The COVID-19 pandemic has led to an increased use of digital screens as well as an increase in e-learning days which had already been implemented in our schools.
Unfortunately, there can be significant downsides to spending so much time in front of a screen.
Although the long-term implications for current school children are unclear, eye care professionals have expressed some concern about a problem called convergence insufficiency, which sometimes persists for a lifetime.
Convergence insufficiency is an alteration of the proper functioning of the eyes. Symptoms include headaches when reading, words that seem to move across the page, blurring, double vision, and eye strain. It can be treated with exercise, prism glasses, or (rarely) surgery.
Previous research has linked the use of digital screens to convergence insufficiency. So when many schools switched to distance learning for the pandemic, researchers at Wills Eye Hospital in Philadelphia studied whether it would impact students’ eyes.
They surveyed 110 healthy students aged 10 to 17 about eye symptoms before and after a virtual school day. Participants spent an average of about seven hours a day in a virtual school.
Participants completed the Convergence Insufficiency Symptoms Survey (CISS), which consists of 15 questions about eye complaints: 61% of participants reported an increase in convergence insufficiency symptoms.
The researchers also found that, on average, the more hours each student spent in a virtual school, the higher their CISS scores.
This makes sense because reading requires convergence. The same problem could occur in the traditional school if students stared at books all day instead of focusing on objects at different distances in their classrooms, such as the teacher or the whiteboard.
Parents can help prevent convergence insufficiency during school by reminding their children to take breaks. The 20/20/20 rule is recommended: After 20 minutes of work that involves looking at nearby objects, students should pause for 20 seconds and look at something 20 feet away.
For a more local perspective, I contacted optometrist Dr. Craig Lichlyter who gave the following comments:
“I wholeheartedly agree with the conclusion of the research, based both on the ‘book science’ of binocularity (eyes working as a team) and based on patients seen in the practice day in and day out! This is a problem, not only for pupils aged 10 to 17!
“Convergence insufficiency is a problem for those who, in the workplace or in the classroom, spend blocks of time exceeding two continuous hours on a PC, laptop, notebook or smartphone. The researchers put developed a quantitative assessment of the clinical symptoms that we hear daily in the office: “My eyes are very tired at midday”, “My eyes are slow to focus from far to near and vice versa”, “I am having difficulty staying focused on the computer, especially towards the end of the day Convergence insufficiency can affect all patients between the ages of 5 and 50.
“Lack of blinking when focusing on near objects, especially digital targets, is well documented in the medical literature as problematic. It causes or worsens dry eye, a medical condition known as keratitis This condition is quite uncomfortable and causes blurred vision.
“I agree that convergence insufficiency can be best addressed by taking digital demand pauses (like the 20-20-20 rule mentioned in this article), but what many do during that pause is pull out their smartphone, which does nothing to relieve eye stress!
“New eyeglass lens technologies have created a very good treatment for convergence insufficiency. These lenses are generated with advanced digital technology using computer controlled diamond blades. The lenses, called Accommodative Support Lenses, provide a “reading boost” at the bottom of the lens, which is different from the prescription needed for distance vision. It helps the eye focus on your device (PC, Laptop, Notebook, Smartphone) and helps relieve eye strain. The lens is not a bifocal lens, and it is not a progressive addition lens.
“Researchers did not specify another concern with increased use of the devices, which is exposure to visible blue light. Accommodatively-supported lenses are treated with a high-quality blue blocker (all blue blockers blue are not of good quality), which reduces the visible blue light reaching the eye.
“We are proactively prescribing accommodating supportive lenses with a blue light blocker to all patients who use a screen for a significant portion of their day. We hear daily from these patients that their lenses have relieved eye fatigue and improved comfort at the end of their day.
My thanks to Dr. Lichlyter for his contribution and expertise.