Related Experiment Video
Updated: Sep 20, 2025
Subjective Refraction Test Using a Smartphone for Vision Screening
Published on: October 18, 2024
Smartphone gaming induces dry eye symptoms and reduces blinking in school-aged children
Ngozi Charity Chidi-Egboka1, Isabelle Jalbert2, Blanka Golebiowski2
1School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, 2052, Australia. n.chidi-egboka@unsw.edu.au.
Insights
Children
Area of Science:
- Ophthalmology
- Pediatric Health
- Digital Health
Background:
- Smartphone use is rapidly increasing among children.
- The impact of smartphone usage on children's ocular surface health is not well understood.
- Understanding these effects is crucial for pediatric eye care.
Purpose of the Study:
- To investigate the effects of smartphone use on blinking patterns, ocular surface symptoms, and tear function in children.
- To assess the immediate impact of one hour of continuous smartphone gaming on these parameters.
Main Methods:
- A prospective intervention study involving 36 children (aged 6-15 years) playing smartphone games for one hour.
- Assessment of ocular symptoms (SANDE, IOSS, NRS) and tear film parameters (lipid layer thickness, secretion, stability) before and after gaming.
- Measurement of blink rate and interblink interval using eye-tracking technology during conversation and gaming.
Main Results:
- One hour of smartphone gaming significantly worsened dry eye symptoms in children.
- Blink rate decreased dramatically (from 20.8 to 8.9 blinks/min) and interblink interval increased (from 2.9 to 8.7 seconds) within the first minute of gaming.
- No significant changes in tear film parameters were observed within the one-hour study period.
Conclusions:
- Smartphone use in children leads to increased dry eye symptoms and a significant, sustained reduction in blinking.
- While tear film function remained unchanged up to one hour, the observed symptom and blinking changes warrant further investigation.
- Long-term effects of prolonged smartphone use on children's ocular surface health require further study.
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 6-15years (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 + 8.2units, p = 0.01; IOSS + 1.3units, p < 0.001; NRS-average +6.3units, p = 0.03; NRS-comfort +7.6units, p = 0.04; NRS-tiredness +10.1units, 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.
