There is no denying that right now we are in the middle of a digital revolution. In almost every aspect of our daily lives, we rely heavily on digital technology that, not much more than a decade ago, did not even exist. Millions of us across the planet are suddenly staring at digital screens to complete our work, organise our days, and fill our leisure time.
Despite this, there is very little knowledge around how we use these devices and what the physical cost of intense usage might be. Is our screen time causing us harm? Would we even be able to recognise it if it was?
These are some of the questions considered in a qualitative research study conducted in the US and the Netherlands (NL) on behalf of Hoya Corporation, Japan.
Study 1 — Group discussion and observation
The study looked at both the reported perceptions and actual behaviour of groups of digital device users. In the first part of the research, participants in both countries were asked to talk about their digital usage in a series of group discussions. In the second part, participants’ usage habits were recorded for an hour, either during their working day or at home in the evening, and their behaviour studied.
Eight group discussions were conducted involving 54 participants in total. In each country, subjects were divided into groups of spectacle wearers or non-spectacle wearers, and each group was also divided by age: 25 to 35 and 35 to 45 years. All participants were heavy users of multiple digital devices, and many had experienced discomfort during or after usage.
Screen use
By their own admission, the participants in both countries spent, on average, between eight and 10 hours a day looking at digital screens, with some users reaching 15 hours. Some participants, particularly in the Netherlands, were actually surprised by their own estimations of the total time they spent looking at various digital screens.
Screen usage time varied depending on the device. Long, uninterrupted periods of several hours was common on laptops or desktops, while very short yet highly frequent usage was the norm for the smaller devices. Smartphones, in particular, were used almost constantly during the entire day, from dawn till dusk.
The ownership of multiple digital devices means screens of all sizes are being used in a vast range of settings away from the desk and outside of the office or home. For instance, many participants in both countries used their laptops while reclining on the sofa when watching TV, their tablets while lying in bed, and their smartphones virtually everywhere else — and often in combination with other devices.
Is digital technology a pain?
Most participants in the study experienced regular or frequent (defined as more than once a week) physical discomfort after using digital devices. The most complained about symptoms were sore, irritated eyes and pain or stiffness in the neck, back or shoulders, with some users experiencing headaches and blurred vision. This was true among both spectacle wearers and non-wearers and of all ages.
Interestingly, participants in NL were not aware of the frequency of their discomforts until probed on the matter whereas in the US, people seemed less surprised. In both countries however, complaints were seen as ‘unavoidable pains of life’.
Solutions to the pains and discomfort were always reactive. Most commonly, participants said they stretched, rubbed their eyes, or took a break to move around. Spectacle wearers removed their glasses for a while. A few participants reported using eye drops, changing the screen light or even taking painkillers.
Although groups in both countries associated their complaints with a hard day at work or the focus of completing an important task, they generally put the discomfort down to bad posture or concentrating intensely on a screen for too long.
No participant spontaneously connected their complaints to switching between screens, and only a few to constant near-distance viewing. Despite their discomforts, hardly any participants sought advice or took any preventative action. And when those who did visited an ECP, their complaints were only discussed in general and never connected to digital device usage.
When asked if they were familiar with the terms ‘computer vision syndrome’ (CVS) or ‘digital eye strain (DES), no participant in either country had heard of the terms . It wasn’t until DES was explained that participants could relate to it.
What’s really going on?
In the second part of the study, different participants from each country were observed using their digital devices at home and at work to gain an insight into usage behaviours that the subjects may have not reported, or even be aware of, when asked.
Sixteen one hour observations were recorded in both the US and the NL, during which participants used their digital devices in their own environment doing what they would normally do. Half of the recordings were made during the afternoon of a working day, either in a home office or place of work. The other half were recorded in the evening when the participants were at home after a working day. All participants were spectacle wearers aged between 35 and 45 years. All were heavy users of digital technology, and many had experienced discomfort during or after usage.
No matter which device, or when and where they were using it, participants in both countries consistently adopted postures that were less than ideal (hunched over a laptop, slouched in the sofa). But despite earlier assumptions, this was unlikely to be the main cause of discomfort.
Whether it was to glance down at a keyboard, view another device (often a TV or phone) or interact with someone else in the room, on average participants switched their focus 333 times in the one hour observation. However, 85% of these were near-to-near focus switches, often for less than a minute, to read a printed document or to look at another digital screen. Of the 10,655 focus switches recorded, no more than 1,640 involved switching focus to a further distance and 1,160 of those were to look at a TV.
There’s no getting away from the screen
Of the 32 participants being observed, 21 never looked away from their digital screen for longer than a minute at a time. And those who did were often motivated by an external factor such as a phone call or the TV. Only two thirds of participants stood up during the observation, and only around half took an actual walk.
