By Ritika Sakhuja
New Delhi: Screens and displays have become ubiquitous with the advent of the digital era. As the technology evolves further their usage is increasing leading to an increase in screen time among individuals. With digital being touted as the future and newer breakthroughs in technology the demand for devices with screens (displays) is rising.
Increased screen time is leaving a debilitating effect on health. Recently, Dr Sudhir Kumar, Neurologist, Apollo Hyderabad, brought to light a disturbing case of a 30-year-old woman suffering from disabling vision symptoms due to excessive smartphone use.
In a viral tweet thread, he shared the case of a 30-year-old Manju who had vision problems for one and half years, which included symptoms such as seeing floaters, flashes of lights, dark zigzag lines, and recurring episodes of blurred vision, lasting for seconds to minutes and repeating every 10-15 minutes. In addition, she would go blind for a few minutes upon waking up in the middle of the night to use the washroom, informed Dr Kumar, calling it a case of the ‘smartphone vision syndrome.’
However, experts inform that the ‘Smartphone Vision Syndrome’ has been sensationalised in popular culture, leading to misinformation that could sway public knowledge. To explore the intricacies of this case, ETHealthworld spoke to Dr Sudhir Kumar to understand the process that led to this diagnosis which labelled excessive smartphone use as the cause behind Manju’s impaired vision. ETHealthworld also spoke to doctors to gain insights into the health impact of regular exposure to digital screens.
Dr Kumar shared that the patient had initially consulted an ophthalmologist who upon conducting a detailed eye check-up, ruled out any eye disease. “She was then referred to me to rule out any neurological cause for her vision-related symptoms. Detailed clinical neurological examination was normal and her symptoms did not point to any specific brain nerve-related disease. So, I took a detailed history,” he added.
Recollecting the details of the history that Manju provided, Dr Kumar said, “She revealed that she had quit her job as a beautician one and a half years ago to look after her specially-abled son. At the same time, she had started spending too much time on her smartphone. She would look at the smartphone screen for eight to ten hours during the day and two hours at night in darkness with lights switched off.”
“I suspected that her vision symptoms were related to looking at a smartphone screen for long hours, as I had seen similar cases in the past too. I did not order any investigations nor did I start her on any medicines. I counselled her and advised her to restrict her smartphone usage. She returned for review after a month and all her vision-related problems had subsided. She reported that her vision was normal. This confirmed our suspicion of her being a case of smartphone vision syndrome,” concluded Dr Kumar.
Labelling ‘dry eyes’ as Smartphone Vision Syndrome
Notifying about the symptoms of prolonged use of smartphones, Dr Abhishek Hoshing, Ophthalmologist, Apollo Hospitals, Navi Mumbai said, “For adults, if people are using the smartphone for a long time, they can have discomfort, redness of eyes, pain in eyes, brows, and the forehead, and can also have lot of dryness of eyes especially if they are in an air-conditioned room. For children, high smartphone can lead to get glass with power or rapid progression of the pre-existing glass power.”
Experts informed that there could be multiple mechanisms behind vision-related problems due to excessive smartphone use. “The muscles involved in moving the eyeballs and for eyes to focus may get fatigued or weakened with excessive use. This can adversely affect the clarity of vision and may cause double vision at times. Many people who are addicted to smartphones don’t get adequate sleep, and sleep deprivation is known to increase eye strain and visual problems,” added Dr Kumar.
He continued, “Short-duration blindness in one eye may occur after using a smartphone at night during darkness. The prevailing hypothesis is that while in the lateral recumbent position, with the head resting on one palm, one eye is blocked such as with a pillow, and subsequently becomes dark-adapted while the other eye exposed to the bright screen of the device becomes light-adapted. After the screen of the device is deactivated and the room is once again lit with low ambient light, the light-adapted eye is perceived to have poor or no vision. The vision returns to the patient’s baseline after several minutes.”
