Eye strain headache: where it hurts and what helps

An eye strain headache is usually felt across the forehead, at the temples, or around and behind the eyes. It tends to build slowly through a long stretch of screen work, arrives with tired or dry eyes, and eases once your eyes get a proper rest. For most people it is uncomfortable rather than harmful, and the fixes are simple: breaks that let you look far away, a screen at the right distance and brightness, bigger text, and glasses that are up to date.

If you get one most afternoons, the pattern is worth reading, because where it hurts and when it starts both point to a fix. What follows is general information, not a diagnosis.

Where does an eye strain headache hurt?

Most people feel it in one or more of these places:

• Across the forehead and brow, often with the sense of having frowned all day.
• At the temples, on one side or both.
• Around or behind the eyes, as a dull pressure or ache.
• The back of the head and neck, when the way you sit to see the screen joins in.

What sets it apart is the timing and the company it keeps. It usually comes after long close work, builds as the day goes on, and arrives with other signs of digital eye strain: eyes that feel tired, gritty or burning, vision that takes a moment to sharpen when you look up, and a new dislike of glare. It typically eases with rest, and is usually gone by the next morning.

A headache that is already there when you wake, that throbs on one side with nausea, or that doesn't change with screen time points somewhere else, and is worth raising with a doctor. Digital eye strain: the symptoms, the causes and the fixes has the wider picture of what screens do to tired eyes.

Why do screens cause eye strain headaches?

The exact link between tired eyes and a headache isn't fully worked out, but several things that happen at a screen are known to contribute. Usually it is two or three of them together.

• Holding close focus for hours. A muscle inside each eye works to keep near text sharp, and both eyes turn slightly inward to point at the same spot. Hours of that without a break is tiring.
• Squinting. Small text, glare and a screen much brighter or dimmer than the room make you narrow your eyes and tighten your brow, often without noticing. Those muscles can ache like any others.
• Eyesight that isn't quite corrected. An out-of-date prescription, a little uncorrected astigmatism, or the focusing changes most people start to notice in their 40s can make every hour at the screen harder work. This is one of the most common causes and one of the easiest to fix.
• Dry eyes. People blink less while they concentrate on a screen, and a dry, irritated eye surface adds to the discomfort.
• Posture. A laptop screen that sits low pulls your head forward and down. That loads your neck and shoulders, and tension there can bring a headache of its own.

Where the ache sits can hint at which of these is doing most of the work. Treat this as a rough map, not a diagnosis.

Quick relief at your desk

When the ache starts, give your eyes a real break, not a glance away.

1. Look far away. Find the farthest thing you can see, a window or the end of a room, and rest your eyes on it for 20 seconds or more. Distance lets the focusing muscles relax.
2. Close your eyes for a minute. Some people like to cup their palms over closed eyes to block the light. It is simply rest, and that is enough.
3. Blink slowly, a few full blinks, to spread tears back across the eye.
4. Unclench. Relax your brow and jaw, drop your shoulders, and turn your head gently from side to side.
5. Cut the glare. Turn the brightness down if the screen glows against a dim room, or close a blind if sun is hitting the glass.
6. Step away for a few minutes, ideally somewhere you can look out of a window or go outside.
7. Drink some water. It won't fix eye strain, but being low on fluids can add a headache of its own. Dehydration headache at work helps tell the two apart.

A pharmacist can tell you which painkiller suits you if you need one. But needing one on most screen days is a sign that your eyes or your setup need checking.

How do you stop eye strain headaches coming back?

Relief helps today. These help next week.

Take breaks with distance in them

The usual advice is the 20-20-20 idea: every 20 minutes, look at something 20 feet away, about six meters, for 20 seconds. Nobody has shown the exact numbers matter. What helps is breaking up long stretches of close focus, regularly. The 20-20-20 rule covers why it works and how to make it stick. Take a longer break away from the screen every hour or two as well.

Put the screen where your eyes like it

Set the screen roughly an arm's length from your eyes, and high enough that its top edge sits around eye height or slightly under, so your gaze tips a little downward to the middle of it. On a MacBook, long days usually call for a laptop stand and an external keyboard, or an external display.

Match the brightness to the room

In System Settings > Displays, switch on Automatically adjust brightness where your Mac has it, and True Tone on Macs that support it. In a dim room, add a lamp rather than dimming the screen to match the dark. Keep windows to the side of the screen, not behind it or behind you.

Make the text bigger

If you catch yourself leaning toward the screen to read, make the text bigger. In System Settings > Displays, choose a scaled resolution nearer the Larger Text end, or zoom the app you are in with Command and the plus key. If text looks faint, Increase contrast in System Settings > Accessibility > Display makes edges and controls stronger.

Get your eyes checked

The NHS recommends an eye test every two years for most adults, or more often if your optometrist advises it. Tell the optometrist how much of your day is spent at a screen, and measure the distance from your eyes to the screen before you go so you can give them a number. Glasses set for screen distance, sometimes called computer or office lenses, can help people whose reading or distance glasses don't suit a screen at arm's length.

When to see an optometrist or a doctor

Book an eye exam with an optometrist if:

• Headaches follow most screen sessions even after you have changed your breaks and setup.
• Your vision stays blurry after rest, or you see double.
• It has been a couple of years since your last eye test, or you have never had one.
• You find yourself holding things farther away to read them.

See a doctor if headaches are frequent, getting worse, or don't seem linked to screen time at all. Get urgent help the same day, calling your local emergency number if needed, for:

• Sudden, severe eye pain with a headache, especially with blurred vision, halos around lights, nausea or a red eye.
• A sudden loss of vision, a shadow or curtain across part of your sight, or a burst of new floaters or flashes.
• A sudden, very severe headache, or a headache with weakness, numbness, confusion or trouble speaking.

Let Bill keep an eye on the breaks

Most of the fixes above you do once. Breaks are different: they need repeating all day, and they are what slips first, because the hours your eyes need them most are the hours you are most absorbed. Notchpals, which runs your reminders through a crew of characters in the Mac's notch, gives this job to its Eyes characters. Blip comes with every copy; Bill the shoebill, Blush the chameleon and Professor Hoot the owl are the others, and your crew has one of them. Bill takes the job more seriously than anyone.

BillLook twenty feet away for twenty seconds. I stare for hours. You can do twenty.

Besides eye breaks like that one, there are blink breaks, which ask for a few slow, full blinks. How often both come is one setting for your whole crew's repeating reminders, Calm, Normal or Chatty, and the clock only counts time you spend using the Mac, so a lunch away from the desk doesn't count as screen time. Even on Chatty, the visits are spaced well apart, far fewer than one every 20 minutes, so the habits above still do some of the work. In the evening there is one more visit, some time between 9 PM and midnight, asking you to dim the screen.

Notchpals can't see your eyes and has no idea you have a headache. It only makes sure the break gets asked for. If the headaches carry on after a few weeks of breaks and a better setup, the optometrist is the next step.