Digital eye strain: the symptoms, the causes and the fixes

Digital eye strain, also called computer vision syndrome, is the set of symptoms many people get after long stretches at a screen: tired, dry or burning eyes, blurred vision, headaches, and often a stiff neck and sore shoulders to go with them. It comes from a handful of causes that tend to arrive together: focusing up close for hours, blinking less, glare, a screen at the wrong height or distance, and eyesight that isn't fully corrected.

For most people it is temporary. It eases with rest, and it is not known to damage your eyes. The fixes are simple and work best in combination: regular breaks to look far away, deliberate blinking, a better placed screen, brightness that matches the room, bigger text, and an eye exam if you haven't had one in a while.

The symptoms

Digital eye strain doesn't feel the same for everyone. The common ones are:

• Tired, aching or heavy eyes, the feeling that your eyes have done a long shift.
• Dry, gritty, burning or stinging eyes. Some people get watery eyes instead, which sounds backwards but is often the eye's response to a dry surface.
• Blurred vision, or focus that takes a moment to catch up when you look up from the screen.
• Headaches, often around the forehead or temples, and often late in the day.
• Sensitivity to light and glare, especially from bright windows or overhead lights.
• Neck, shoulder and upper back pain, from the way you hold your head to see the screen.

The pattern is a clue in itself. Symptoms that build through the day, get worse through the week and fade after a weekend away from screens point toward eye strain rather than something else.

What causes it

There is rarely a single cause. Most people have two or three of these at once.

Focusing up close for hours

Looking at something near takes work. A muscle inside each eye tightens to bring the text into focus, and both eyes turn slightly inward to point at the same spot. Hold that for a few hours without a break and the eyes tire, the same way any muscle would. The 20-20-20 rule exists to interrupt exactly this.

Blinking less

People blink less often when they concentrate on a screen, and more of their blinks are partial ones that don't close the eye fully. The tear film on the surface of the eye dries out between blinks, which causes most of the stinging and grittiness.

Glare and brightness

A screen much brighter or much darker than the room around it is harder to look at for long. A bright window behind the screen, or one behind you reflecting in it, makes things worse, as do bright overhead lights.

Screen position and posture

A screen that is too close keeps the focusing effort high. One that sits too high makes you open your eyes wider, which exposes more of the eye's surface to the air. One that sits too low, like most laptop screens on a desk, pulls your head forward and down, which is where the neck and shoulder pain comes from. Leaning in to read small text does the same.

Eyesight that isn't fully corrected

This is one of the most common causes, and the easiest to miss. A slightly out-of-date prescription or a small amount of uncorrected astigmatism can be enough to make screen work tiring. From around your 40s, the eye also finds close focus harder, and glasses set for reading distance or for distance vision may not suit a screen at arm's length. Some people with progressive lenses tilt their head back to see the screen through the right part of the lens, which adds neck strain on top.

The air around you

Air conditioning, heating, a desk fan or a vent pointed at your face all dry the eyes faster. Contact lenses can add to it.

Match the fix to the symptom

The fixes

Take breaks that use your distance vision

Every so often, rest your eyes on something 20 feet or more away, about six meters, for 20 seconds or so. A window is ideal. Take a longer break away from the screen every hour or two as well. The exact numbers matter less than doing it regularly.

Blink on purpose

When you look away, close your eyes slowly and fully a few times. It spreads the tears back across the surface. If dryness is your main problem, dry eyes at the computer goes into it in more detail, including when it is worth seeing an optometrist.

Put the screen in the right place

Aim for about an arm's length away, with the top edge level with your eyes or a little under, so your gaze tips slightly down. With a MacBook, that usually means a laptop stand and an external keyboard, or an external display.

Match brightness to the room, and cut glare

In System Settings > Displays, turn on automatically adjust brightness if your Mac offers it, and True Tone on Macs that have it. Turn the desk so windows are to the side of the screen rather than behind it or behind you. Close a blind if the afternoon sun hits the screen. There is more on each display setting in Mac screen brightness for eye comfort.

Make text bigger

Leaning toward the screen is the giveaway that text is too small. In System Settings > Displays, pick a scaled resolution nearer the Larger Text end, or press Command and plus to zoom in the app you are using.

Fix the air

Turn vents and fans so they don't blow across your face. If the room is very dry, a humidifier may help. If you wear contact lenses, ask your optometrist whether a different lens, or glasses on long screen days, would be more comfortable. For eye drops, ask a pharmacist or your eye doctor which kind suits you.

Get an eye exam

If the changes above don't help within a couple of weeks, book an eye exam with an optometrist or ophthalmologist. Tell them how much of your day is spent at a screen, and measure the distance from your eyes to your screen before you go, so you can give them a number. They may suggest glasses set for screen distance, sometimes called computer glasses or office lenses.

Blue light filtering glasses are often sold as a fix for eye strain. The American Academy of Ophthalmology says blue light from screens does not damage the eyes and does not recommend special glasses for computer use. Breaks and a correct prescription do far more.

When to see someone soon

Eye strain is uncomfortable, not dangerous. But some symptoms are not eye strain, and need attention rather than a new desk setup:

• Symptoms that don't improve with breaks and setup changes, or that are there every day.
• Blurred vision that stays blurred after rest, or double vision.
• A painful or red eye, or new sensitivity to light.
• Sudden flashes of light, a shower of new floaters, or a shadow or curtain over part of your vision. These need urgent care, the same day.
• Headaches that are severe, new or getting worse. See a doctor.

Let the notch keep count

Most of the fixes above you do once: move the screen, change a setting, book the exam. Breaks and blinks are different. They have to happen every day, and they are the first thing to slip, because the hours when your eyes need them most are the hours you are most absorbed.

Notchpals has three Eyes characters for that daily part: Blip, who comes with every copy of the app, plus Bill and Blush. Your crew holds one of them.

Whichever one you have comes out of the notch for two kinds of visit: an eye break, which is the 20-20-20 idea, and a blink break, which asks for a few slow, full blinks. Bill, a shoebill with a famously unblinking stare, has a point to make about the second.

BillBlink slowly. You are staring like me. Only one of us should do that.

Done tells it you looked away or blinked. It can't check, so it takes your word. Later sends it off for 20 minutes, and a second Later lets that visit go. How often it comes depends on the daily allowance you pick for your whole crew's repeating reminders (Calm, Normal or Chatty), and even the busiest setting means far fewer visits than a strict every-20-minutes rule. That is on purpose: the habits above cover the gaps. It also has one evening visit, in the 9 PM to midnight window, that asks you to dim the screen, the time of day when a bright screen glares most.

If your eyes still complain after a couple of weeks of all this, book that eye exam.