A New Look at Digital Lifestyles Part 2: The Opportunity

When Dr. Jeffrey Anshel coined the 20-20-20 rule in the 1990’s, the then Southern-California optometrist didn’t know the first iPad and iPhone would explode onto the scene in the following decade. But what Dr. Anshel did know was that his patients who were spending excessive time in front of their computer screens were complaining of a specific set of symptoms, which he wanted to help address.

“Before the 20-20-20 rule, I first called it the Three-B-Approach, blink, breathe and break,” Dr. Anshel explains. “People blink less when they’re on computers. I have a yoga background, so I realized that breathing is important in reducing stress. And I came across a study that showed shorter, more frequent breaks were better than longer breaks.  I then realized everyone was familiar with the 20/20 concept in eye care, so I thought, why don’t I suggest patients look away 20 feet every 20 minutes for 20 seconds?”

Three decades later, the founder of the 20-20-20 rule isn’t surprised by the findings of a new report1 which show digital device use has only increased since COVID and symptoms related to digital device use is on the rise in the U.S.

“I don’t ask ‘if’ a patient is using a computer anymore. I assume they are. Now, I ask, ‘How many hours a day do you spend on a computer or digital device?’” Dr. Anshel says.

CooperVision’s report, “A New Look at Digital Eye Strain,” is based on survey results from 750 adults, aged 18-44, who lived in the U.S. and required vision correction.1 Its findings illustrate the opportunity for eye care professionals to talk to their patients about symptoms related to digital lifestyles and help them find solutions.

The Facts: Digital Lifestyle Symptoms and Trends

Digital device use symptoms are generally defined as the ocular discomfort felt after two or more hours in front of a digital screen.2 

The report indicates most people spend at least three hours a day on smartphones alone. Additionally, nearly 7-in-10 respondents reported symptoms associated with digital lifestyles.3 Further, nearly 4-in-10 experienced symptoms multiple times per week or more.3

While digital lifestyle symptoms are generally linked with eye tiredness and dryness, a range of other symptoms have been associated with the condition.1 These include eye burning and irritation, eye strain or soreness, headaches, tearing/watery eyes, and text moving/floating.4

Beyond the ocular surface and neurologic-related symptoms, prolonged digital device use can also affect the visual system, and particularly accommodation, Dr. Anshel explains. “The longer you look closely at a screen, the more sustained accommodation you need. And there’s a convergence aspect too. Accommodation and convergence are aligned. When you converge, you accommodate, when you accommodate, you converge,” he adds.

Accommodation-related symptoms related to digital lifestyles can encompass blurred near or distance vision and difficulty refocusing from one distance to another.5 

The report also found a growing awareness amongst patients that their symptoms may be tied to screentime.

Patients Seek Symptom Relief

When it comes to digital lifestyles, those experiencing symptoms are looking for solutions.7 In fact, 99% of survey responders with symptoms had tried at least one technique or tool to reduce them.7 These tools include the 20-20-20 rule; lubricant eye drops; blue light screen filters; blue light glasses; maintaining proper posture; and glasses or contact lenses designed to help with the symptoms of digital lifestyles.8

Contact lenses designed to help with eye tiredness and dryness associated with digital lifestyles were the least known tool. Only half of the survey respondents were familiar with this option—although a majority said they would be interested.9,10

Start the Conversation

Eye care professionals are their patients’ trusted stewards when it comes to education and guidance on ocular health and treatment recommendations.

Initiating the conversation about digital lifestyles is easy, according to Dr. Anshel, who’s written several books on the subject. He suggests eye care professionals should consider solutions based on a three-pronged approach: a patient’s visual acuity and ocular health, their work environment and work habits, and treatment or lifestyle modifications.

CooperVision’s Digital Eye Strain report provides a thorough checklist of considerations and conversation starters. Some of these include:

  • The patient’s lifestyle and experience with digital eye strain, in addition to their time spent each day on digital devices.
  • Digital lifestyle symptoms and their frequency.
  • Past symptom-reducing tools or techniques used and their effectiveness. 

