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The 20/20/20 rule: Practicing pattern and associations with asthenopic symptoms
Sourav Datta1, Shivalika Sehgal1, Bidisha Bhattacharya1
1Brien Holden Institute of Optometry and Vision Sciences, Hyderabad, Telangana, India.
Indian Journal of Ophthalmology
|May 19, 2023
Summary
Only 34% of people use the 20/20/20 rule for digital eyestrain relief. Adult females reported more symptoms and practiced the rule more often, possibly due to dry eye conditions.
Area of Science:
- Ophthalmology
- Public Health
- Digital Health
Background:
- Increased digital device usage is linked to rising rates of digital eyestrain.
- The 20/20/20 rule is a common recommendation for mitigating digital eyestrain.
- The validity and practice of the 20/20/20 rule remain under-investigated.
Purpose of the Study:
- To survey the practice of the 20/20/20 rule during the COVID-19 pandemic.
- To investigate the association between 20/20/20 rule practice, digital device use, and asthenopic symptoms.
Main Methods:
- An online survey was distributed via social media and email.
- Eye-related symptoms were assessed using questions similar to the Convergence Insufficiency Symptom Survey (CISS).
- Participants aged 5 years and older were included, with parental completion for children under 16.
Main Results:
- 34% of 432 participants regularly or occasionally practiced the 20/20/20 rule.
- Participants experiencing burning sensations and headaches were more likely to practice the rule.
- Adult females (47%) practiced the rule more than males (23%) and reported higher symptom scores (P=0.04).
Conclusions:
- The 20/20/20 rule is underutilized, with only one-third of participants practicing it.
- Higher symptom scores and rule practice in adult females may be linked to a greater prevalence of dry eye.
- Headaches could indicate refractive errors or binocular vision issues, while burning sensations may relate to dry eye.
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