Adding to the reasons behind smartphone vision syndrome, Dr Hoshing relayed, “When you have to look at something very close to your eyes or your face, there is a muscle in the eyes called the ciliary muscle which has to keep on contracting at a steady time for a prolonged period to keep your vision sharp. When it stops contracting that is what causes blurry vision leading to eye pain, eye redness, and head pain.”
However, one common phenomenon that all experts agreed can be induced by long periods of staring at a digital screen was dry eyes leading to a blurring of vision and other eye-related symptoms. Explaining the same in detail, Dr Sudipto Pakrasi, Chairman, Ophthalmology, Medanta, Gurugram said, “The exposure to smartphones or any other screen including normal television, especially if we are we are sitting in an air-conditioned environment, causes the tear film to dry up by evaporation very quickly. This is because usually there is a normal setting of the eye that is happening every six to eight seconds when we blink to reset the tear film. But when we are sitting and observing screens, the blink rate is low to prevent us from skipping over what we are engrossed in. This leads to the disruption of the refractive system of the cornea which leads to the degradation of the quality of the image.”
Busting the myth around smartphone vision syndrome circulating in the media since Manju’s case has been brought to light, Dr Asad, Consultant Ophthalmologist, Apollo Hospitals, Hyderguda agreed with Dr Pakrasi’s prognosis and said, “To my understanding prolonged screen time doesn’t make you go blind completely but it certainly has consequences. In our practice, blurry vision is caused due to dryness of the outer front transparent part of the eye called the cornea – which is timely lubricated by our tears, We roughly blink about 15-20 times per minute and staring at the screens reduces the blink rate, (eyelids spread the tear film over the cornea with every blink) – this leads to dryness and floaters in the vision. If ignored, it can lead to severe dryness, infection and ulcers which cause profound visual loss.”
Highlighting another phenomenon induced by smartphones that can cause blurry vision, Dr Pakrasi added, “Cervical spondylitis, which means that the blood supply to the brain is getting affected to a certain extent, can be caused as a result of a curved neck caused by people bending their neck to look at the phone. This will give a person a cloudy feeling sometimes till they move their neck and the blood supply gets restored.” However, Dr Pakrasi informed that cervical spondylitis is a rare condition and is not seen in younger people, and to reassure the masses, expressed that smartphone vision syndrome can not cause vision loss, and is just a fancy term for dry eyes.
Safeguard eyes against digital screens
In today’s digital era, completely avoiding digital screens is impossible as it is not only used for leisure and entertainment any more but also for work and studies too. At such a time, doctors recommend that everyone should seriously consider reducing the time they spend watching digital screens.
Dr Kumar recommended, “Screen time beyond work or studies should be reduced. One should maintain an adequate distance from the screen. Avoid watching the smartphone screen in darkness. Follow the 20-20-20 rule, take a break every 20 minutes to look at something 20 feet away for 20 seconds.”
Calling excessive screen time inescapable, Dr Asad advised, “Conscious measures to restrict screen time should be followed. All those people requiring screen time for long hours, should follow the 20-20-20 rule, and minimise glare. Lubricating eye drops can be kept handy, they help to keep the cornea moist for a longer period. An anti-reflective coat on glasses helps to reduce eyestrain. Try to maintain a good distance of the screen from your eyes. Proper posture of the head and neck is also very important.”
To protect yourself from eye-related ailments caused due to digital screens, Dr Hoshing suggested, “For children, if it is essential then only they should be using digital screens, for example for school work, and it should not exceed one to two hours during the day. Reduce recreational usage of smartphones, television, and desktop screens. Restrict usage as much as possible. Children need to spend more time outside in daylight which has been shown to reduce the progression of glass power.”
Doctors believe that smartphone vision syndrome can not lead to total vision loss or partial blindness, but it can cause disabling vision symptoms that can affect the long-term health of a person indulging in excessive screen time. Doctors recommended that if any vision-related symptoms are noted, one should consult a doctor for proper diagnosis and timely treatment.