An Eye ‘Sore’

17 January 2025

AS technology permeates our daily lives, the increasing reliance on screens, gadgets, and repetitive physical tasks has given rise to two modern health conditions: Computer vision syndrome (CVS) and repetitive strain injury (RSI).

Both of these conditions result from prolonged, continuous activity and impact millions of people globally, often without them realising the root causes. Understanding the physical causes behind these conditions is vital for prevention and maintaining long-term well-being.

In this first article of a two-part series, we look at CVS - now a common health issue affecting people of all ages, particularly in areas where digital device usage is highest.

What is computer vision syndrome?

CVS is caused by prolonged screen use, and it affects the eyes and visual system, leading to discomfort, blurred vision, and headaches.

Almost everyone is at risk, especially those who cannot live without their digital gadgets.

According to Sunway Medical Centre, Sunway City consultant ophthalmologist Dr Chin Pik Kee, CVS can manifest in a few different ways. The symptoms are wide-ranging and impact not only the eyes but also the surrounding musculature.

These include blurred or double vision, dry eyes, eye fatigue and discomfort, and even headaches and neck pain from the physical strain placed on the eyes and surrounding muscles.

Risk factors for CVS

The human eye is not designed to stare at anything for hours on end. Hence, several physical factors contribute to the development of CVS, including:

Reduced blink rate: When people focus on screens, their blink rate drops significantly, leading to dry, irritated eyes. Those who are prone to dry eyes are at increased risk of CVS.

> Poor lighting conditions: Glare from bright lights or reflections on the screen can make it harder for the eyes to focus, leading to strain. Conversely, working in dimly lit environments can also contribute to visual discomfort.

> Improper viewing distances and angles: Eye strain worsens when devices are held too close or too far from the eyes.

"These days, many people are exposed to computers, whether for work in sales, customer service, banking, or office roles, or for leisure activities like gaming, watching videos, and attending online classes—all of which can pose risks," says Dr Chin.

Dr Chin estimates that two hours is the limit before one’s risk of CVS increases, although this also depends on other factors, such as whether we take breaks, how often we blink during that time, and so on.

Who is at risk?

In Malaysia, several groups are particularly susceptible to developing CVS.

With the rise of remote working and increasing reliance on computers in office environments, many employees spend long hours at their desks. This prolonged screen time is a major contributor to CVS among working adults.

Students are increasingly using digital devices for learning, especially with the growth of online education. Long hours spent studying on computers or tablets can lead to eye strain, particularly in younger children whose eyes are still developing.

The popularity of video games, social media, and streaming services means that many people, particularly teenagers and young adults, are spending excessive amounts of time viewing screens. This puts them at higher risk for developing CVS.

Senior citizens: Older Malaysians may be at risk for CVS as they begin to use digital devices more frequently. Age-related vision changes, such as presbyopia (difficulty focusing on close objects), can make it harder to see screens clearly, contributing to eye strain.

Eye care for CVS

According to Dr Chin, CVS won’t directly damage the eyes per se, but if the person in question cannot change their viewing habits, it’s almost impossible to relieve them of their symptoms.

In addition, such strain can lead to misalignment of the eyes, a condition called strabismus (cross eyed). In children, this can lead to convergent strabismus (where one eye is turned inward), which can be permanent.

Dr Chin says that a study in South Korea found that in children who had developed convergent strabismus, many were using their smartphones up to eight hours a day. Some of these children recovered, while others had to undergo surgery to correct the strabismus.

The good news is that CVS can be effectively managed with a few simple lifestyle changes and adjustments to how we use digital devices.

> Follow the 20-20-20 rule: A simple and effective way to combat eye strain is to take regular breaks. Every 20 minutes, take a 20-second break and look at something 20 feet away. This allows the eyes to relax and reduces the strain from prolonged focusing on a screen.

> Adjust lighting and screen settings: Make sure your workspace is well-lit, but avoid harsh overhead lighting or bright sunlight that creates glare on your screen. Adjust the brightness and contrast settings on your device to reduce eye strain, and consider using a blue light filter, especially at night.

> Optimise screen position: Ensure that your computer screen is positioned at a comfortable distance (about 50-70cm from your eyes) and slightly below eye level. This reduces strain on both your eyes and neck.

> Increase blink rate: Try to consciously blink more often while using digital devices. This helps to keep the eyes moist and prevents dryness. If necessary, use lubricating eye drops to alleviate dryness.

> Use ergonomic furniture: Proper ergonomics can make a big difference in preventing both eye and body strain. Make sure your chair, desk, and monitor are properly adjusted to promote good posture, reducing tension in the eyes, neck, and shoulders.

> Regular eye exams: Malaysians who spend long hours on screens should schedule regular eye check-ups to monitor their vision health. Eye doctors can prescribe corrective lenses or recommend special glasses designed for screen use, which can help reduce the symptoms of CVS.

> Limit screen time: Where possible, try to limit non-essential screen time. For children and teenagers, balancing screen-based activities with outdoor play or other non-digital hobbies can help reduce the risk of CVS.

Dr Chin comments that the above measures are not only effective for reducing CVS, but can also help address the rising incidence of myopia (short-sightedness), especially in children.

“It is recommended that children spend more than two hours outdoors everyday. This is to allow the eyes to develop normally. Prolonged near work (looking at phone screens etc) can induce myopia,” she notes.

Addressing CVS requires a collective effort to raise awareness, particularly in workplaces and educational institutions. With increased awareness, Malaysians can take proactive steps to protect their eye health in this overwhelmingly digital world.

Source: The Star

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