Blinded by video games? Try something more serious

When a Chinese woman's binge gaming session came to a blinding halt, social media quickly settled on a familiar pop culture diagnosis—but what actually happened is far more troubling.

Reportedly, the 21-year-old suddenly lost sight in her right eye after playing a popular multiplayer smartphone game, Honour of Kings, for hours on end. The woman admitted to spending the entirety of Oct. 1, a public holiday, playing the game until her abrupt loss of vision prompted a trip to the hospital. There, hospital staff diagnosed her with a central retinal artery occlusion (CRAO), and that's when her story went viral.

Social media users on the website, Weibo, were quick to draw a correlation, while others hearkened back to popular adages about too much TV and ruined vision. A comment in Chinese state media from hospital staff said that her CRAO "likely" resulted from excessive gaming.

The comment raised flags not only for its dubious nature but also because China has a history with this smartphone game. In fact, the Chinese government recently suggested restricting children to no more than one hour of playtime daily after a rash of obsessive incidents involving the game. But the situation begs the question: Can excessive screen time cause blindness?

The short answer is most likely not, says Leonard Messner, O.D., executive director of the Illinois Eye Institute and vice president for patient care services at the Illinois College of Optometry (ICO).

"I can think of no correlation between device screen time and CRAO," Dr. Messner says. "The most common causes of CRAO are carotid atherosclerosis, cardiac arrhythmias and giant cell arteritis. That said, many have no known cause."

Analogous to a stroke of the eye, CRAO is an ocular emergency whereby the blood vessel supplying the retina becomes blocked, resulting in sudden and painless vision loss. It's estimated to occur at a rate of 1:100,000 with approximately two-thirds of patients only recovering vision to 20/400. Given that CRAO is commonly correlated with other cardiovascular diseases, patients presenting with such a condition may be at future risk for cerebral stroke or ischemic heart disease, according to some studies. That, alone, makes this woman's diagnosis serious.

While it's highly unlikely the etiology of this woman's eye problems was video game playing, that doesn't belittle other concerns prolonged screen time and device use can have on the eyes, says Dominick Maino, O.D., professor of pediatrics and binocular vision at ICO.

Screen time takes toll on eyes

The Pew Research Center estimates that 60% of Americans, ages 18-29, play video games at least occasionally, while more than half of those ages 30-49 do, too. On top of that, the AOA's 2016 American Eye-Q® study found that the average American spends seven hours daily using digital devices, with the Millennial generation spending an average of nine hours daily. All that time staring at a digital device can have repercussions, just not in the way social media thought here.

High-energy, short-wavelength blue light—the kind of visible light emitted from digital devices—has been at the center of scrutiny. Researchers believe viewing such bright lighting at nighttime can disrupt circadian rhythms by suppressing melatonin production to keep people wakeful. This, in turn, can hinder natural sleep cycles and affect alertness. But blue light isn't the only concern.

Digital eyestrain is another common occurrence from prolonged device use, and manifests itself in headaches, blurred vision, dry eyes, neck and shoulder pain, and general eyestrain. To counter the effects of digital eyestrain, the AOA recommends these five tips:

1. Follow the 20-20-20 rule: Take a 20-second break every 20 minutes to view something 20 feet away.
2. Keep a distance: Sit a comfortable distance away from any computer monitor or device, generally, keeping the screen 20 to 28 inches from your eyes.
3. Consider the angle: Ideally, computer screens or devices should be 15 to 20 degrees—4 or 5 inches—below eye level as measured from the center of the screen.
4. Decrease glare: Try a glare filter to minimize the reflected light bouncing off the screen or device.
5. Blink often: Minimize your chances of developing dry eyes when using a computer or device by making an effort to frequently blink.

Read more about the good, bad and ugly of video games and eye health in the April 2016 issue of AOA Focus.