Are Video Games Harming Your Childs Eyes?

The past 20 years has seen an increase in video gaming.  Video gaming has a huge impact on the youth who engage in it and society in general. Parents concerns about the effects extended video game play has on their children has increased as well. These concerns include (in no specific order) effects on concentration, mental and physical development or lack thereof, violence, ergonomic strain and many other concerns. One of the effects of gaming that is well understood is how gaming can affect ones vision. The largest concern related to gaming as it relates to vision change is what is known to optometrists and ophthalmogists as the users “working distance”. Working distance can be defined as the distance the users eyes focus from the screen where the video image is displayed.
Sustaining vision at working distances closer than 20 feet can lead to eyestrain, headaches and other general symptoms of fatigue that fall within a category called “asthenopia”, a fancy word for eyestrain and related symptoms. The vision system in people who have naturally clear vision or are corrected with eyeglasses or contact lenses is usually most comfortable when engaged in viewing activities that are 20 feet (6 meters) or further from their eyes. As objects loom closer to the eyes, effort via different muscles that innervate the eye must be sustained, and this can lead to symptoms of eyestrain. For most, the closer the object to the face, the more strain the eye undergoes, whether the user notices or not.
Accommodation Disorders
The system within the eye and the brain that manages shifting ones vision from distance targets to near targets and back is known as the Accommodative system. Most children and young adults have no trouble focusing from far to near and back. In some people, when the focus is sustained at distances greater than 20 feet (6 meters) for extended periods of time, the focus system can go into “spasm”. A typical example is upon finishing a video game, the user looks at a distance farther away from the screen and notices things are blurry, and it takes some time for the vision to clear up again. This “spasm”, also known as pseudomyopia can lead to more permanent vision change, or true myopia, especially in people who are already myopic (nearsighted) or have eyes that prefer to turn inwards slightly (esophoria). The spasm of the accommodative system is greater the closer the video game working distance. This means the potential for vision to worsen is higher in hand-held video games like the Nintendo DS than the Wii which is typically used at a farther working distance.
Axial Length Changes
Myopia (nearsightedness) is caused when the power of the optics of the eye is too strong for the length of the eye. Myopic eyes are longer eye (axially) and myopic eyes that are worsening are axially elongating. Many eye doctors believe that sustaining the focus at near distances for long periods of time causes sustained pulling of the muscles against the eyeball, elongating it and leading to worsening vision.

Damage from UV radiation
Ultraviolet radiation damage to the eyes from these games is relatively small and harmless and not usually even a minor consideration of an eye doctor as it relates to extended use of video games.
Reminding the Brain
As human beings we are programmed to adapt to different environments. If the message our brain is getting is that the eyes need to be focused up close for long periods of time, the brain will send out signals that encourage the eye to “grow” to become more “near sighted” to adapt the user. Think about people you know in different careers; academics, scientists, scribes, accountants etc are stereotypically people prone to wearing glasses. These are people who spend a significant amount of time at work and possibly away from work staring at objects very close to them. We don’t think of our police, firefighters, forest rangers and others who spend much of their time away from intensive near work as wearing thick eyeglasses. While there are always exceptions to the rules, most people engaged in an activity over long periods of time will adapt to their situations, be it thei r posture, getting callused on hands and feet or manifesting vision change being just a few of many examples. When engaged in extended near work, it is important to take breaks, using the time to refocus at distance to remind our brain that it also needs to see at distance. We do this in the hopes that our potentially permanent adaptation to near vision is limited.
It might be obvious to the reader that video games played on a television screen several feet away from the user are better for the eyes and vision system than video games played on a computer screen or held in the hand and they would be correct. If you want to minimize changes in the vision system of your child I recommend:
1. Encourage the child to increase their working distance.

For children using a computer to play video games the screen should be placed beyond their extended arm and extended finger-tip distance.  They should also be sitting above the computer, so their eyes are angled downwards to view the screen as this reduces eyestrain.  For this reason, laptops are better, although by definition they end up closer than the recommended working distance, being on the “lap”.

For children using hand-held devices the device needs to be held in a position where the angle of the arm (elbow) is at 90 degrees or greater (obtuse, as opposed to acute). This will help keep the game farther away from the face and lessen eyestrain and accommodative effort.

2. Children should also be encouraged to take a break every 20-30 minutes and look out a window, reminding the eye and brain that it not only is tasked with seeing up close, but needs to be able to readjust to see distance targets as well.

3. Get regular eye examinations – don’t wait too long. Typically an annual eye examination is fine, but if you notice your child squinting or your child complains that their vision might be worse, don’t wait; the sooner the problem can be addressed at the doctor’s office the better chance the change can be managed long term and the final prescription might be less than it would have had you waited.

Some studies have shown that video games can improve vision, but these studies are generally referring to visual skills, such as reaction time, peripheral awareness etc and aren’t referring to changing eyeglass prescriptions secondary to video game use

Don’t forget more information is available at Our doctors are always available to answer your questions via Twitter, Facebook or email.

Courtesy of the Doctors at Shady Grove Eye and Vision Care; Optometrists, Ophthalmologists and Opticians working together to help you see better.  Serving the Rockville, Potomac and Gaithersburg Maryland suburbs of Washington, DC for over 40 years. For more information visit or call (301) 670-1212

Follow us on Twitter @EyeInfo

Copyright 2010 – Dr. Alan N. Glazier, Optometrist, P.A. All Rights Reserved


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