Many of us are concerned about our screen use, especially since it’s increased for most people during the COVID-19 quarantine. We asked several specialists in their field for their thoughts and how we can counteract our new device-heavy activities. In this blog, we feature answers from Louise Sclafani, OD, FAAO, Andrew “CKG” Smith, Assistant Director of Maryville Esports, Tanner “Zeu” Deegan, Maryville League of Legends Head Coach, and Drew Schwartz, DC.
Have You Noticed Increased Screen Time Making an Impact On Your Patient’s/Client’s Health? If So, What Kind of Impact?
Dr. Sclafani: Definitely. My patients consist of mainly working middle-aged women like me. They’ll come in and basically set up a mobile office because to them, every moment counts. They have the mindset of “If I have five minutes, I’m going to work.” So, I can tell that screen time is something I’m going to need to address.
When I do my exams, I’m trying to get their best correction for glasses or contacts, so I include questions like, “Where’s your working space? Are you on a laptop or a desktop? How far away is the screen? Have you ever had any issues?” Most of the time, I get the answer, “No, I’m fine.”
Smith: Yes, in many ways other than eye health as well. I think the biggest one is sleep issues: difficulty falling asleep, inability to maintain a sleep schedule, consistently messing up their sleep schedule, etc.
Deegan: I’ve noticed that increased screen time can lead to some eye irritation and even things like tension headaches. Eye sharpness also has a chance of deteriorating with increased screen use over long periods of time.
Dr. Schwartz: Screen time can affect numerous systems. However, I focus primarily on musculoskeletal complaints, with headaches, neck pain, thoracic stiffness, and loss of active extension at the thoracic spine.
What Are the Most Common Symptoms You See/Hear About Associated With Screen Time?
Dr. Sclafani: I’d say tired, dry, strained eyes are the most common complaints I hear related to screen time, but I’m not sure patients recognize that it’s a “complaint.” When I ask my patients if their eyes ever feel tired at the end of the day or if they ever get red, they usually answer, “Yeah, but that’s normal.” It’s interesting that patients just assume that to be normal. I explain, “Yeah, it’s normal because it’s a consequence of working on computers, but you shouldn’t accept that as ‘normal.’”
I explain that they can and should do something about it. For example, you wouldn’t expect to go to work right now without any personal protective gear on, right? So why would you just accept a non-optimal desk setup or work environment? Yes, we all get tired at the end of the day, but you shouldn’t come home physically ill because of what you have to do at work.
Smith: The most common symptoms would be eyestrain or “tiredness.” I have experienced issues with eye strain and have had many players communicate these issues as well.
Deegan: The most common symptom that I see when dealing with periods of screen time is dry eyes. Far too many people in our business have extended hours in front of a screen, and it leads to a lot of strain and drying out of our eyes, leading to some irritation and discomfort the longer we work.
Schwartz: I commonly hear complaints of headaches due to a multitude of factors, including eye strain, poor screen positioning, or the user simply not taking breaks when they are needed.
What Do You Tell People Who Want to Reduce the Impact of Screen Time On Their Health?
Dr. Sclafani: There are several options for reducing the impact of screen time, especially on the eyes. Uncorrected vision can be a huge factor in whether your eyes feel comfortable throughout a screen session. Setting up your environment around your device is critical to relieving that tired, strained, dry feeling that’s become so “normal” for many of us. For example, glare on your screen can cause great discomfort for your eyes. Ensuring there’s not too much backlighting or direct lighting on or around the screen and reducing glare will make for a more comfortable screen experience.
Smith: Take breaks. After every game/every hour take 5-10 minutes to walk around and look at something other than a screen. It’s helped my eyes sort of “go back to normal.”
Deegan: I tell them that time must equal maintenance (time = maintenance). If you are on top of your own health, you will be self-aware of how your body is responding to increased screen time and take the necessary precautions to help it. I typically recommend taking a few short breaks for every hour of screen time by getting up out of your chair and being in a well-lit area.
Dr. Schwartz: My approach has always been to start with small changes that can then grow into more significant changes. One habit I tend to emphasize is limiting screen time to 30 minutes before bed. If you read via a tablet, then have the red light shift up to max and the backlight brightness decreased as much as possible.
What Kind of Advice Do You Give to People Who Must Spend Long Hours On Screens Or Who Won’t Change Their Habits?
Dr. Sclafani: Protect your eyes. Whether you use blue light glasses, supplements, or screen covers, you need to reduce the amount of blue light, the harmful light produced by screens, that enters your eyes. Blue light glasses and screen covers are great for immediate action, but I tell all my patients to build their internal protection, or macular pigment, by supplementing their diets with zeaxanthin and lutein.