Pain is considered normal
Perhaps unsurprisingly considering their lack of screen breaks, over two thirds of participants showed indications of pain or discomfort while being observed. In total, 211 separate instances were recorded, including 105 involving neck/back stretches and 107 cases of eye rubbing — all recognised symptoms of DES.
Other less obvious indicators including removing eye glasses and yawning.
Following the observation, participants were asked to complete a short questionnaire. Reflecting the findings of the group discussions, participants from the NL did not recall experiencing any discomfort at all, even though their observed symptoms were in line with those from the US.
However, contrary to the assumptions reported in the group discussion, when it came to the setting or time of day pain indicators were observed, there were no consistent differences between work or home, and daytime or evening. Pain or discomfort went hand-in-hand with digital device use in every observed setting.
Key conclusions
- We are probably spending more time than we think looking at digital devices.
- We are not aware of our constant focus-switching between small digital screens.
- The pain and discomfort brought on by device usage is considered by many to be normal, not serious, and is often ignored.
- Where users are aware of discomfort, it is put down to bad posture or periods of intense concentration.
- There is very little understanding of digital eye strain, and therefore there are huge opportunities for ECPs to raise awareness of it.
Study 2 – Large Sample International Survey
So how many hours a day do we spend staring at digital screens? What effect does this have on our physical condition? What eye problems do we have as result, and how are they being dealt with? What solutions can the eye care industry and opticians offer? And last but not least, what acceptance of these can be expected from the end consumer?
These and more questions are answered by an international study commissioned by Hoya in autumn 2017 and conducted by Elke Dobisch Market Research and specifically looking at usage habits of digital devices and the associated eye problems.
Study profile
The study was conducted online and involved interviews with users of smartphones, laptops, desktop computers, iPads/tablets and e-book readers. Participants were aged between 20 and 50 years and were resident in either the UK, the US, or Hong Kong. In total, 3,165 interviews were conducted. The number of participants was split evenly between the countries, with an almost equal ratio of men and women taking part.
Sixty-one percent of the participants were users of eyewear, with several using more than one kind. Of the total, 48% required prescription eyewear, 30% used contact lenses and 12% used ready-to-wear reading glasses. Two-thirds of the respondents were fully employed, 11% part-time.
Initial results
Ninety percent of all respondents have a smartphone, 70% use laptops, 61% use desktop PCs, and 54% own an iPad or tablets. Only 19% have e-book readers (see figure 1).
The numbers show that the majority of participants use multiple devices, with mobile devices being the most popular. Almost two thirds use the combination of smartphone and laptop. And more than 10% claim to use their smartphone, laptop or desktop PC for more than eight hours a day – and that is just that single device. PCs and laptops in particular are also used professionally.
Ninety-nine percent of study participants believe that using digital devices causes eye stress. More than 40% assume that four hours of usage is enough to feel adverse effects, while another 40% think that five to eight hours is detrimental, which is about the length of a working day (figure 2).
Figure 2: Assumed connection between duration of use and eye strain
The physical symptoms reported by the participants were many and varied (figure 3). More than 80% of the respondents suffered at least the occasional head, neck, back or shoulder pain, with some experiencing pain all over their bodies. More than half of those affected reported this occurred almost daily or several times a week.
Figure 3: Frequency of complaints (as a percentage). Where values were above average they appear as bold
On the whole, women were affected more often than men, possibly because they are more sensitive to physical strain. The younger participants were more prone to headaches, but generally those over 30 years were more frequently affected by physical discomfort.
When it comes to eye problems, inflammation, dry eyes and difficulty concentrating on near vision were the most commonly reported.
The prevailing response to the onset of any physical discomfort was to take a screen break. Further measures including stretching, moving around and a change of sitting position or head posture.
In cases of eye problems, rubbing the eyes and/or using eye drops was common. Ten percent of the participants have tried various remedies without success, and only another 10% have asked their doctor or optometrist for help.
The symptoms occur most commonly during working hours, and at weekends decrease significantly. The respondents themselves suspect this points to a clear connection between their discomfort and the use of a digital device.
For those who suffer complaints several times a week, the picture becomes even clearer. Without exception, all of the queried problems occur more often than average among users of eye care, regardless of which corrective product is used – however users of ready-to-wear reading glasses are most frequently affected by all the complaints that have been reported (figure 4).
Figure 4: Suspicions of the effects of using digital devices
In view of the intensive use of digital devices and the frequency of complaints, one might assume that opticians’ and doctors’ practices are literally overrun by those seeking help. However, this is far from reality. A good 40% of those affected have never talked about their eye complaints, and another third have only commented on it in private.
