The Effects of Computer Use on Eye Health and Vision (1997) [pdf]

1. Monitor should be arms length away. 2. Brightness should conform to the light in the room. 3. Try to get a good bit of ambient light from the side (via a lamp or window). 4. Keep eyes at a 10-15° downward angle on the monitor. 5. Take a break every hour and let your eyes rest for a second. 6. If you have glasses, wear them.

Those six principles will go a long way toward keeping your eyes happy!

one factor people miss is that, it's not just the amount you spend staring at screen that causes eyestrain and headache, but also how focused you are, we squint a lot when we focus and that appearantly is an issue, looking at a screen for 3 hours without having to think hard versus 1 hour of hard squint, the 1 hour is more damaging. for me at least...

Rather it's a combination of genetic susceptibility to being near/far sighted and straining your eyes during the susceptibility "period".

That is if you aren't genetically inclined to eye problems, no reading or computer use is going to make your require glasses. If you are genetically inclined and do near work (reading books, computers,phones etc...) then your number will rise during childhood and early adulthood. The number usually stabilizes between 20 and 30 years.

If you are genetically inclined but don't do near work, you will not need glasses.

Staring at a computer for long hours without blinking will give you headaches though, and maybe blurry vision, but that'll pass in a day or two.

Here's everything that I tried, along with a comment about how well it worked:

- Switched from monthly contact lenses to dailies (Helped moderately, but at that point my eyes were getting worse fast enough for me to not notice a real difference

- Switched from contact lenses to glasses (Helped with comfort once I got used to glasses again, but not with dryness)

- Various OTC eye drops (Retaine MGD is still the best for my eyes, but overuse seems to make it worse)

- Eye doctor prescribed a 2 week steroid eye drop regimen. (So no difference)

- 10 minute warm compress on the eyes twice a day (This helped a lot when done consistently, but my eyes were still really bad throughout the day)

- Omega 3 supplements (Seemed to help a bit when I was consistent with the dosage)

- Various eye exercises (helps a lot, but I HAD to be consistent for multiple days before seeing results)

- Restasis (no benefit after 3 months)

- Xiidra - okay, so this has given me the MOST relief out of anything, even consistent eye exercises. My eyes actually feel normal again, and I saw results after just a couple weeks. Using a new medication kind of makes me nervous, and it's incredibly expensive (even with insurance), but I got to the point where I was willing to take the risk because I was getting desperate. Having severe dry eyes can negatively effect every waking moment.

I'm hoping that after a few more months on Xiidra my gland inflammation and tear composition will be in a good enough place that I'll be able to stop using the medication (which I'll be following up with my eye doctor about soon).

If you're just getting started with a career on the computer START TAKING CARE OF YOUR EYES NOW. Take frequent breaks and perform frequent eye exercises. Hopefully that will help prevent you from getting to the place I did, where it takes a significant amount of work and money to get back to having healthy vision.

"As we stare at the computer screen or while reading, our blinkrate decreases. We actually blink 66% less while working on the computer. This can make your eyes burn, dry out, turn red or feel itchy ... research demonstrates that we do enter some sort of altered mental state when we blink — we’re not just doing it to lubricate our eyes. A blink could provide a momentary island of introspective calm in the ocean of visual stimuli that defines our lives."

Using a standup workstation during part of the day may also help you because the "activation energy" required to move around and leave your workstation is minimal compared to sitting in a chair.

You can also get a weaker prescription if you have eyeglasses (not sure about contacts) that will help if you stare at a screen all day.

I buy those cheap standard supermarket glasses, currently at strength +2. They get me nicely through 8 to 10 hours af screen in a day. Whenever I go off the deep end, and spend more hours than that for several days running, I do tend to get reddish, itchy eyes.

As others in the thread have reported, the arrival of flat screens was a blessing. CRTs would generally tire me out quite a bit sooner. But I don't seem to have suffered long term adverse effect from them.

Had is the keyword here, because two years ago I began spending around half of my time in a place 1500km away from my home, to and from which I drove, because I needed to both have a flexible schedule and bring with me items that I couldn't or didn't want to bring aboard a plane(like my guitar). Also I despise flying.

After a year of those 17-20h drives back and forth I started experiencing symptoms of dry eye syndrome which eventually developed into styes, and later a total of three chalazions.

