Almost immediately, device use results in disruption of the tear film, study finds. Photo: Getty Images.

Children may be at long-term risk of developing ocular surface disease and dry eye from excessive use of smartphones. Given the rising use of these devices, a better understanding of the associated ocular surface effects could help mitigate potential adverse impacts in the long term. Researchers in Australia recently determined that one hour of smartphone use led to increased symptoms of dryness, discomfort and tiredness in children but did not impact tear film function.

The prospective intervention study recruited 36 children between the ages of six and 15 (14 male and 22 female). Symptoms 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 a 10-minute conversation) and continuously throughout gaming.

While questionnaire scores revealed that symptoms worsened during gaming, the researchers did not find any associations between the changes in the ocular surface and the changes in blink parameters over the same timeframe. Nevertheless, blink rate decreased from 20.8 blinks/minute to 8.9 blinks/minute, and interblink interval increased from 2.9 seconds to 8.7 seconds within the first minute of gaming relative to baseline; this effect remained unchanged throughout gaming. In the short term, changes in ocular symptoms and blinking were not accompanied by disturbances to the tear film.

“Knowing that hours of smartphone use in the real world are longer than the short-term intervention in the present study, it is reasonable to consider that the ocular symptoms and blink effects reported herein will persist or get worse over a longer term, causing cumulative damage to the ocular surface,” the study authors wrote in their paper.

The researchers believe that blink amplitude analysis during in situ blink measurement is an essential next step to better understand the role of blinking in smartphone-associated discomfort.

“This work highlights blinking as a useful indicator of ocular surface changes in future investigations of the effects of prolonged and/or repeated use of smartphones and digital devices on the ocular surface of children,” they concluded.

Chidi-Egboka NC, Jalbert I, Golebiowski B. Smartphone gaming induces dry eye symptoms and reduces blinking in school-aged children. Eye (Lond). June 6, 2022. [Epub ahead of print].