Understanding and Mitigating the Impact of Excessive Screen Time

In today’s connected world, digital screens are a fundamental part of our everyday lives. Nearly 50% of Americans aged 18-64 spend over seven hours each day looking at screens. This surge in screen time, particularly among children and young adults, has sparked serious concerns about its effects on physical health, mental well-being, and social development.

Is Screen Time Harmful to Our Eyes?

Excessive screen use significantly increases the risk of various eye health problems, including:

• Myopia (Nearsightedness): A 2021 study revealed a 30% higher risk of developing myopia with increased screen time.
• Digital Eye Strain (DES): Up to 90% of digital device users experience symptoms like headaches and blurred vision after just two hours of continuous screen use.
• Dry Eye Disease: Using screens for more than eight hours daily nearly doubles the risk of developing dry eye disease. Long-term screen use (8–12+ years) can increase the likelihood of tear production issues by 2.49 to 3.61 times.

Prolonged screen time affects blinking patterns and tear production, leading to these cumulative eye health issues over time.

The Growing Trend of Screen Time

Recent studies highlight alarming increases in screen time across all age groups, especially among children and adolescents:

• A 2023 survey by Deloitte Access Economics found that approximately 104 million Americans aged 18-64 (nearly 50% of this age group) spend more than seven hours daily on digital screens.
• The same survey indicated that 70% of office workers experience excessive screen time, compared to 42% in other professions.
• The American Academy of Child and Adolescent Psychiatry reports that children aged 8-12 spend 4-6 hours a day on screens, while teenagers can spend up to 9 hours daily.

These statistics emphasize the widespread use of digital devices in modern society and the urgent need to understand and address their impact on eye health.

The Impact of Excessive Screen Time on Eye Health

One of the most immediate and noticeable effects of prolonged screen use is on our eye health. The American Optometric Association (AOA) has identified several vision-related issues associated with excessive screen time:

Digital Eye Strain (DES)

Also known as Computer Vision Syndrome (CVS), DES is a group of eye and vision-related problems resulting from prolonged digital device use. Symptoms include:

• Eye fatigue and discomfort
• Dry eyes
• Headaches
• Blurred vision
• Neck and shoulder pain

A 2022 study published in Ophthalmology and Therapy found that up to 90% of digital device users experience symptoms of DES. The study also noted that even two hours of continuous screen time can induce DES symptoms.

Myopia Progression Caused by Screen Time

Increasing evidence suggests a link between excessive near-work activities (including screen use) and the development and progression of myopia (nearsightedness), especially in children:

• A 2021 meta-analysis published in The Lancet Digital Health found that increased digital screen time was associated with a 30% higher risk of myopia.
• The World Health Organization predicts that by 2050, half of the world’s population may be myopic, with excessive screen time being a contributing factor.

Dry Eye Disease (dry eye disease) in Digital Screen Users

• The estimated prevalence of dry eye disease among workers who use digital screens ranges widely from 9.5% to 87.5%, indicating a significant potential impact.
• Office workers using screens for more than 4 hours per day had 1.83 times higher odds of experiencing severe dry eye symptoms compared to those with less screen time.
• Individuals using screens for more than 8 hours daily had 1.94 times higher risk of definite or probable dry eye disease.
• Each 1-hour increase in daily screen time was associated with:
  • 1.18 times higher odds of clinically diagnosed dry eye disease
  • 1.11 times higher odds of severe dry eye symptoms in men
  • 1.12 times higher odds of severe dry eye symptoms in women

The Impact of Extendry eye disease digital screen time on dry eye

• Screen use exceeding 8 hours per day was linked to 1.55 times higher odds of symptomatic dry eye compared to less than 4 hours of daily use.
• Working on digital screens for 8-12 years was associated with 2.49 times higher odds of reduced tear production (Schirmer I score ≤5mm).
• This risk increased to 3.61 times for those working with screens for more than 12 years, suggesting a cumulative effect of prolonged screen use.

