Dry Eye Symptomatology Exacerbated by Smartphone Use

Boy playing alone on smart phone in living room
No significant changes in tear film parameters occurred during the 1-hour study duration, according to the report.

Smartphone use leads to an increase in dry eye symptoms and decreased blink rate, according to research published in Eye. 

Researchers enrolled 36 children (mean age 10.3±2.6 years, 22 girls) in a prospective intervention study to assess the effects of smartphone use on blinking, tear function, and dry eye symptomatology. The team provided participants with a smartphone and instructed them to play 2 games for 1 hour. They measured blink rate, interlink interval, lipid layer thickness, tear secretion and stability, and evaluated subjective, patient-reported symptoms through the Symptoms Assessment in Dry Eye (SANDE), Instant Ocular Symptoms Survey (IOSS), and Numerical Rating Scale (NRS).

Upon completing the activity, patients reported a worsening of dry eye symptoms. Scores increased significantly for the SANDE (+8.2 units, P <.001), NRS-average (+6.3 units, P =.03), NRS-comfort (+7.6 units, P =.04), and NRS-tiredness (+10.1 units, P =.01). Investigators observed a reduction in blink rate (20.8 to 8.9 blinks/minute, P <.001), and an increase in interblink interval (2.9 to 8.7 seconds, P =.002) within the first minute of gaming. These values persisted throughout the 1 hour duration. The team did not note any significant changes in tear film parameters. 

“Given the ubiquitous and rapidly rising use of smartphones by children globally, a better understanding of their ocular surface effects in this younger population will help to mitigate potential adverse impacts in the long term,” according to the investigators. “Knowing that hours of smartphone use in the real world are longer than the short-term (1 hour) intervention in the present study, it is reasonable to consider that the ocular symptoms and blink effects reported herein will persist or get worse over a longer term, causing cumulative damage to the ocular surface.”

Study limitations include the potential for regional bias and the lack of a control group. 


Chidi-Egboka NC, Jalbert I, Golebiowski B. Smartphone gaming induces dry eye symptoms and reduces blinking in school-aged children. Eye. Published online June 6, 2022. doi:10.1038/s41433-022-02122-2