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Eye Health and Technology

by Mr Robert Morris(more info)

listed in vision and eye sight, originally published in issue 249 - October 2018

In an increasingly technological world, a spectrum of devices are creating a level of demand on our eyes both at home and at work beyond anything previously experienced.

We have gone from barely any computer and small screen contact in the early 1990s to now spending several hours a day intensely staring at screens. Latest research in the UK by eye hospital group Optegra shows that on average British adults spend four hours 35 minutes a day on computers, one hour 45 minutes a day on tablets and three hours a day on smartphones.

For 16-24-year-olds these figures are even higher - 20 per cent spend six-seven hours on a computer screen, 22 per cent spend up to three hours on tablets and a fifth spend four-five hours a day on smartphones.[1]

What does this close-up, highly focused vision for hours every day mean for our eye health?

It’s hardly surprising that two thirds (63 per cent) of optometrists across the UK have noticed an increase in patients with tech-related eye strain in the past five years, and 57 per cent said that excessive use of games consoles, smartphones and computers can definitely lead to eye strain. Indeed one in five (19 per cent) of GPs and opticians see technology as the biggest cause of vision problems.[2] 

Blue Light

Blue Light

However, it’s important to note that the impact is eye strain rather than damage to eye health. And this is caused by the artificial blue light which screens produce. Sunlight contains red, orange, yellow, green and blue light rays. Combined, this spectrum of coloured light rays creates what we call ‘white light’ or sunlight. Depending on where they fall on the spectrum, light rays have long wavelengths (with less energy) or short wavelengths (with more energy).

Blue light is a high-energy visible light and has shorter wavelengths. It is known as blue light because it is on the violet-blue band of the spectrum.

Blue light affects the body’s circadian rhythm, our natural wake and sleep cycle or ‘body clock’. During the day, natural blue light from the sun wakes us up and stimulates us. But too much blue light exposure late at night from a phone, tablet or computer can disturb the sleep hormone melatonin, making it harder to go off to sleep, and so we recommend avoiding technology for the last couple of hours of the day.

It is a myth that tablets, PlayStations and computers damage eyes - they don’t.  But because we are concentrating on the screens we only blink three or four times a minute, rather than the normal 20 to 30.  This means eyes dry out. We often hear complaints that vision is disturbed after long periods of screen time.  In reality, it is just that patients’ eyes have dried out. And this can be exacerbated with air conditioning. The remedy is to take breaks and try to blink frequently.

Computer Vision

Computer Vision Syndrome

Computer Vision Syndrome is now recognized as a valid eye condition and can affect about 90 per cent of people who spend three or more hours a day at a computer.[3]

Some of the symptoms of digital eye strain are:

  • Temporary blurred vision
  • Sore and tired eyes
  • Red eyes
  • Double vision
  • Dizziness
  • Dry eye
  • Headaches
  • Twitching eyes
  • Sensitivity to light

The 20-20-20 Rule

The 20-20-20 Rule

So what can we do to protect our eyes?  Optometrists recommend giving eyes a break from technology by looking away every 20 minutes. We recommend, especially for those who are potentially straining they eyes with many hours on technology, following the 20-20-20 rule: rest your eyes by looking at something at least 20 feet away from your tech screen for 20 seconds every 20 minutes.

In addition, try to remember to blink! That will help to moisten the eye - but as we focus on tablets and computers, we actually forget to blink and our eyes become uncomfortable.

You can also check that you have a high-resolution display, try to reduce any glare around your screen and use night settings if you have them to reduce the amount of blue light given off.

The other, essential way to protect your eyes is to have regular eye tests. Not only will they remedy any short or long sightedness, they will pick up on eye strain, dryness and any more serious eye health conditions.

The Gaming Generation

Even for our youngest Brits, there is concern for their vision as parents are allowing their children to spend hours every day on small screen technology.[4]  

Children aged 3-18 are spending an average of 2 hours 54 minutes a day playing on their games console, computer or iPad. Eight in 10 (80 per cent) 16-24-year-olds think that an increased reliance on technology has a damaging effect on their eyes.

Crystalline Lens

So are Children More at Risk?

As the College of Optometrists explains, when we are born, the crystalline lens inside our eye, which we use to focus from seeing far away to seeing close up, is clear.  As we get older, it naturally yellows and absorbs short wavelength (blue) light, protecting the retina.

In addition to this, children’s pupils are larger than the pupils of older people, so that more light (of all wavelengths) reaches the retina of a younger person than of an older one.

The combination of both of these factors means that more blue light will reach the retina of a child than that of an older person.

