Digital Accommodative Asthenopia. Message 2: Accommodative Response Indicators in Adolescents with Different Screen Times

Purpose: to study the accommodative response indicators in adolescents with different screen time durations.
Patients and methods. A clinical and experimental study involving 86 participants (16 males, 70 females; mean age 16.6 ± 0.17 years) consisted of two blocks of research. The psychometric block included the determination of internet-addiction (IA) and the nature and duration of digital information technology (DIT) use. The ophthalmology assessment included the determination of the accommodative response coefficient (ARC) and the accommodation lag (AL) using a Speedy-K autorefractometer (Right MFG, Japan); the data were analyzed using nonparametric statistical methods. This experimental approach allowed us to identify the relationship between the nature of DIT use, screen time (ST), and accommodation, as well as to gain insight into the neuro-ophthalmological mechanisms underlying digital accommodative asthenopia.
Results. In the overall group of adolescents, the average level of IA was 50.0 (43.0; 60.0) points; signs of IA were not detected in 22.1 % (n = 19), 61.6 % (n = 53) showed IA in the formation stage; Internet addiction was identified in 16.3 % (n = 14), but we did not find any statistically significant patterns between IA and accommodative response indicators. Subjects had been using computers for 9.5 (8.0; 11.0) years, smartphones for 7.0 (5.0; 9.0) years, and the Internet for 8.0 (7.0; 10.0) years. Based on screen time duration (hours per day), subjects were divided into 4 groups: short (≤1 hour, n = 11), medium (1–3 hours, n = 26), long (4–6 hours, n = 20), and excessive (>6 hours, n = 17). Analysis of the obtained results revealed significant differences between the groups with different screen time durations for stimuli ranging from –1.5 to –3.0 D (p < 0.001 for most stimuli). A clear dose-dependent effect of screen time on the studied accommodative response parameters was demonstrated: with increasing screen time, the lag increases, and, accordingly, the accommodation coefficient decreases. The data are discussed from the perspective of modern neuro-ophthalmological approaches to the development of digital accommodative asthenopia (DAA), and taking into account the neurophysiological mechanisms of accommodation regulation.

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