We’ve seen lots of studies that the overall macular pigment, which is what protects our retina from damage that can lead to severe vision loss, can be enhanced using lutein and zeaxanthin supplementation. The more, or denser, macular pigment we have, the safer our eyes are from blue light and other damages. There’s also a lot of research supporting Z+L supplementation as a method for reducing some of the symptoms that we see with computer vision syndrome such as contrast sensitivity, eye fatigue, and photostress recovery.
What Kind of Workouts/Movements Do You Recommend to Counteract Sitting At a Screen All Day/Night?
Dr. Sclafani: For everyone, I recommend taking a break at least every two hours. I don’t mean just the 20-20-20 rule. I mean a total break every two hours. Get up and move around. Some of us have those Apple watches or Fitbits to help us remember, but we need to make a conscious effort to listen to those reminders and actually follow through. At night, I recommend shutting down devices at least an hour before bed.
Smith: In conjunction with taking breaks, any cardio workouts are good. Activities that get the blood flowing. Lots of stretching is good, too, and of course, any movements that work on posture.
Deegan: Stretches and exercises that focus on the lower back and core are very important for those sitting at a screen for extended hours. I also recommend stretching your wrists & forearms every hour of computer time.
Dr. Schwartz: Everyone is built and performs their tasks differently while at their desk. In general, getting out of your chair and going for a walk around the office or house is a start. Typically, we see tightness in the hamstrings, hip flexors, pectorals with straining in the posterior chain musculature of the back and neck.
How Can We Better Prepare for Extended Screen Time?
Dr. Sclafani: As we’ve discussed, setting up the environment around your screen is imperative for extended screen time comfort. The screen should be slightly below eye level and about an arm’s length away. The surrounding lighting should match the brightness of the screen, and there should be no glare. Additionally, taking eye vitamins can help prepare our eyes by giving them the nutritional support they need to power through those hours of screen time.
Smith: Educate on exercises, taking breaks, and other ways to reduce the impact of screen time. Know when to stop using screens, like at night before bed to help with sleep quality and regulation.
Deegan: I think it is about getting people to just be more aware and mindful of how their body is feeling. If we understand that we are going into an extended session, we should be ready to take frequent breaks while listening to our bodies.
Dr. Swartz: Take breaks, use redshift when possible, decrease brightness when possible, and check your posture periodically while you use your screen(s).
In Your Opinion, What’s the Worst Effect Screen Time Has On Health?
Dr. Sclafani: Perhaps the most worrisome is the fact that it disrupts our melatonin levels, and that messes with our sleep. A Harvard study showed that reading on an e-reader vs a regular book can push back the time you fall asleep by nearly 2 hours! Additionally, cortisol levels become elevated, and this can lead to stress, agitation, anger, and even outbursts.
Smith: To me, it would be the sleep issues that can, in turn, combine with mental health concerns. I frequently see individuals having issues when it comes to managing their lifestyles. The effects of screen time can be managed with a good routine. However, poor diet, disrupted sleep cycle, lack of exercise, and other correlated health concerns can all lead to poor physical and mental health, which can then perpetuate the cycle.
Deegan: The worst effect screen time has on our health is our general eye health. Long nights in poorly lit rooms with bright screens shred our eyes over time and can impact our eyesight. I know my eyesight has definitely gotten less sharp over the years working in front of a screen.
Dr. Schwartz: For my line of work, there is a definite uptick in neck pain and headaches associated with poor posture.
In Your Opinion, How Will This Impact Healthcare In the Future?
Dr. Sclafani: We can’t ignore technology; it touches almost every aspect of our lives. Even when patients come into the practice, their medical history has been completed online prior to the appointment. When we do very specialized contact lens training, we’ll have patients watch online videos before coming in. If they don’t have a chance to watch them, we give them an in-in-office iPad to watch it. Even our in-office testing like imaging and visual field testing requires digital information. Ultimately, it’s not going anywhere, so we as medical professionals need to recognize that and adapt our care to best serve our patients.
Smith: Health issues related to an unhealthy lifestyle are already frequent in American culture, even outside of gaming. Overall, it would be adding to these already existing issues. The specific impact would be further demand for eye, wrist, back, and neck care, even in addition to what we have now.
Deegan: As we move into more work-from-home and in-front-of-screen work situations, especially nowadays with the COVID-19 pandemic, I think healthcare will focus a lot more on reducing the negative effects of extended screen time.
Dr. Schwartz: I assume we will continue to see the effects of poor posture increase, as well as an increase in the number of younger individuals that will experience these symptoms. Children continue to be exposed to excessive screen time at a younger age, which is coupled with the fact that our world is becoming more and more digitized.
Whether you are a medical professional or just someone affected by screen time, it’s important to educate yourself about the ways screen time affects the body and the many options you have to lessen its effects. Prepare your body and mitigate the risk of screen time symptoms with the right exercises and nutrition to better handle those extended hours on screens.