Visual environment, viewing habits different during pandemic
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So much for the year 2020 to be all about eye care! What was once thought of as a slam-dunk to promote the need for comprehensive eye exams (“see 20/20 in 2020”) turned out to be a lesson in social distancing, hand washing and face masks.
However, along with that came the concept of quarantine and the stay-at-home mandates. Fortunately for many workers, they had the option to stay at home and maintain productivity because most of their work depended on using a computer. Hooray for the digital age!
Now, while many people likely maintained a “home office,” many were thrown into the dilemma of how to adapt their rec rooms, dens, dining room tables or a corner of the nursery into an actual office. This may not sound like much of a challenge but it has become a very real situation. So, where our eye exam once started out with, “Do you use a computer?” it has exploded into a dozen or so necessary questions about their daily visual demands and viewing situations. Also, it is now less likely that patients are going to complain about poor distance viewing because they are looking at near-point computer screens more often.
And what is a “computer” today? We’ve gone from desktops to laptops to tablets to cell phones to watches to fitness trackers and more. Finding out about a visual environment requires an entirely new set of questions, and not many practitioners really know how to respond to the answers they might receive. At least when working in an office, we had a sense of how it might be set up due to environmental specifications. Today, one person’s living room with an overhead chandelier is another’s rec room with a window and a desk lamp.
Reviewing digital display use should address the three main areas of concern: the viewing environment, the visual status and the viewing habits.
Visual environment
This is obviously the most complicated issue, because the patient is sitting in your chair, and you must dig up information about how they are viewing while sitting in their chair.
Visual display distance is the most critical measurement (and most variable). Very few people will come into the exam with their viewing distance recorded, so having a “picture” of a computer display to help gauge this distance would be helpful.
The second – and equally critical – factor is the height of the monitor. Most displays are set up too high in the visual field for comfortable viewing. The top of the display should be at eye level so that they are mostly looking downward toward the center of the display.
Visual status
Myopic patients who can read paper copy (16 inches) clearly might have to lean forward to get closer to a digital display. Studies have shown that digital displays are held closer to the eyes than the same size text on paper.
Small astigmatic corrections might be more critical for display viewing, as would low plus lenses for pre-presbyopes.
Viewing habits
These will obviously vary with the type of work the patient performs. Data entry usually involves viewing hard copy more than the display, while customer service is more display centric. It is also important to know if patients are taking any breaks or are required to work for long periods or in air conditioned rooms.
When preparing for news media interviews on computer vision syndrome in the late 1990s, I was asked to develop a recommendation that computer users could follow to relieve the strain on their eyes. I came up with the “3-B” approach, which consisted of blink-breathe-break. At that time, a typical recommended break was for 15 minutes after 2 hours of computer work. I found that to be a potential stress for the visual system.
Shortly after that, a study was released that shorter, more frequent breaks were suggested (Galinsky et al.). Because most people were familiar with the “20/20” of eye care, I suggested a 20-second break every 20 minutes while looking 20 feet away. So, yes, this is the origin of the 20-20-20 rule. While there have not been any scientific studies to confirm that it has validity, it sure has taken hold in the industry. I am proud to see it recommended so often and, while it will not “cure” myopia it will likely help your patients use their digital displays with more efficiency and less eyestrain.
Reference:
- Galinsky TL, et al. Ergonomics. 2010;doi:10.1080/001401300184297.