Impact on Children:

• The prevalence of smartphone use was significantly higher in children with dry eye disease (71.4%) compared to those without dry eye disease (50%).
• Daily smartphone use in children was associated with 1.86 times higher odds of developing dry eye disease.
• Total daily screen time across all devices was linked to 1.82 times higher odds of dry eye disease in children.
• In a larger study:
  • 96.7% of children with dry eye disease used smartphones compared to 55.4% without dry eye disease.
  • Children with dry eye disease averaged 3.18 hours of daily smartphone use, compared to 0.62 hours for those without dry eye disease.
  • Computer use was also higher in the dry eye disease group (1.10 hours) compared to the non-dry eye disease group (0.76 hours).

Effects on Blinking Dynamics:

• Blink rate decreased dramatically during screen use:
  • From 22 blinks per minute at rest to 10 blinks per minute when reading a book
  • Further reduced to 7 blinks per minute when viewing a screen
• During computer game play, blink rate decreased to about 42% of the resting rate.
• The percentage of incomplete blinks increased with screen use:
  • 80% of blinks were incomplete at baseline
  • This increased to 88-92% during video game play
• Comparative studies found:
  • 7.02% of blinks were incomplete when reading on a computer
  • Only 4.33% of blinks were incomplete when reading from printed material
• Task complexity on screens further impacted blinking:
  • Blink frequency was 5.0 per minute during an active computer task
  • This increased to 16.0 per minute when passively watching a video

Possible ocular impact of digital screen time

There are various opinions regarding additional negative effects of digital screen time, although the science is yet to be decidry eye disease. 

Blue light: Digital devices contain light in the blue spectrum, which has been shown to impact the circadian rhythm cycle which regulates hormones and sleep. Furthermore this wavelength may cause damage to the retina. 

The Science: There is not enough evidence of the impact of blue light on the retina and circadian rhythm, but even if we assumed it to be true, the amount of blue light coming from digital devices is insignificant when compared to being outdoors, making this a yet-to-be resolved question. 

Glaucoma and Screen Time: There are some studies that point to a possible connection between screen time and glaucoma, with some speculating that extended screen use may increase intraocular pressure.   

The Science: The research is very limited and at this time the consensus is that there is no causal relationship known between screen time and glaucoma. 

Straining the visual system

Extended periods of near work, such as using digital screens, can lead to significant visual strain, but the root cause is not the digital nature of the task itself—it’s the prolonged focus on close-up activities. Symptoms such as eye strain, tired eyes, blurred vision, headaches, and difficulty concentrating often arise from extended near tasks, whether on screens or printed material.

These issues are intensified by factors such as:

• Improper viewing angles, deviating from the normal reading position.
• Small text sizes that require more effort to focus on.
• Screens positioned too close to the eyes.
• Uncorrected or suboptimal vision prescriptions.
• Eye teaming challenges (vergence dysfunctions), making it difficult to align both eyes on the target.
• Eye focusing difficulties (accommodative dysfunctions), affecting the ability to maintain sharp focus.
• Poor eye movement control (oculomotor dysfunctions), hindering smooth tracking, target jumps, or detailed reading.

If extended near work such as reading or being on a phone causes headaches, fatigue, or severe discomfort, visit a developmental or functional optometrist to evaluate for an underlying vision problem. Issues such as binocular vision and convergence insufficiency, eye tracking and eye focusing, are thought to impact 1 in 5 people, yet are rarely identified during a standard eye exam.

Conveniently situated in Costa Mesa, we attract patients from across Orange County, including Irvine, Huntington Beach, and Santa Ana, for advanced vision therapy treatment.

Beyond Eye Health: Broader Physical Impacts

Excessive screen time affects more than just our eyes. Research has identified several other physical health concerns:

Musculoskeletal Issues

Prolonged device use, especially with poor posture, can lead to various musculoskeletal problems:

• A 2019 study in BMC Musculoskeletal Disorders found that smartphone overuse was significantly associated with neck and shoulder pain among adolescents.

Obesity and Metabolic Health

Sedentary behavior associated with excessive screen time has been linked to obesity and related health issues:

• A 2020 systematic review in Obesity Reviews found a strong association between screen time and obesity in children and adolescents.
• Another study published in the Journal of Clinical Endocrinology & Metabolism in 2022 linked excessive screen time to increased risk of metabolic syndrome in adults.

