Hardly a day goes by without discussing vision issues related to the use of computers and devices. Anecdotal opinions surrounding blue light, digital eye strain, and myopia progression abound. Sometimes we feel there is insufficient evidence to guide us.
Best practise – when it comes to managing the spectacle needs of digital device users – will become clearer with increasing research. In the meantime, we need to sift through articles in journals as well as the posts that bombard us on social media, websites and via marketing, in order to make the best prescribing decisions.
…practitioners are… failing in their duty of care to address the issues and provide the best method to reduce accommodative demand and minimise eye strain
We have dealt with so called ‘computer vision syndrome’ since the advent of computers and video display units (VDUs) in the 1970s. UV and other radiation, eye strain, and even the risk of miscarriage were all believed to be associated with computer use. The judicious use of stress relieving lenses and the correct design of bifocal and progressive lenses, multicoats, and filters worked well to alleviate ‘computer vision syndrome’, and still do.
Stressing the importance of correct posture, regular breaks, appropriate blinking, and the use of lubricating eye drops was also effective and, coupled with the correct prescription eyewear, seemed to resolve most issues.
People adapted to using computers on a daily basis at home, work, and school.
Today, along with computers, digital devices are ubiquitous across most of the population from two-year olds, to teens, adults, and seniors.
Many people now spend the bulk of their day on computers. Meanwhile, during tea and bathroom breaks, meals, commuting, and at home, they’re using devices to read documents, surf, post, check and respond to emails. Devices are also increasingly used for television programs and movies once viewed on TV screens or at the cinema.
NEAR VISUAL STRESS
One of the major vision issues associated with digital devices, is that screens tend to be viewed at a distance that is much closer than traditional reading materials. Typically, humans evolved to read at around 40cm, while computer monitors were set up at a 60–80cm viewing distance. Many however view smartphones at around 18–30cm. Younger people, with active accommodation are at the closer end of this range. The accommodative demand at 18cm (≈5.5D), is more than double that of a more ‘traditional’ 2.5D of accommodation at 40cm. This means there is a much greater demand on accommodative convergence. It also means that fatigue and asthenopia are likely to kick in and become an issue much sooner, particularly for those with underlying visual problems.
The ‘myopia epidemic’ is increasingly discussed,1 though how much of this is being driven by the uptake and use of digital devices is debatable. Screen time can range from two hours to well over nine hours per day and the majority of users report asthenopia at some stage. According to The Vision Council, individuals (other than those who regularly wear vision correction), report not using eyewear for digital device usage for the following key reasons:
- They don’t think eyewear is necessary,
- Their eye care provider didn’t recommend using eyewear,
- Eyewear is too expensive.2
Point two is rather alarming. It tells us that practitioners are not only missing out on a significant revenue stream but, more importantly, failing in their duty of care to address the issues and provide the best method to reduce accommodative demand and minimise eye strain.
Premium progressive and/or occupational lenses – ideally specialised or custom designs – should be prescribed for presbyopic users of digital devices.
Younger patients may benefit from an increasing range of specially designed digital and computer lenses manufactured by major lens suppliers.
Lenses with light tints, in the 10–15% range, can also be effective, with some users reporting improved visual comfort and a reduction in irritating glare.
Prescribing ‘blue blocking’ filters – that reduce the amount of high energy visible light (HEVL) striking the eye – are also worth considering. Although there’s some debate on the issues surrounding blue light exposure and the effects of HEVL on humans, our patients are probably better off blocking it.
Myopia controlling spectacle lens designs may be considered if myopia progression is detected. These can also be considered a form of digital lens.
Offer advice on posture, holding devices further away, taking frequent breaks (ideally outdoors in daylight/sunlight) and limiting screen time. Parents should also be made aware of the issues surrounding younger children and screen time. All too often we see toddlers glued to their screens while their parents have a coffee or take a stroll. Concerns are increasingly being raised regarding screen time in children as far as development, vision and perception are concerned.
Read about the key features of digital lenses from major suppliers on the following pages.
- www.healio.com/optometry/pediatrics/news/print/ primary-care-optometry-news/%7Ba7c5f86e-f0d7-498fbb43- 1be6224ecaf1%7D/myopia-dry-eye-maculardegeneration- are-linked-to-digital-device-use 2. www.thevisioncouncil.org/content/digital-eye-strain/kids
Lenses for Relaxed Screen Time
Hoya’s indoor lens solutions are designed for prolonged visual tasks to help alleviate eye strain and reduce fatigue.
The Hoyalux iD WorkStyle V+ comes in three variations:
Hoyalux iD WorkStyle V+ Close – for specialist hobbies and professions that require high levels of concentration and perfection. Wearers benefit from the widest possible near area and perfect vision at intermediate distances up to one metre.
Hoyalux iD WorkStyle V+ Screen – for smooth, sharp depth, and width vision from near distances up to two metres. Ideal for computer work.
Hoyalux iD WorkStyle V+ Space – for activities where the focus is a little further than a computer screen, offering reliable distance vision up to four metres and above, with crystal clear vision on the screen.
Dynamic Sync – reduces eye fatigue and eye strain for non-presbyopes who use devices, providing relaxed, comfortable, and clear vision in all directions and distances all day long. Available with two boost add power options; up to +0.53D and up to +0.88D. Diamond Finish BlueControl – a coating that neutralises harmful high energy blue lights to protect eyes, offer more comfortable, relaxed vision, and a more natural colour perception. Offered in combination with Hoya’s Diamond Finish anti-reflection coating, for up to five times more scratch resistance than conventional multi-coats.