Advances in technology have resulted in an increasing dependence on looking at gadgets and devices up close for much of the day.

The effort on the eyes for this close focusing on smaller and smaller objects which may be moving around, and when staring for long periods, can result in eye strain, headaches, blurred vision and soreness.

Regular eye checks are important to maintain eye health and to ensure spectacle and contact lenses remain up to date with their prescription.

For our children, it is important that, as parents, we supervise and limit the time that they spend each day looking at small screens.

As we get older and we use these devices we may rely more and more on optical aids. Optegra and its specialist expert eye surgeons have laser and surgical solutions to reduce dependence on spectacles and contact lenses and continue to research into the latest techniques.

Red Flags

No matter how many hours you spend on technology, or even if you do not use it at all, there are certain ‘red flags’ to be aware of with your eyes  – symptoms that could be a sign of a serious eye condition, and should not be ignored as many eye conditions can be best treated the earlier they are diagnosed.

If you have any of these symptoms, it is highly recommended to book an eye test as soon as possible:

  • Sudden loss of vision
  • Blind spot or ‘curtain’ across vision
  • Double vision
  • Flashes and floaters – dark shapes passing across vision
  • Distorted vision

Advances in Technology

While advances in technology are having an impact on our vision, is tech helping save our sight too? 71 per cent of optometrists say that improvements in technology are making it easier to treat eye conditions  And a quarter (24 per cent) of GPs and 18 per cent of optometrists think eye test apps are helpful at diagnosing eye problems.

Across Optegra eye hospital group a number of investments have been made which demonstrate the benefits of the latest technologies in helping us, as surgeons, to treat eye disease.

These include SMILE, third generation laser surgery technology.  SMILE stands for SMall Incision Lenticule Extraction and is a bladeless, flapless, minimally invasive alternative to traditional laser surgery. Considered the ‘keyhole surgery’ of laser, the technology means that the popular 30-year-old laser eye techniques can, for the first time, be performed without creating a ‘flap’ on the surface of the eye.

Glaucoma patients have traditionally relied on numerous eye drops every day to keep their eye pressure at a safe level, and now we can treat them with a tiny stent called Cypass.  Just the size of an eye lash, it is positioned to help drain fluid the eye and so reduce eye pressure.  We can now operate earlier in the disease to prevent vision loss occurring and we’re starting to use it to improve quality of life and eye drop burden.

The rapid evolution of technology has led to a change in how we use our eyes and the development of new conditions such as computer vision syndrome. Technology also enables eye care professionals to diagnose and treat eye conditions in a way that was unthinkable even 10 years ago. I anticipate that over the next 10 years we will see similar progress. 

References

1. Optegra Eye Health Care commissioned independent research with Censuswide. The online research took place in January 2017 with 2,009 UK adults aged over 16 and 101 GPs and optometrists.

2. Optegra commissioned research with Censuswide in July 2015; online research with 2,016 adults aged 16 or over throughout the UK, 50 GPs and more than 50 optometrists.

3. Becoming a Squinter Nation, Wall St. Journal, August 17, 2010

4. www.college-optometrists.org ; https://www.college-optometrists.org/the-college/media-hub/college-in-the-news/watchdog-episode-2-series-37-bbc-9-august-2016.html

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About Mr Robert Morris

Mr Robert Morris BSc(Hons) MB BS(Hons) MRCP(UK) FRCS(Eng) FRC Ophth is Consultant Opthalmic Surgeon at Optegra Eye Health Care. He graduated with honours from St Bartholomew’s Hospital and obtained a BSc with honours from the University of London. He initially trained at Oxford Eye Hospital, Moorfields Eye Hospital and the University of Iowa, one of the top five training programmes in the United States. Mr Morris has been a Consultant Ophthalmic Surgeon at Southampton General Hospital since 1991 and in Winchester where he has been Deputy Medical Director since 1995. He has performed over 8,500 cataract procedures and is recognized as a national expert in squint surgery. He has been carrying out laser vision correction since 1994 and is experienced in LASIK, LASEK and Wavefront treatments. He also has considerable expertise in presbyopic lens exchange.

Mr Morris has been Chairman of the Wessex Deanery Education Committee and Regional Adviser for Wessex to the Royal College of Ophthalmologists. He is an examiner for the Royal College of Ophthalmologists and a member of their Microsurgery Training Faculty. He has lectured and presented papers nationally and internationally on cataract, refractive and strabismus surgery and has published over 35 papers in peer-reviewed journals. He is a member of both the American and European Societies of Cataract and Refractive Surgery. Mr Morris may be contacted via Optegra Eye Health Care.

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