Cardiovascular Health

Prolonged sitting and screen use may have negative impacts on cardiovascular health:

• A 2019 study in the Journal of the American College of Cardiology found that adults who spent more than 4 hours daily watching TV had a 50% higher risk of heart disease and early death compared to those who watched less than 2 hours.

Mental Health and Cognitive Impacts

The effects of excessive screen time extend beyond physical health, significantly impacting mental well-being and cognitive function:

Attention and Cognitive Development

Concerns have been raised about the impact of screen time on attention spans and cognitive development, especially in children:

• A 2019 study in JAMA Pediatrics found that excessive screen time in children under 5 was associated with lower scores on developmental screening tests.
• Research published in Scientific Reports in 2021 suggested that high screen time was linked to lower cognitive abilities in children aged 8-11.

Mental Health Issues

Multiple studies have found associations between excessive screen time and various mental health concerns:

• A 2021 meta-analysis in Computers in Human Behavior reported a significant association between screen time and depression risk in adults.
• Another study published in Preventive Medicine Reports in 2022 found that adolescents with higher screen time had increased risks of anxiety and depression.

Sleep Disturbances

The impact of screen time on sleep is well-documented:

• A 2019 systematic review in Sleep Medicine Reviews confirmed that screen time is adversely associated with sleep outcomes in children and adolescents.
• The blue light emitted by screens has been shown to suppress melatonin production, disrupting natural sleep-wake cycles.

Orange County’s Trusted Pediatric Eye Care Team

At Insight Vision Center Optometry, Dr. Valerie Lam and Dr. Ariel Chen lead our pediatric eye care services, offering Orange County families a range of advanced options for their children’s vision health. From developmental eye exams and myopia control to vision therapy and post-concussion care, our doctors bring unmatched expertise and a warm, kid-friendly approach. Referrals from across Orange County reflect our commitment to providing knowledgeable care with the latest in technology.

The Impact of Excessive Screen Time on Productivity

Multitasking and Cognitive Load

• A 2018 study in the Journal of Experimental Psychology found that even the presence of smartphones can reduce cognitive capacity, impacting task performance.
• Research published in Computers in Human Behavior in 2020 showed that media multitasking (using multiple screens simultaneously) was associated with poorer attention and memory.

The Relationship Between Screen Time and Addiction

The addictive potential of digital devices, particularly smartphones and social media, has become a growing concern:

Internet Gaming Disorder

• Recognized by the World Health Organization, Internet Gaming Disorder is characterized by impaired control over gaming and increasing priority given to gaming over other activities.
• A 2021 meta-analysis in Addictive Behaviors reported a global prevalence of 3.05% for Internet Gaming Disorder, with higher rates among younger populations.

Social Media Addiction

A 2022 study in Cyberpsychology, Behavior, and Social Networking found that up to 5% of adolescents meet the criteria for social media addiction.

Research published in the Journal of Behavioral Addictions in 2023 linked excessive social media use to symptoms similar to those seen in substance use disorders, including mood modification, tolerance, and withdrawal.

Neurobiological Basis

A 2019 neuroimaging study in Addictive Behaviors Reports showed that excessive smartphone use was associated with decreased gray matter volume in certain brain regions, similar to changes seen in substance addiction.

Social and Behavioral Impacts

Excessive screen time can also affect social skills and behavior:

• A 2020 study in JAMA Pediatrics found that higher levels of screen time at 24 months were associated with poorer performance on developmental screening tests at 36 months.
• Research published in Child Development in 2021 suggested that excessive screen time in adolescents was linked to decreased social skills and increased behavioral problems.

Insight Vision Center Optometry: Pediatric Eye Care and Vision Therapy for Orange County Children

At our Costa Mesa office, Insight Vision Center Optometry specializes in advanced pediatric eye care. Dr. Lam and Dr. Chen bring extensive experience to Orange County families, addressing issues like digital eye strain, visual learning difficulties, and myopia progression. With a caring approach, we treat young patients from Irvine, Huntington Beach, and Santa Ana, supporting each child’s vision journey. Call (714) 942-1361 to schedule, or book online.