Contact: Hoya Account Manager
Mono Plus 2 is a full back surface digital design SV lens with a power boost. This Silmo d’Or award winning lens is optimised using Listings Law for eye rotation at both distance and near, providing remarkably clear vision up to the frame rim.
This lens design gives wide fields of clear vision for less head movement that can be associated with multiple screen use. Available in 0.50D and an 0.80D boost for relaxed and fatigue-free vision at near, particularly when using digital devices, such as smartphones, e-books etc.
When prescribed in combination with Solitaire Protect Balance 2 coating for reduced exposure to artificial blue light, Rodenstock’s Mono Plus 2 gives patients increased visual comfort and may balance sleep/wake cycles.
Contact: Rodenstock (AUS) 02 9748 0988
Transitions Light Intelligent Lenses help protect against harmful blue light emitted indoors by digital devices and screens, and outdoors, where the sun emits over 100 times more harmful blue light than digital devices.
Transitions Signature filters at least 20% of harmful blue light indoors. Outdoors, where protection is really needed, Transitions Signature filters over 76% of harmful blue light.
Transitions XTRActive and Transitions Vantage filter at least 34% of harmful blue light indoors. Outdoors, Transitions XTRActive provides the greatest protection filtering over 88% of harmful blue light, while Transitions Vantage filters over 85%.
Contact: Transitions (AUS) 08 8238 3257
The Zeiss Digital Lens allows patients to easily move between their screens and the world around them, with clear, crisp, comfortable vision all day. Eye strain is reduced and the physical strain associated with using digital devices is minimised.
The benefits of the Zeiss Digital Lens are further enhanced with the addition of Zeiss DuraVision BlueProtect, which can protect against high amounts of blue light emitted from modern light sources and digital screens. Blue light can interfere with sleep/wake cycles and contribute to reduced visual clarity due to the scattering associated with blue light.
Contact: Zeiss Account Manager
TechShield Blue provides advanced blue light defence in a premium antireflective coating, allowing patients to enjoy all the benefits of digital life without digital eye strain. This lens targets blue wavelengths associated with digital eye strain (400–430nm), reducing exposure by as much as 85% at its peak.
With an attractive near clear appearance when not in the presence of blue light, TechShield Blue offers blue light reflection and absorption, glare reduction, and minimises front and back side reflections.
Contact: VSP Australia Account Manager
Varilux Digitime is designed to help patients with power perfectly matched to their working distance, to truly relax their eyes and posture in front of screens.
This digital lens solution is available in three styles:
Digitime Near – for computer use, smartphones, and near,
Digitime Mid – for the computer, around the desk, and near, and
Digitime Room – for near, the computer and across the office. Crizal Prevencia coating enhances the lens, reducing blue-violet light, and enhancing contrast and comfort.
Contact: Essilor Account Manager
Nikon Home and Office NEO, and Nikon Soltes Wide NEO belong to the Nikon e-Life Series. These digital lenses provide specific solutions for patients requiring assistance with their digital or daily lifestyles. Different versions of each design stretch the patient’s vision, at times out to full distance vision.
Contact: Essilor Account Manager
Shamir Smart Office is a personalised digital freeform occupational lens with multiple viewing zones and clear vision when the direction of gaze is above the computer screen.
This lens family includes Shamir Workspace for optimum near and intermediate vision, and up to 3m of distance vision for close tasks or mid-distance viewing. Additionally, Shamir Computer provides perfect near and intermediate vision and up to 1.5m of distance vision.
Shamir Relax digital lenses reduce digital eye strain and fatigue associated with prolonged intermediate and near vision tasks. Available in three viewing shifts of 0.50, 0.65 and 0.80, and can be combined with Shamir Glacier Blue Shield coating or the new Shamir Blue Zero, a lens material with built-in protection from the potential harm of artificial light.
Opticare has a wide range of freeform lenses designed to provide protection and reduce visual strain:
ClearPro Relax – this lens helps reduce myopic shift and accommodative strain in children who perform excessive close activities. It can also be prescribed for any patient with accommodation or convergence problems.
ClearPro Office – variable visual zones to satisfy any computer distance with minimum head position tilt. Use Opticare’s Visual Range Finder to create the perfect solution.
Blue Guardian – an embedded blue lightblocking lens which prevents UVA and UVB rays from damaging the retina.
Skye Multicoat – improves visual clarity of any lens from 92% to 99%.
Contact: Opticare (AUS) 1800 251 852
Bonastar offers digital lenses and blueEase coating to meet the vision needs of people who frequently use digital devices.
BlueEase lenses block UV and harmful blue-violet light (approx. 380–450nm) while allowing beneficial blue-turquoise light (approx. 450–500nm) to pass through. Contrast, comfort, and focus is increased while eye fatigue and visual stress is minimised for those who spend hours using digital screens. BlueEase lenses also cut most blue light emitting from LEDs, xenon lights, energy saving bulbs, and electromagnetic radiation from screens. They minimise glare for sharp, clear vision. Available in stock 1.56, 1.60, 1.67, 1.74. Bonastar also supplies Crizal Prevencia stock lenses and Eyezen – Essilor’s innovative digital screen protection lenses which reduce eye strain.
Contact Bonastar: (AUS) 1300 763 988 or (02) 9310 1688