How Do Different Digital Displays Affect the Ocular Surface?

Abstract

SIGNIFICANCE Digital display use has been accepted as a contributing factor to dry eye disease. Nowadays, plenty of new models of digital displays have been developed, and the differences in their nature and the ways in which they are set and used may contribute to differences in the eye-related problems they cause. PURPOSE This study aimed to analyze the differences in ocular surface, tear film, and visual fatigue parameters after reading on different digital displays, with and without initial instillation of artificial tears. METHODS Thirty-one healthy individuals ranging in age from 20 to 26 years (mean ± standard deviation, 21.26 ± 1.73 years) were included in this prospective clinical study. Subjects' ocular surface, tear film, and visual fatigue parameters were assessed after reading for 15 minutes on a laptop computer, tablet, e-reader, and smartphone with matching characteristics and a baseline measurement. Measurements were taken with and without the instillation of artificial tears before the reading tasks and included the Ocular Surface Disease Index questionnaire, the Computer Vision Syndrome Questionnaire, tear meniscus height, the Schirmer I test, noninvasive keratograph break-up time, osmolarity, bulbar redness, and pupil size. RESULTS Statistically significant differences in the Ocular Surface Disease Index, Computer Vision the Syndrome Questionnaire, tear meniscus height, the Schirmer I test, noninvasive keratograph break-up time, osmolarity, and bulbar redness were obtained when comparing the displays (P < .05). Best results were obtained with the smartphone and the e-reader. Conversely, the computer produced the highest disturbance on the ocular surface and tear film. Finally, the instillation of artificial tears revealed no statistical improvement of ocular surface or tear film parameters for the same device (P > .05). CONCLUSIONS Taking into account the clinical tests for dry eye diagnosis, the smartphone may be considered as the least disturbing display, producing lower dry eye signs and symptoms in comparison with other devices.

Student Health Implications of School Closures during the COVID-19 Pandemic: New Evidence on the Association of e-Learning, Outdoor Exercise, and Myopia

“…We contribute to the current literature on youth public health and build on prior studies on adolescent health that examine the association between near-vision electronic use [ 24 ], outdoor activity [ 7 ], lighting condition [ 21 ], and myopic vision progression by assessing these risk factors in conjunction and leveraging an extended period of COVID-19-pandemic-induced remote learning. While this study does not directly assess how student learning is affected, prior studies have underscored the critical negative impact myopic vision can have on student learning, particularly if corrective vision interventions are not afforded [ 25 ].…”

“…Additionally, another reason for adopting self-reported measures is to allow for rapid and large-scale survey rollout [ 30 ], which would not have been feasible given the logistical and social-distancing requirements due to the COVID-19 pandemic. Nonetheless, it has been increasingly common in optometry and visual science studies to leverage questionnaire survey designs, considering the relatively high cost-effectiveness [ 24 ]. Future studies may find it useful to conduct professional ophthalmic evaluations in lieu of collecting subject self-reports.…”

The Relationship Between Dry Eye Disease and Digital Screen Use

“… 38 When different digital devices have been compared, reading on a computer resulted in lower tear meniscus height, higher osmolarity, and greater conjunctival redness compared to reading on a smartphone, possibly because reading on a smartphone was associated with a lower gaze angle and lower extent of exposed ocular surface. 39 The results of these studies suggest digital screen use is associated with an acute deterioration of tear film quality.…”

“…In addition, strategies that may help in management of computer vision syndrome-a broader category of eye and vision problems related to digital screen use-such as enlarging font size, reducing glare, improving contrast, and using a downward gaze may also be beneficial for those with symptoms of dry eye. 39,[74][75][76] As eye strain from digital screens may make overall symptoms worse, diagnosis and management of refractive error and/or binocular dysfunction may help to alleviate symptoms associated with digital screen use. 74,75 However, given that it may be difficult for some patients to reduce high use of digital screens for work and communication in the modern era, there may be a need for regular follow-up and proactive management strategies that include ocular therapies in addition to digital habits.…”

Meibomian Gland Dysfunction Causing Dry Eye Syndrome in Computer Users

“…Tear osmolarity was determined as a stronger and good contributer of dry eye syndromes in computer users than the ocular surface index [18]. A fundamental aspect of meibomian gland dysfunction is abnormal tear osmolarity, which is caused by a breakdown of homeostatic osmolarity regulation.…”