It is widely accepted, anecdotally, that long-term exposure to television and computer screens causes a reaction in the eyes; namely, blurred vision, redness and dry eye symptoms. But is this a condition that is worthy of its own name?

"I noticed an increasing number of patients attending my practice that were presenting with these symptoms but, surprisingly to me, they had no refractive errors and visual acuity (VA) was within normal range," said Arieh Solomon, MD, PhD of the Goldschleger Eye Research Institute, Sheba Medical Center, Tel-Aviv University, Israel. Upon detailed questioning and further inspection, Dr Solomon discovered that many of these patients were spending up to 10, and no less than two, hours per day in front of a virtual screen. "After a while, I began to see more and more patients presenting with similar symptoms and screen habits, which led me to name this bothersome and incredibly uncomfortable condition 'virtual screen conjunctivitis'," said Dr Solomon.

Dr Solomon began tracking the progress of these patients and documented the data. He treated 124 patients aged between six and 58 years, 58% of whom (n=72) were aged six to 15 years. Adult patients generally presented with a complaint of blurred vision and a request for spectacles; the parents of child patients, however, complained of blurred vision, eye rubbing and uncontrolled blinking. Some patients also complained of discomfort, including 'red eye', photophobia, tearing and itching.

Patients must have "normal" eyesight

The patients that were included in this study did not suffer from likely or causative factors for these symptoms, such as allergy, infection, rhinitis, sinusitis or dry eye; traditional environmental factors, such as dust or exposure to ultraviolet rays, were not present.

Patients underwent an initial eye examination to test VA and the condition of the anterior and posterior segment. Tonometry and cycloretinoscopy were also performed.

To be included within the study, patients had to have "normal" VA (ranging between 6/6 and 6/9) for everyday activities, whether corrected or uncorrected. Sphere and cylinder correction values for eligible patients were between -0.50 and +0.50.

Common traits amongst patients

Figure 1: Aspect of conjunctiva of a Vernalis case.

Once refractive and VA risk factors had been eliminated, Dr Solomon found that all of these patients also presented with a reaction in the conjunctiva, which had a papillary-like appearance similar to that of vernal conjunctivitis, mostly in children and teenagers (Figure 1). This reaction ranged across the spectrum from mild to severe.

Amongst affected patients, time in front of a virtual screen was found to range from a minimum of two all the way up to 10 hours a day, almost every day. Remarkably, the amount of time spent in front of a virtual screen correlated directly to the severity of inflammation of the conjunctiva.

Dr Solomon concluded that the inflammation of the conjunctiva was the cause of the blurred vision, as the surface tissue secretion of mucus film had spread over the cornea. The blurred vision could be dispelled by intended blinking.