The use of hand-held digital devices for gaming and social media has shown a marked increase in the past two years.1,2
Children who are teenagers in 2019 did not grow up having video games with the intensity, the close distance, nor the wider periphery necessary to be successful in the game as the 7- to 10-year-olds face today.
The heightened use of their “fight or flight” process, and increased engagement of peripheral awareness and scanning when following posts on social media is potentially having a significant effect on their development and function.3-6
Because gamers have a significantly heightened push into peripheral awareness at the closer distances, accommodation and visual acuity are diminished.
It is becoming the norm to hear vague complaints from children of not being able to see as well at distance or near and for them to show inconsistent and variable responses on testing that requires central function. The outcomes are not consistent with the refractive assessments.
Pupils show a significantly larger size than typical, are less reactive to light, and show less accommodative response to near targets on Just Look! Retinoscopy (near dynamic retinoscopy)—an observation of the manner in which a patient uses “looking” when engaged in a nearpoint task. It assesses patient response rather than refraction.
The most frequent observation I see in an eye examination is an initial assessment of pupil size during near retinoscopy. It is expected to see pupil constriction during a nearpoint activity.
This is not the observation noted in pupil size of the children who are compulsive gamers or who compulsively participate in social media activities. These children show a sustained increase in pupil size of 7 mm to 10 mm. Those who participate for longer periods of time tend to gravitate toward the larger sizes.
See Figures 1A and 1B.
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15. World Health Organization. Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age. Available at: https://apps.who.int/iris/bitstream/handle/10665/311664/9789241550536-en.... Accessed 8/7/19.