In fact, just 22% of suffers have contacted their family doctor with their complaints, and only 18% have talked to an eye specialist about it. Even in the case of spectacle and contact lens wearers, the proportion of individuals seeking medical help was just under a quarter. The treatment offered consisted mainly of administering eye drops and the advice to wear (other) glasses (figure 5).
Figure 5: Therapy and recommendations (percentage responses)
The study did not measure the extent to which those affected obeyed the recommendations. However, those who do not use vision correction are more likely to be resistant to counselling: if they were given the recommendation to wear glasses or contact lenses it was obviously not followed by these patients.
It should be noted again that the subjects recognised a clear connection between the use of digital devices and their widely occurring eye complaints.
Interest in intervention
The second part of the study looked at how participants reacted to solutions offered, and which requirement eyeglass wearers generally have for their vision care. Specifically, participants were introduced the concept of Hoya SYNC III, a near-comfort lens for Generation Y.
The format of the survey simulated a consultation with an optician, in which, after a thorough patient anamnesis (account of their medical history), an appropriate solution was proposed for reported symptoms. Figure 6 summarises the reported symptoms.
Figure 6: Frequency of reported symptoms
The following features and advantages of the new lens were described:
- The lower part of the lens supports close-up vision and relaxes the eye muscle
- Relaxed vision at close range makes viewing digital devices more comfortable
- The lens has been specially designed for younger customers who spend a lot of time using digital devices
- The lens is not just aimed at users of eyewear, but is recommended for those who spend a lot of time looking at illuminated screens
Afterwards the participants we asked how much they were interested in the presented product (see figure 7).
Figure 7: Spontaneous product interest according to concept template (as percentages)
Next, buying interest was addressed. Again, there was a positive response from the study participants (figure 8).
Figure 8: Interest in buying within the next 2 years (as percentages)
Forty-two percent of study participants were interested in buying the new lenses. By international comparison, the willingness to buy was between 36% (UK) and 47% (USA), with the greatest interest from those in the youngest age group of 20 to 30-year-olds. Also noteworthy is that even a third of those who currently use no eyewear were interested in purchase. This implies an even wider market.
Of course, no reliable sales planning can be developed from these results, but the trend is clear: the product answers an important need for users of digital devices. As soon as users become aware of the connection between their complaints and their screen usage, the solution to the problem is obvious.
Around two-thirds of the study participants with an interest in the product expected it to provide a higher level of visual comfort, protection against long-term eye damage and an improvement in their wellbeing. The lenses aroused curiosity and were perceived as new, as an offer that differs greatly from the ‘office’ lenses currently in the market.
Sixty-four percent of those asked expressed the desire to talk to an optician about these lenses. In the first part of the survey, we saw that very few customers voluntarily spoke of their visual stress caused by the use of digital devices. This should be the motivation for opticians to provide focused advice. The need exists, customers just need to know what products are available. Figure 9 summarises what participants consider when purchasing spectacles. The importance of professional advice on the purchase of glasses has also been shown in these results.
Figure 9: Relevance of different factors when buying glasses
Quality and comfort are top priority for spectacle buyers, followed by the price of the lenses. For 70% of participants a consultation with an optician is still an important factor – even more proof that a targeted consultation is expected and desired.
Key conclusions
- Today’s digital users typically use multiple devices. Ninety percent of respondents have a smartphone and two thirds also use a laptop. This makes the smartphone / laptop combination the most common.
- Forty percent of respondents report having physical ailments attributed to the use of digital devices, although 99% believe that digital use can cause eye stress.
- The most common complaints (at least once a month) are neck, back and shoulder pain and overall body fatigue (61%), followed by eye irritation (60%) and headache (53%).
- Hoya SYNC III is met with great interest from those affected, especially younger people.
Overall conclusion
Digital users are open to offers that provide relief, but they hardly ever take the initiative to talk about their problems. Therefore, proactive counselling opens up the possibility of additional sales for opticians. This can be achieved by targeting new groups (people who do not yet use eyewear), by providing a higher-quality care to users of ready-to-wear reading glasses, and by providing additional offers to wearers of glasses and contact lenses.
Elke Dobisch is CEO of Elke Dobisch Market Research, Munich, Germany. Dr Natalia Vlasak is an ophthalmologist and clinical specialist based at Hoya Vision Care in the Netherlands and is responsible for clinical trials, wearer tests, studies, marketing research
Acknowledgments
Parts of this article are translated materials previously published in Eyebizz Magazine www.eyebizz.de The authors and Hoya Corporation thank the Eyebizz team for the permission to be able to translate and reproduce material.