Patients with concussions often ask, “How much screen time is okay?” The answer to this for someone with a concussion is complicated. It can depend on what aspects of your visual system are affected and to what degree. It can depend on if your vestibular system and neck are affected. Your symptoms while using screens can also be complicated by something called Computer Vision Syndrome, also known as Digital Eye Strain.
Computer Vision Syndrome describes a temporary condition from the use of prolonged digital devices that can lead to uncomfortable symptoms. This is something that can occur in the general population, however can complicate symptoms in those with a concussion. Devices that can lead to Computer Vision Syndrome include but are not limited to computers, laptops, tablets, e-readers, cell phones, and TVs.
Symptoms of Computer Vision Syndrome include:  
  1. When we use digital devices, we become so incredibly focused on the task at hand that we forget to blink properly. This includes a reduced blink rate (not blinking frequently enough) and/or completeness of blink (the eyelids not coming in full contact with each other during a blink). A good blink is important to lubricate, nourish, and protect our eyes. With improper blinking, our tear film evaporates more quickly, leading our eyes to become dry. Symptoms of dry eye from extended use of digital devices can include eye fatigue, eyes that are irritated and itchy, eye redness, blurred vision, and sensitivity to light.
  2. Prolonged use of digital devices closer than arm’s length causes increased demands of our vergence (eye-teaming) and accommodative (eye-focusing) systems. Put simply, our eyes undergo significant visual stress by the constant demand of crossing and focusing required to use digital devices at near. This can lead to eye strain, eye fatigue, and blurred vision.
  1. Glasses: In some cases, glasses can help reduce the load on the visual system when using digital devices.
  2. Blink!!: When we use digital devices, we become so incredibly focused on the task at hand that we don’t blink adequately. A good blink is important, as it helps us replenish the tear film. The tear film is extremely important to lubricate, nourish, and protect our eyes. The less often we blink, the more our eyes are exposed to the environment and the more quickly our tear film evaporates. This can lead to our eyes becoming dry. One way to remind you to blink is to place a post-it note on your laptop that says “BLINK”.
  3. Keep your distance from the screen: The closer material is to you, the harder your eyes have to work. Try keeping your devices at arm’s length to reduce the amount of work your eyes need to do.The most comfortable position for our eyes when we are completing near work is looking downward. The optimal position to keep your computer screens, laptops, tablets, and phones is 15 to 20 degrees below eye level, measured from the center of the screen.
  4. Sit comfortably: Choose a chair that is comfortable and conforms to the body. The chair should be adjusted so your feet rest flat against the floor. Adjust chair arms to provide you support while you are typing. Keep your neck in a comfortable position, in line with the rest of your body.
  5. Make sure you have good lighting: Contrasting levels of light, such as a bright screen and dark room, can increase eyestrain. Make sure your surrounding light is similar in strength to the background lighting from your digital device.
  6. Visual breaks are important: Try your best to engage in activities that don’t require screen time, such as listening to podcasts or going for walks.When using digital devices try to follow the “20-20-20 rule”. What this means is to give your eyes a break from the screen every 20 minutes by looking at an object located 20 feet away for 20 seconds. This will not only allow your eyes to blink, but will also allow your eyes to relax.
  7. Try not to use digital devices before bed: It’s believed that blue light can affect your body’s natural sleep and wake cycle. Try your best not to use screens 1 to 2 hours before bedtime to limit blue light exposure. A better night’s sleep will also allow for more control over your concussion symptoms.
Last update: April 2020