By Tara Bannow

Wescom News Service

Kids tend to get a bad rap for being on screens all the time, but eye doctors warn that the 55-and-older crowd ought to pay attention to their device use, too.

Optometrist Dr. Dora Adamopoulos said her older patients are keeping up with their grandkids through Facebook, using devices when they travel and using video call functions on their phones.

“As they get older and have more free time, they get gifted devices or they purchase them on their own,” she said. “So even though they’re retired and they’re not on their computer so much for work, per se, they’re on it for leisure or pleasure.”

Doctors don’t tend to think about that when they’re probing patients during eye exams, said Adamopoulos, who works in the Washington, D.C., area and serves as medical adviser to The Vision Council, a nonprofit trade association for the optical industry.

That’s why it’s important for everyone — young and old alike — to be forthcoming about their screen use and any eye discomfort they notice.

“I think from a patient perspective, you should go in saying, ‘Hey, I’m on my iPad a lot. I love to play solitaire for a few hours, and when I do, my eyes feel a little dry and red and irritated,’” she said.

These days, many patients don’t even recognize those issues as symptoms of screen use, said Dr. Michael Coffman, an optometrist with the Coffman Vision Clinic in Bend, Oregon. Sometimes, it takes asking questions during an eye exam or reading their answers to intake questions to put two and two together.

A number of eye doctors interviewed for this article marveled at how common it’s become in recent years to see patients struggling with symptoms stemming from too much screen time or so-called computer vision syndrome: dry eyes, tired eyes, burning eyes, light sensitivity or blurred vision. And it’s no wonder — a Nielsen Co. survey taken earlier this year found Americans spend an average of 10 hours and 39 minutes per day in front of a screen. Most of that is still television, but it’s also things like computers and smartphones. To arrive at that number, Nielsen drew from a handful of its consumer pools, including 26,000 households with televisions, more than 200,000 internet users and more than 10,000 smartphone and tablet users over the age of 18.

Coffman doesn’t villainize screens or tell his patients to crack down on their use. Let’s face it — many jobs today require at least eight hours of computer time per day. Rather, he provides them with strategies to manage the side effects.

His first piece of advice is simple: Make sure your corrective eyewear prescription is up to date. If it’s even a little bit off, it can make a big difference in one’s ability to discern details on a screen.

“There are plenty of folks who either don’t know they need glasses to improve on that, or they have glasses that are several years old that aren’t exactly right any longer,” he said.

If you’re feeling the effects of screen time, here are some things to try:


Perhaps you’ve heard of the 20-20-20 rule. It’s pretty simple. If you’re working at a computer for an extended period of time, turn away from your screen every 20 minutes and focus your vision on something 20 feet away (preferably outside a window) for 20 seconds. Eye doctors say this will help re-energize the eyes and counteract some of the effects of staring at a screen.

In recent years, the American Optometric Association has added another 20 onto that rule: Blink 20 times, said Dr. Karl Citek, an optometrist and chair of the association’s Commission on Ophthalmic Standards.

“With the recognition that blink rate decreases, just to make people mindful of it, we’ve added that fourth 20,” said Citek, who also teaches at Pacific University’s optometry college.

Some research has found that staring at screens for extended periods of time reduces the frequency and quality of people’s blinks. That’s significant, because when the eyelids close during a blink, they stimulate the production of an oil that’s secreted into the eye’s tear film, a layer on the eye that reduces the amount of tear evaporation that happens naturally, helping to keep the eyes moist.

At InFocus Eye Care in Bend, doctors use a special machine that measures the quality and frequency of patients’ blinks when patients complain of dry eyes, said optometrist Elizabeth Potvin.

Amid what Potvin calls an epidemic of screen-induced dry eyes, she often teaches patients an exercise designed to retrain their eye muscles to blink properly — something that’s not easy to do. She tells her patients to stop reading something on their screen, blink normally, then open their eyes and squeeze them shut for two seconds, repeating that for about 10 minutes.

“If you do that a couple times a day, you can actually retrain your blink to be better,” she said.


For cases more serious than mere exercises can solve, there’s technology.

Anti-glare coating for glasses is nothing new, but in recent years, eyewear manufacturers have come out with anti-glare coating that also blocks some of the high-energy blue light that’s emitted from computers and other screens. While some animal and test tube research has linked ultraviolet light such as blue light to the retinal damage that leads to problems such as macular degeneration, no studies in humans has found such a link. Researchers in South Korea were able to induce signs of macular degeneration in mice using blue light, according to an April study published in Graefe’s Archive for Clinical and Experimental Ophthalmology.

Several local optometrists offer the anti-glare coating that blocks blue light, which is applied to lenses that contain patients’ corrective eyewear prescription. Potvin’s shop is one of them, but she said the technology is so new, she doesn’t have much to say about it yet.

Coffman agrees the coating is too new to say for sure what impact it will have.

“We’ll see 50 years from now whether that was a good idea,” Coffman said.

People who wear contact lenses or don’t need glasses to improve their vision can still buy frames with the coating. Adamopoulos said many of her clients leave this pair at work to use while they’re at their computers.

“As soon as they sit down, they wear them while they look at the screen,” she said.

Potvin also touts what are called progressive glasses, prescription frames for people who need help reading things close up and also spend a lot of time in front of screens. Different sections of the lens — the middle, the bottom and the top — offer different strengths for people when they’re reading or looking at screens, for example.

“You look up, you have intermediate vision, you look down and you can see up close,” Potvin said. “You take them off and go away from your desk. They’re fantastic.”

Such glasses are available at most eye clinics, including InFocus in Bend.

Ergonomics, etc.

The location of a computer screen relative to the face and nearby light sources is important to consider, too.

The top of the screen should be no higher than eye level, said Dr. Derek Louie, an optometrist and clinical associate professor of ophthalmology at Oregon Health & Science University’s Casey Eye Institute. That way, the person reading the screen is naturally looking slightly downward.

“If you’re looking slightly down, your eyes are more closed and so you don’t have as much surface area exposed and so you get less dryness,” he said. “That tends to make a difference towards the end of the day.”

Several doctors also recommend positioning computer screens so they’re about an arm’s length away and positioning smaller devices like iPads and smartphones roughly the distance of a book or regular piece of paper.

If windows are nearby, a computer screen should be positioned roughly perpendicular to the windows to reduce glare, Citek said. That means a person should never be facing a window or have his or her back to a window, he said.

If the room is lit with typical fluorescent tubes, make sure the screen is oriented perpendicular to those lights, Citek said. That’s to reduce the chances of the light reflecting into the eye.

If those things aren’t possible, Citek recommends tilting the computer screen either horizontally or vertically to direct reflections away from the user.