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

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.

Inclusion criteria

• Published observational studies (cross-sectional, cohort, or case-control) and interventional studies.
• Studies involving individuals participating in online learning or remote work.
• Studies reporting the prevalence, risk factors, severity, or management of digital eye strain (computer vision syndrome).
• Studies published in English.
• Publications from January 2020 onward.
• Full-text articles available for review.

Exclusion criteria

• Case reports and case series.
• Editorials, commentaries, letters, conference abstracts, and narrative reviews.
• Studies unrelated to online learning or remote work.
• Animal or laboratory studies.
• Duplicate publications.
• Studies with insufficient data for extraction.