Recently I had a checkup done and while my left eye is still good(insignificant defect), the one that had chalazions is currently -0.5D with 0.25 astigmatism.

My point being: It took only two years of extremely long driving vs 17 years of staring at screens to cause eye problems in my case.

[0] When I was 17 I could easily read time from a 30cm high LED display from 120m.

EDIT: emphasis.

Since ebook readers have become more commonplace in the last 20 years, I also have to wonder what effects that might have on us. Even on days when I avoid using my computer, I still spend a good couple of hours reading ebooks on a tablet.

There have also been tons of advancements in technology. I don't think high-DPI displays were commonly available, but the technology is increasingly commonplace, especially on mobile devices.

THIS. After about 7 years of staring at a screen all day at work, then coming home and staring at a screen all night (gaming, programing, etc), plus marijuana = dry squinty eyes-- the cumulative effect was that my eyes began to always focus slowly and unevenly, especially on things far away.

I got glasses and they helped, but it felt like more of a bandaid than a solution.

I have since reduced my close-up computer screen usage dramatically. I also do the occasional eye exercises (youtube has a lot of these and they really help).

I stopped wearing glasses and spend more time outside and away from the screen so my eyes actually have more things to do than look at bright pixels 3 feet away.

If I could give any advice to my younger self it would be to minimize long stretches of staring at the screen. Take plenty of breaks to give your eyes a break.

Somehow I think this direct light into our eyes is impacting our not only our eyes, but our brains negatively.

Some background: eyes are lubricated by the tear firm which consists of three layers: inner mucous layer, an aqueous solution layer, and an outer lipid layer (meibum). The mucous layer is the thinnest and keeps the tear film to your eye. The aqueous solution is released from the lacrimal gland and makes up the bulk of the tear film. Meibum is secreted from meibomian glands in the eyelids every time you blink and keeps the tear film from evaporating. With a healthy tear film you should be able to keep your eyes open for at least 30 seconds before you start feeling a burning sensation. If you don't have a stable tear film you will start to feel a burning sensation much sooner and this is what is known as "dry eye". Dry eye and can be caused by a deficiency in any of the three layers and is usually categorized into two main categories: aqueous-deficient dry eye and evaporate dry eye. Aqueous-deficiency dry eye is usually caused by systemic diseases such as autoimmune diseases (e.g. rosacea, lupus, Sjogren's syndrome) that prevent the lacrimal gland from producing tears and from the statistics that I've seen this accounts for about 20% of dry eye cases. Evaporate dry eye is caused by a deficient lipid layer which is usually caused by meibomian gland dysfunction and accounts for the majority of dry eye cases.

There's not a lot known about what causes meibomian glands to malfunction but some theories are that: inflammation causes them to get blocked, autoimmune diseases attack the tissues, hormone imbalance causes deficient secretions, harsh environments cause inflammation which causes them to get blocked, and contact lenses interferes with blinking rates and the mechanics of blinking. Once meibomian gland dysfunction starts, it often starts a vicious cycle which causes inflammation which causes more blockages which causes more inflammation. Blockage of the meibomian glands eventually (think several years) leads to meibomian gland atrophy where the glands start shriveling up and die, starting from the back. Healthy glands are normally about 10 mm long but over time they will become truncated and eventually completely atrophy (known as "gland drop out"). This process is also seen to a lesser degree in elderly people, and especially postmenopausal women.

I started wearing contact lenses when I was a young teenager, and also as a young teenager, I spend an unhealthy amount of time staring at computer screens. A few years later my contact lenses started to become uncomfortable and I switched contact lens brands and cleaning solutions and I was able to continue wearing them for another couple of years. Eventually it got to the point where I couldn't tolerate wearing them because they were just too uncomfortable. I figured this was normal because lots of people complain about their contact lens comfort, and I attributed it to living in a dry climate and spending lots of time on the computer. But then, even with wearing glasses I started noticing that my eyes were uncomfortable. I started waking up with red, gritty eyes. I went to my optometrist and told him about this and he simply gave me some eye drops and told me to put them in before bed and whenever I felt dry eyes. But over the years problem only got worse. I had to constantly blink, and my eyes were always bloodshot. This is when I started to seriously investigate dry eyes.

