How to guide patients in the use of digital devices

• Published in: Optometry times Vol. 11; no. 8; pp. 29 - 30
• Main Author: Steele, Glen T
• Format: Magazine Article
• Language: English
• Published: Monmouth Junction MultiMedia Healthcare Inc 01.08.2019
• Subjects: Addictions; Age; Children & youth; Computer & video games; Patients; Pediatrics; Screen time; Social networks; Teenagers
• ISSN: 0890-7080; 2328-3904

Parents are looking for guidance from eyecare providers on gaming and social media activities The use of handheld 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. Effects of devices When a patient presents with the following signs and symptoms and shows these criteria during testing, I immediately think persistent sympathetic response: - Playing games on the device as I come into the room - Vague complaints of not being able to see as well at distance or near - Responses on visual acuity (VA) or any detailed testing is not precise nor sharp - Large pupils during near dynamic retinoscopy - Darker retinoscopic reflex when asked to look at a central accommodative target but the pupil does not reduce in size accordingly - Reduced fine stereo Eckhard Hess wrote in Scientific American in 1965 that: "Dilation and constriction of the pupils reflect not only changes in light intensity but also ongoing mental activity. Research results Other things that have not been adequately investigated in the current literature include the following: - Heart rate - Blood pressure - Direct and consensual pupil responses - Respiratory responses - Decreased sensitivities to touch, sound, and smell During nearpoint testing, the patient will attempt to engage focusing (more than accommodation) in which case against motion will be seen on Just Look! Numerous studies are beginning to show that children who utilize devices from an early age develop language more slowly, do not have the fine motor skills necessary for writing, and have a markedly shorter attention span when reading.4-6,8-12 Other studies show children exhibit more anxiety and depression when using the devices longer than one hour per day whereas children who use devices less than an hour a day experience less anxiety and depression.1'8'12'14 The World Health Organization strongly suggests that limiting social media use to about 30 minutes per day may lead to significant improvement in well-being.