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By Jennifer Zolman, OD

Dec. 9, 2020

In our increasingly virtual world, it is important that we take note of patients complaining of symptoms of digital eye strain. With our increasing reliance on laptops, tablets and smartphones, especially since the outbreak of COVID-19, patients no longer have the luxury of taking a “digital vacation.” A recent survey showed that 70 percent of adults, aged 18-54, spent more than half their day looking at screens, while one in three spent more than 75 percent of their day on digital devices.1

Greater Screen Time, Greater Eye Strain & Discomfort
It’s no wonder that so many patients have been expressing concern about digital eyestrain. Digital eyestrain is defined as ocular discomfort felt after two, or more, hours in front of a digital screen.2 However, the average time on screens for adults in 2019, even before the COVID pandemic, was a whopping six hours a day or roughly 2,500 hours a year!3 Children, ages 5-18, are also logging a significant amount of screen time due to virtual learning, putting them at potential risk of digital eye fatigue. A recent survey found that 65 percent of children spend at least three hours per day and 23 percent of children spend six hours per day on digital devices for school.2

As a result, there has been a significant uptick in patients contacting me requesting help with ocular discomfort associated with digital device use. This is a nationwide trend with 77 percent of adults experiencing symptoms of digital eye strain daily, and 39 percent of school aged children reporting at least one symptom of digital eye strain following school-related digital device usage.2

Prescribing a Contact Lens that Addresses Digital Eye Fatigue
When patients contact me, I explain that their eyes are working their hardest when looking at digital devices. I tell them that one study indicates that our normal blink rate is 12-15 times per minute4, but, when using digital devices, that rate drops by half, which contributes to eye dryness as well.5 I also tell them about accommodative burden, which can make eyes feel tired, and can also be a consequence of prolonged usage of digital devices.6 Biofinity Energys® has shown to be an ideal option to help manage these patients’ concerns as it has technology to address both tiredness and dryness associated with digital eye strain. The contact lens material leverages Aquaform Technology® helping to soothe dry eyes during periods of reduced blinking, such as during digital device use. The unique optical design, Digital Zone Optics®, helps ease ciliary muscle stress and accommodative burden7, and helps with the eye tiredness caused by digital device use. Finally, since the lens is a monthly replacement, it is a cost-effective choice.

In our practice, we do a comprehensive needs assessment and ask our patients to complete online forms in advance of their visit that ask key questions, such as, whether they are experiencing any ocular discomfort and what types of eyewear they currently use. It is important to take a proactive approach with patients as 78 percent of contact lens wearers are interested in seeking ways to reduce eye tiredness8, but only 14 percent of contact lens wearers or their ODs bring up digital device use during appointments.10 This proactive approach helps us assess their unique needs and to introduce Biofinity Energys® contact lenses as a viable option for them early in their eyecare journey. Good candidates are not rare – they are any new or established spherical wearer with symptoms of digital eye strain.6

Once it is determined that a patient is indeed a good candidate, I explain why the unique combination of material and optical design of Biofinity Energys® could be an ideal option for them. While the concept of reduced blinking leading to eye dryness is simple to explain to patients, a concept like accommodative burden can be more challenging. I find the “rubber band” demonstration tool, provided by CooperVision®, a helpful way to talk to patients about ciliary muscle stress that can lead to accommodative burden and eye tiredness. CooperVision® has also introduced a variety of “touchless” digital assets that I can send to patients to learn more about the Biofinity Energys® contact lens or how screen time impacts their eyes.

Recommending small lifestyle changes like implementing the 20/20/20 rule9 (every 20 minutes take a 20 second break and look at an object 20 feet away) combined with prescribing newer technology like Biofinity Energys® allows me to offer a comprehensive approach for my patients with digital eye strain. Interestingly, the total benefit of the lens is not always evident immediately.11 However, after 3-6 months, patient satisfaction increases considerably because they no longer experience the symptoms of eye tiredness or dryness as they did before11. During follow-up office visits, feedback from children, college students and adults alike has been overwhelmingly positive due to the notable reduction in eye strain on digital devices. This is consistent with data that eight out of 10 digital device users agreed that Biofinity Energys® contact lenses made their eyes feel less tired.

I can personally attest to the benefit of Biofinity Energys® contact lenses because I myself upgraded to them. I found them to be an easy fit and the decrease I noted in eye strain was considerable.

Maintaining an open dialogue with patients regarding digital eye strain throughout all stages of their care continues to be the primary focus of our practice. By having these discussions around their symptoms and new technologies available it helps to address their needs. Those conversations build trust and loyalty, and in turn, help inspire patients to refer friends and family11, so it proves to be a practice building opportunity as well.

REFERENCES
1. YouGov Plc. Survey of 2,444 adults in the United States. August 26-28, 2020. The survey was conducted online.
2. The Vision Council. Eyes Overexposed: The Digital Device Dilemma – 2016 Digital Eye Strain Report.
3. eMarketer. April 2019 report. Ages 18+.
4. Coles et al 2018 Clin Exp Optom (management of digital eye strain) that summarized work in this area “Many studies show that blink rate is reduced during computer use (3.6–11.6 blinks/minute). compared to normal blinking (17–26 blinks/minute).
5. “Blehm C, Vishnu S, Khattak A, Mitra S, Yee RW. “Computer vision syndrome: a review.” Surv Ophthalmol. 2005;50(3):253–262.
6. “Symptoms associated with eye fatigue in soft contact lens wearers.” Authors: D. Meyer, S. Huenink, M. Rickert, P. Chamberlain, and P. Kollbaum. Presented at the American Academy of Optometry Annual Meeting, October 2015, New Orleans, La., USA.
7. Kajita M et al. Changes in accommodative micro-fluctuations after wearing contact lenses of different optical designs. Contact Lens Ant Eye (2020) In Press https://doi.org/10.1016/j.clae.2020.03.003.
8. CooperVision Digital Device Usage Report, 2017.
9. The Vision Council. Digital Eye Strain. https://www.thevisioncouncil.org/content/digital-eye-strain
10. CVI Data on file 2016. Prospective, multi-center, subject-masked, bilateral, one month dispensing study in USA with Biofinity Energys® in existing Biofinity® sphere wearers. N=52, after 2 weeks.
11. CVI data on file, 2018. Online survey Biofinity Energys CL wearers, USA. n=200.


Jennifer Zolman, OD
, practices with Draisin Vision Group in Charleston, S.C.

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