Digital eye strain and lens-based prescribing: exploring the gap between evidence and clinical practice

In response to the growing incidence of digital eye strain, a variety of spectacle and contact lens interventions have been introduced and are frequently prescribed in clinical and retail settings. However, the evidence supporting their effectiveness remains limited and inconclusive. This narrative review explores the real-world implementation of lens-based interventions for digital eye strain, focusing on how contextual factors influence prescribing practices. Using the Consolidated Framework for Implementation Research, the review examines the characteristics of these interventions, the outer setting in which they are prescribed, individuals involved in their adoption, and the processes that support or hinder their integration into routine care. Findings reveal that prescribing is often driven more by societal demand, commercial pressures, and clinician perceptions than by robust clinical evidence. Blue light filtering and anti-reflective coated spectacle lenses are commonly recommended, while contact lens interventions are less frequently studied but increasingly marketed. The review highlights a disconnect between evidence and practice and underscores the need for more rigorous research and context-specific clinical guidance to support evidence-based prescribing for digital eye strain.