Digital Eye Strain in Online Learning and Remote Work Environments: A Systematic Review

Overview

This systematic review aims to evaluate the prevalence of digital eye strain (DES) among individuals engaged in online learning and remote work, identify associated demographic, behavioral, environmental, and ocular risk factors, and summarize evidence regarding preventive and therapeutic management strategies. Electronic databases including PubMed/MEDLINE, Scopus, Web of Science, Embase, Cochrane Library, and Google Scholar were systematically searched for relevant studies published from January 2020 onward. Eligible studies included observational and interventional studies involving online learners or remote workers that reported the prevalence, risk factors, or management of DES. Two independent reviewers performed study selection, data extraction, and quality assessment. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Where appropriate, quantitative synthesis using a random-effects meta-analysis was planned; otherwise, findings were synthesized narratively. The review is intended to provide evidence-based recommendations for reducing the burden of digital eye strain in educational and occupational settings characterized by prolonged digital device use.

Digital eye strain (DES), also known as computer vision syndrome, has become an increasingly important public health concern due to the widespread use of digital devices in education and the workplace. The rapid expansion of online learning and remote work, particularly following the COVID-19 pandemic, has substantially increased daily screen exposure among students and employees, leading to a higher prevalence of visual and ocular symptoms. DES encompasses a range of symptoms including eye fatigue, dryness, burning sensation, blurred vision, headache, diplopia, neck pain, and shoulder discomfort. These symptoms result from multiple interacting factors, including prolonged accommodation, decreased blink rate, tear film instability, poor ergonomics, improper viewing distance, glare, inadequate lighting, and prolonged uninterrupted screen use. The condition may adversely affect quality of life, academic performance, workplace productivity, and overall well-being. The objective of this systematic review was to synthesize the current evidence regarding the prevalence of digital eye strain among individuals participating in online learning and remote work, identify associated risk factors, and evaluate available preventive and therapeutic management strategies. The review included observational studies (cross-sectional, cohort, and case-control) and interventional studies involving online learners or remote workers published in English from January 2020 onward. Studies were identified through comprehensive searches of PubMed/MEDLINE, Scopus, Web of Science, Embase, Cochrane Library, and Google Scholar. Two independent reviewers screened titles, abstracts, and full-text articles according to predefined eligibility criteria, extracted study data, and assessed methodological quality using the Joanna Briggs Institute Critical Appraisal Checklists for observational studies and the Cochrane Risk of Bias 2 tool for interventional studies. Extracted data included study characteristics, participant demographics, sample size, duration of screen exposure, methods used to assess digital eye strain, prevalence estimates, identified risk factors, evaluated interventions, and principal findings. A narrative synthesis summarized the available evidence, while quantitative meta-analysis using a random-effects model was planned when sufficient homogeneous data were available. Statistical heterogeneity was assessed using Cochran's Q test and the I² statistic. The findings of this review are expected to provide a comprehensive synthesis of the current literature, identify modifiable risk factors, summarize evidence-based preventive and therapeutic approaches, and support recommendations for educational institutions, employers, healthcare professionals, and policy makers aimed at reducing the burden of digital eye strain among digital device users.