I went to an optometrist seeking for help who told me about some things I could try such as warm compresses (which I was already doing) and blinking exercises. I also went to an ophthalmologist who basically told me that lots of people have dry eye and bluntly told me "I deal with people who are about to lose their eyesight, and you are not going to lose your eyesight because of this" and prescribed me a short course of corticosteroid drops. I saw a couple more optometrists who were of no help, before I decided to seek a dry eye specialist in another city, who looked at my meibomian glands and confirmed what I feared the worst: my meibomian glands were in very bad health. I was only in my 20s, and my meibomian glands had already truncated to about 25% of their original length. (You can see how healthy glands are supposed to look compared to unhealthy, truncated glands: http://www.clemsoneye.com/Portals/0/meibomian_glands.png)

I found a supportive optometrist in my city who is sympathetic and willing to try different treatments with me. So far I have tried the following:

* Lubricating eye drops: I take preservative-free drops every day but they only offer limited short term relief. I've also tried lubricating gels but I find that they clog my glands even more and cause more discomfort. I only use them in emergencies when I'm willing to trade off short term comfort for more misery (they will unbalance up my tear film for several days).

* Warm compresses: Applies heat to your eyelids to unclog the glands. I do this once every few days but if I do it any more I will end up with more inflammation which makes my symptoms worse.

* Corticosteroids: They do seem to reduce inflammation but doctors won't prescribe these for more than a few weeks at a time because they cause high intraocular pressure.

* Tetracycline antiobiotics: Low dose tetracycline antibiotics (usually doxycycline, minocycline) are taken off-label to reduce inflammation. I've been taking these on and off for months at a time for the last 5 years. I believe it helps my comfort but my optometrist warns me to not stay on long term, but I will continue taking these for the rest of my life because at this point I don't care if long-term antiboitic use destroys my kidneys and liver.

* Restasis: An eyedrop that helps primary for aqueous-deficient dry eye. I've been on this for a while as well and I will continue to take it even thought I don't think it helps much. It's normally very expensive but luckily my insurance covers it.

* Lipiflow: A treatment where a machine places a cup on your eyeball and applies heat and massages the inside of your eyelids. I spent $1500 out of pocket on this and it was just as effective as my next item.

* Manual expressions: Using forceps my optometrist squeezes my eyelids to force meibum out of my glands to keep it from clogging and stagnating. This helps short term, but it can only be done so frequently because it can cause long-term tissue damage. I purchased my own forceps and (probably to the horror of my optometrist, I never told him) I do this myself.

* Controlling environment: Having a humidifier helps me a lot and I keep the relative humidity above 80%. Being in a dry environment such as airplanes is very uncomfortable and whacks my tear film out of balance for days.

* Moisture chambers: Essentially, these are air-tight goggles that prevent moisture from evaporating from your eyes. They do help but I hate having to wear them and I don't wear them in public, but I will probably have to eventually.

* Eye exercises: I consciously blink hard several times, every 30 minutes. It helps a bit.

Overall, my symptoms have only marginally improved. My life has become miserable because of this and my social life and professional life have suffered. I don't enjoy going out anymore because I hate being in dry environments where it causes my symptoms to get worse. Just being in a dry environment for a couple hours will disrupt my tear film for days after. It has caused me depression and I considered ending my life at one point.

There is a lot unknown about this disease. Nobody can tell me why my glands got into such bad shape, but I believe wearing contact lenses and using the computer, and having bad blinking hygiene contributed a lot to it and I see that even most optometrists have been clueless and are only now learning about dry eye because of its increasing prevalence. Because it's not understood well, there's not much support for sufferers of dry eyes. The immediate reaction of optometrists upon hearing a complaint about dry eye is "here, try this brand of sample drops that they sent to my clinic". Insurance doesn't cover treatments and I've incurred thousands of dollars in out-of-pocket expenses, and had to take significant time off from work to seek specialists and treatments.

Looking back, here's what I wish I had done:

* Not wear contact lenses, especially when on the computer for 12+ hours a day

* Blink regularly and consciously when using a computer

* Investigated sooner about dry eye when I started experiencing symptoms (it is not normal to have dry eye)

* Spend more time outside

Perhaps how previous generations were taught about oral hygiene and the importance of brushing teeth, future generations will be taught about ocular hygiene and the importance of blinking exercises and health of eyelids.