TFOS lifestyle report: Effects of the digital environment on the ocular surface and adnexa

Abstract

This presentation summarizes the findings of the Digital Environment Subcommittee of the recent Workshop of the Tear Film & Ocular Surface Society, entitled “A Lifestyle Epidemic: Ocular Surface Disease” (www.tearfilm.org). Digital environments are common in modern life and involve extensive screen time, often exceeding 4 h a day. Examples of digital devices include professional items, such as networked wayfinding systems or connected workstations, but also personal computers, televisions, and mobile phones. Although the prevalence of digital eye strain is very high, reaching 97% across the world, currently there is a lack of an agreed definition and established diagnostic criteria for the condition. Symptoms of digital eye strain are heterogeneous and non‐specific, may overlap with other ocular diseases, and include ocular tiredness, blur, ocular soreness, eye strain, ocular pain, burning, ocular dryness, and light sensitivity. They produce significant, chronic, and frequent discomfort that can affect the quality of life and reduce work and school performance. Although there is a large demand for treatments to relieve symptoms of digital eye strain, interventions are not well established. Proposed methods, such as incorporating rest breaks and the 20/20/20 rule, improving blinking, oculomotor exercises, and optimizing the work environment will be discussed. Also, the influence of such interventions as refractive correction, blue‐blocking filters, ocular surface disease management approaches to improve tear film quality and/or quantity and nutritional supplementation will be presented based on current, best evidence data. In conclusion, considering the ubiquitous use of digital technology, screening for digital eye strain should become incorporated into routine ocular assessments. The unified definition and diagnostic criteria proposed in the TFOS report will help standardize and improve the quality of future epidemiological studies.