Smartphone gaming induces dry eye symptoms and reduces blinking in school-aged children

Abstract — Purpose

Smartphone use by children is rising rapidly, but its ocular surface impact is unknown. This study examined the effect of smartphone use on blinking, symptoms, and tear function in children.

Methods

Prospective intervention study where 36 children aged 6–15 years (14 M:22 F) played games on a smartphone continuously for one hour. Symptoms (SANDE, IOSS, NRS) and tear film (lipid layer thickness, tear secretion, stability) were assessed before and after gaming. Blink rate and interblink interval were measured in situ using an eye tracking headset, before (during conversation) and continuously throughout gaming. Symptoms and tear film changes were examined using paired t-tests. Changes in blinking throughout one hour were examined using repeated measures ANOVA, post-hoc comparisons with Bonferroni correction. Associations examined using Pearson bivariate correlation. Significance level was 0.05.

Results

Symptoms worsened following one hour smartphone gaming (SANDE + 8.2 units, p = 0.01; IOSS + 1.3 units, p < 0.001; NRS-average +6.3 units, p = 0.03; NRS-comfort +7.6 units, p = 0.04; NRS-tiredness +10.1 units, p = 0.01), but tear film remained unchanged.

Blink rate reduced from 20.8 blinks/min to 8.9 blinks/min (p < 0.001) and interblink interval increased from 2.9 s to 8.7 s (p = 0.002) within the first minute of gaming relative to baseline conversation, and this effect remained unchanged throughout one hour of gaming.

Conclusions

Smartphone use in children results in dry eye symptoms and immediate and sustained slowing of blinking, with no change in tear function evident up to one hour. Given the ubiquitous use of smartphones by children, future work should examine whether effects reported herein persist or get worse over a longer term causing cumulative damage to the ocular surface.

연구 요약 (한국어)

6–15세 아동 36명이 1시간 스마트폰 게임을 한 전향적 연구입니다. 게임 시작 1분 안에 깜빡임이 평균 20.8회/분에서 8.9회/분으로 줄었고, 이 상태가 1시간 동안 유지됐습니다. 건조·불편·피로 증상 점수는 악화됐습니다. 눈물막 기능 지표는 1시간 기준에서 큰 변화가 없었습니다.

키즈크로스와의 관련성: 아이 영상·게임 시청 시 ‘깜빡임이 바로 줄어든다’는 점을 실험으로 보여 준 대표 연구입니다.

Original paper: nature.com/articles/s41433-022-02122-2 · © The Author(s) / Eye (Springer Nature). Full text rights remain with the publisher.