Are our Phones, Laptops and Tablets Hurting our Eyes?

Over the past several years, I have noticed increasing numbers of young patients complaining about eye strain and headaches towards the end of the day. Since the pandemic pushed kids indoors and forced the development of “e-learning”, this issue is even more common.

What’s going on here?

When performing near work such as reading or watching a Zoom conference, the eyes have to change focus (accommodate) as well as converge. This feels a bit like having your eyes lift a small weight to look up close – something we’re designed to do for short periods, but which becomes tiring with sustained effort.

Young children have a large reserve of accommodation, but this decreases in adulthood, especially following age 40. This is not due to a muscle losing strength, but more like a spring losing elasticity.

The eye lens gets stiffer over time and just can’t change focus, necessitating the use of reading glasses or bifocals to accomplish the task. There is no proven way to prevent this age-related loss of accommodation, and the 40 to 45-year-olds who doggedly insist on not using reading glasses are only making life difficult for themselves.

Specifically, because the problem isn’t a “weak muscle”, there is no point in trying to do eye exercises to improve lens focus. Conversely, convergence – the two eyes moving towards each other – is indeed a muscle action, specifically of the medial rectus muscles simultaneously pulling towards the nose.

A small percentage of people have a weakness of convergence, termed convergence insufficiency. This may result in poor coordination with near work and often causes double vision when the two eyes don’t line up properly. An eye doctor can easily and quickly test for convergence insufficiency by measuring the reserve ability (the convergence amplitude) at near fixation.

Unlike the much more common age-related loss of accommodation, convergence insufficiency can be improved with eye exercises. From an evolutionary standpoint, the discomfort we feel with prolonged near work is not surprising. We are designed to look for predators across the veldt, occasionally looking up close to gather nuts and berries, not binge watch hours on Netflix.

So, what’s to be done?

My first advice is to take more breaks when using technology. This might mean pausing a game or video, or just closing eyelids for a moment, to reflect on what we just read. Making an effort to reduce technology use is important – but admittedly a difficult sell, given how addicted many have become to phone use, in particular.

For young people with more persistent symptoms, however, a low-strength reading glasses or bifocal can provide enormous relief.

Benjamin H. Ticho, MD