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Those of us who have been in practice long enough can recall a time when we would ask our patients whether they used a computer. Today, virtually every patient we see uses some form of digital device (desktop, laptop, tablet, or mobile). We are all living in the digital world.
Smart Insights, a UK mobile marketing consultant firm, estimates that globally more than 1.9 billion people use mobile digital devices and more than 1.7 billion use desktop digital devices. In the United States, adults spend a median 5.6 hours on some form of digital display device, more than double the time spent in 2008.1
The Vision Council’s 2015 annual Digital Eye Strain Report estimated that more than a third of millennials spend 9 or more hours a day on digital devices.2 And according to its 2016 report, 33% of children use a digital device for 3 or more hours each day.3
With all of this screen time, concern has risen about the effects of digital eye strain (DES). According to the Vision Council, adults aged younger than 30 years experience the highest rates of DES symptoms (73%) compared with other age groups, and 90% of patients do not talk to their eye care providers about their digital device use.3
Eye care professionals know from experience in patient care that there is a relationship between the use of digital display devices and ocular symptoms. Contact lens wearers often report greater frequency and severity of DES symptoms than nonwearers.4 DES symptoms can be categorized into three groups: global sensations (eg, headache, soreness, strain); surface sensations (eg, dryness, burning, irritation); and visual sensations (eg, blur or image floating).5
We all acknowledge that contact lenses likely exacerbate DES, but can contacts also be used to remedy the problem? Some contact lens manufacturers think so. Lenses have been designed and introduced recently with the express purpose of positively affecting DES and digital device–related eye fatigue.
This past year CooperVision introduced Biofinity Energys contact lenses. According to the company, these lenses incorporate Digital Zone Optics, a lens design that helps with the tiredness commonly associated with digital device use. Specifically, Biofinity Energys lenses incorporate multiple front-surface aspheric curves across the entire optical zone. These curves distribute power evenly to simulate more positive power in the center of the lens. The resulting low effective add is intended to ease accommodative demand without negatively affecting distance vision. From the patient’s perspective, the lens seems to function like a monofocal contact lens in terms of distance vision clarity while also reducing symptoms commonly associated with digital device use.
According to the manufacturer, the combination of Digital Zone Optics with its comfilcon A material with Aquaform Technology allows Biofinity Energys to positively address both the visual and ocular surface impacts of digital device use. CooperVision claims that the Biofinity lens material optimizes oxygen transmission, wettability, deposit resistance, and modulus.
Based on internal studies, Cooper Vision has reported that, among patients who use digital devices at least 4 hours per day at least 5 days per week and who report symptoms of eye fatigue at least once per week, eight of ten said that the Biofinity Energys lenses with Digital Zone Optics made their eyes feel less tired. The company has not, however, reported specific studies regarding objective visual performance with Biofinity Energys, such as accommodative response or how the lens affects near vision performance.
A custom contact lens manufacturer, United Contact Lenses, has developed a lathe-cut soft contact lens, the RelaxLens, that is also meant to address aspects of DES. This lens design, which can be fabricated in a number of materials, incorporates a proprietary graduated progressive aspheric power profile to provide a net add power. The progressive add varies with the labeled distance power of the lens. Higher minus-power lenses have a greater net add effect to offset inherent induced spherical aberration. In addition, the manufacturer integrates a blue wavelength–blocking tint. Blue wavelength light emitted by digital devices has been reportedly linked to DES.
According to the patient advocacy group Prevent Blindness, blue light from computer screens and digital devices can decrease contrast, leading to DES.6 However, the association between blue light exposure from digital devices and negative impact on the eyes or visual performance is controversial. According to Adam Gordon, OD, of the University of Alabama at Birmingham School of Optometry, “Products created to block out blue light minimize eyestrain when using computers and digital devices, but have not been tested or shown to prevent any type of eye disease.”7
Undoubtedly, the use of digital devices has become integrated into all of our lives on a daily and extended basis. Although contact lenses can often exacerbate eye and vision symptoms associated with digital device use, contact lens technologies are now being developed to address these symptoms. We should be on the lookout for further developments in this area.
1. Smart Insights. Mobile Internet Trends. June 11, 2015. http://www.smartinsights.com/?attachment_id=53811. Accessed January 5, 2017.
2. The Vision Council. Hindsight is 20/20: Protecting Your Eyes from Digital Devices. The 2015 Digital Eye Strain Report. https://www.thevisioncouncil.org/sites/default/files/VC_DigitalEyeStrain_Report2015.pdf. Accessed December 12, 2016. www.thevisioncouncil.org/sites/default/files/VC_DigitalEyeStrain_Report2015.pdf
3. The Vision Council. Eyes Overexposed: The Digital Device Dilemma. The 2016 Digital Eye Strain Report. www.thevisioncouncil.org/digital-eye-strain-report-2016. Accessed December 12, 2016.
4. Kojima T, Ibrahim OM, Wakamatsu T, et al. The impact of contact lens wear and visual display terminal work on ocular surface and tear functions in office workers. Am J Ophthalmol. 2011;152(6):933-940.
5. Meyer D, Huenink S, Rickert P, et al. Symptoms associated with eye fatigue in soft contact lens wearers. Paper presented at: American Academy of Optometry Annual Meeting; October 7-10, 2015; New Orleans, LA.
6. Digital devices and your eyes. Prevent Blindness. April 19, 2016. www.preventblindness.org/computers-and-your-eyes. Accessed January 5, 2017.
7. Rohan A. Debunking digital eyestrain and blue light myths. UAB News. April 26, 2015. www.uab.edu/news/youcanuse/item/7258-debunking-digital-eyestrain-and-blue-light-myths. Accessed January 4, 2017.
S. Barry Eiden, OD, FAAO
• President and medical director, North Suburban Vision Consultants, Deerfield and Park Ridge, Illinois
• Assistant clinical professor, University of Illinois, Chicago, Department of Ophthalmology
• President and medical director, Keratoconus Specialists of Illinois
• President and cofounder, International Keratoconus Academy
• Financial interest: consultant to Alcon, Allergan, Bausch + Lomb, Cooper Vision, Marco, Oculus, Oasis, Optovue, Special Eyes, SynergEyes, Visionary Optics, and Vistakon; a member of EyeVis Eye & Vision Research Institute and International Keratoconus Academy of Eye Care Professionals