For conversation starters, establish a partnership with the patient to customize the best solution for their specific needs. And remember you are the expert. Make sure to provide recommendations for addressing symptoms associated with digital lifestyles including contact lenses specifically designed to help.

Discover the Breakthrough Design Behind MyDay Energys® and Biofinity Energys® 

CooperVision MyDay Energys® daily disposable and Biofinity Energys® monthly replacement contact lenses combine an innovative aspheric lens design and advanced material technology to help with eye tiredness and dryness associated with digital lifestyles.11

DigitalBoost™ Technology is a single vision aspheric lens design that delivers a +0.3D boost, which may help ease strain on eye muscles so the wearer can shift focus from on screen to off with less effort.*12 This design is unique to MyDay Energys® and Biofinity Energys®, making them the only contact lenses with DigitalBoost™ which can help with eye tiredness.

Also found in MyDay Energys® and Biofinity Energys® is Aquaform® Technology, which retains water from core to surface without the need for surface coating or added wetting agents in the lens material.13 This results in incredible comfort, which can help eyes feel less dry, even during times of reduced blinking such as when on digital screens.14

MyDay Energys® and Biofinity Energys® provide eye care professionals with the unique opportunity to prescribe an innovative lens that may help patients with some of the symptoms of digital lifestyles.11

Start the digital lifestyle conversation with your patients and keep it going. You can also download the full “A New Look at Digital Eye Strain” report, and discover more about MyDay Energys® and Biofinity Energys® for your patients.

*Based on a statistically significant dierence of the mean change in Accommodative Microfluctuations and when compared to a lens without DigitalBoost™/Digital Zone Optics® after reading on an iPhone 5 for 20 minutes held at a distance of 25 cm. Study conducted with Biofinity Energys and sphere.


1. CooperVision (February 2024). “A New Look at Digital Eye Strain”. Report of online survey results (2023): N=750, Vision corrected patients. US Adults Ages 18-44 who wear corrective spectacles and/or contact lenses.

2. Coles-Brennan C, Sulley A, Young G. Management of digital eye strain. Clinical and Experimental Optometry. 2019;102(1):18-29.

3. CVI data on file 2023. US online survey: N=750, Vision corrected patients US Adults Ages 18-44 who wear corrective spectacles and/or contact lenses. 32% experience digital eye strain at least a few times a week. 6% experience digital eye strain every day.

4. Computer Vision Syndrome. American Optometric Association. https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/computer-vision-syndrome?sso=y. Accessed April 8, 2024.

5. Kaur K, Gurnani B, Nayak S, et al. Digital eye strain- a comprehensive review. Ophthalmol Ther. 2022 Oct; 11(5): 1655-1680.

6. CVI data on file 2023. US online survey: n=586, Vision corrected patients US Adults Ages 18-44 who wear corrective spectacles and/or contact lenses and experience eye tiredness. 48% responded that excessive screen time is what causes their eye tiredness.

7. CVI data on file 2023. US online survey: N=516, Vision corrected patients US Adults Ages 18-44 who have digital eye strain at least once a week or less and who wear corrective spectacles and/or contact lenses.

8. Mayo Foundation for Medical Education and Research. (2022, September 15). Eyestrain, Diagnosis and Treatment. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/eyestrain/diagnosis-treatment/drc-20372403.

9. CVI data on file 2023. US online survey: N=750, Vision corrected patients. US Adults Ages 18-44 who wear corrective spectacles and/or contact lenses. 50% never heard.

10. CVI data on file 2023. US online survey: N=750, Vision corrected patients. US Adults Ages 18-44 who wear corrective spectacles and/or contact lenses. Regardless of recommendations from their eye doctor, 56% interested/ very interested.

11. CVI data on file 2024.

12. Kajita M et al. Changes in accommodative micro-fluctuations after wearing contact lenses of dierent optical designs. Cont Lens Ant Eye. 2020 Oct;43(5):493-496.

13. CVI data on file 2022.

14. CVI Data on file 2022. Based on global product sales and internal estimates of products using Aquaform® Technology over 12 months in 2022.


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