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What is digital eye strain (DES)?

DES - I am very tired.

Digital device usage has increased substantially in recent years across all age groups, so that extensive daily use for both social and professional purposes is now normal.

Digital eye strain (DES), also known as computer vision syndrome, encompasses a range of ocular and visual symptoms, and estimates suggest its prevalence may be 50% or more among computer users. Symptoms fall into two main categories: those linked to accommodative or binocular vision stress, and external symptoms linked to dry eye.

Use of digital devices

Across all age groups in developed nations, engagement with digital devices has increased substantially in recent years, particularly in the field of mobile media. A multination European study including England, reported that by 3 years of age, 68% of children regularly use a computer and 54% undertake online activities.

In 2016, it was estimated that UK adults typically spend 4 hours 45 min per day using digital media, with a similar pattern in the USA, where approximately two-thirds of adults aged 30–49 years spend five or more hours on digital devices.

In older age groups, use of technology is growing rapidly (figure 1) between 2011 and 2017, the proportion of the population classed as ‘recent internet users’ (within the last 3 months) more than doubled in the 75 years and over age group, and increased from 52.0% to 77.5% in those aged 65–74 years.9 Recent US data indicate that 37% of adults aged 60 years and over spend five or more hours per day using digital devices, and this age group prefers using laptops and desktops for browsing the internet, whereas younger adults are more likely to use smartphones for this purpose.8 Use of social media and multitasking is particularly prominent among younger adults with 87% of individuals aged 20–29 years reporting use of two or more digital devices simultaneously.

Symptoms and prevalence

According to the American Optometric Association, the most common symptoms associated with DES are eyestrain, headaches, blurred vision, dry eyes and pain in the neck and shoulders.

Asthenopia is the formal term for eye strain, for which two distinct mechanisms and sets of symptoms were described by Sheedy et al.

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