, and may be inadequate. Your doctor of optometry can perform a CVS-specific eye examination to diagnose the reasons for CVS. After testing, your doctor may prescribe special computer lenses that help relax the eyes and deliver better viewing. An anti-glare coating can also be added to the lenses to improve vision.

§ Regular eye exams: The AOA recommends comprehensive eye examinations annually. Your doctor of optometry may recommend more frequent visits, especially for those with vision problems caused by health-related issues or CVS.


A Final Word


Today’s technology may help enhance learning and provide entertainment, but many devices are still relatively new and the long-term effects on the eyes are not yet fully known. Early-stage research on the blue light associated with many of today’s devices shows signs that overexposure and the obsessive way many of us stare at our screens may affect or even age the eyes.


Be sure to watch for signs of digital eyestrain, which can cause burning itchy or tired eyes, headaches, fatigue, loss of focus, blurred vision, double vision or head and neck pain. Remember to take frequent visual breaks and practice the 20-20-20 rule as recommended by the AOA.


[ Courtesy of American Optometric Association ]





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