Intense Movies Elevate IOP in Patients With Primary Open-Angle Glaucoma

Individuals with primary open-angle glaucoma may benefit from not viewing certain movies on their smartphones, because intense movies elevate IOP when viewed on smaller screens.

Intense movies elevate intraocular pressure (IOP) in individuals with primary open-angle glaucoma (POAG) when viewed on smartphone screens that are 4.0, 6.1, or 7.9 inches, according to research published in Journal Français d’Ophtalmologie. 

Researchers enrolled 48 participants from a glaucoma clinic, consisting of individuals with a POAG diagnosis (mean age, 42.4 years; women, 14) and control group participants without a POAG diagnosis (mean age, 45.4 years; women, 9). Study participants underwent IOP, anterior chamber angle, Schlemm canal cross-sectional area, heart rate and blood pressure measurements at baseline and less than 25 minutes after viewing movies with NC-17 and R ratings. 

The team began the assessment of how intense movies elevate IOP by directing participants to view the movies on smartphone screens of various sizes (4.0, 6.1, 7.9, and 10.2 inches) under artificial intelligence (AI) supervision for 90 minutes, at a distance of 40 cm. Participants wore blue-blocking glasses and repeated the trial during a second phase. Investigators monitored attention using AI, which prompted interval breaks to limit IOP increases. 

[I]nterval rest from intense movies is critically important for IOP stability.

Mean IOP significantly increased among individuals with POAG after watching the R and NC-17-rated movies in both the right (4.828 and 4.974 mm Hg, respectively; P <.05) and left eyes ( 2.876 and 5.767 mm Hg, respectively; P <.01). However, no significant IOP changes were noted when participants used the 10.2 inch screen. Maximum IOP difference was significantly and negatively correlated with Schlemm canal cross-sectional area and positively associated with blood pressure in individuals with POAG. 

Blue blocking glasses improved patient symptom scores, but had no effect on how the intense movies elevated IOP. AI monitoring decreased attention loss and limited IOP increases by implementing interval rests, the report shows. 

The researchers suggest that patients with POAG refrain from watching movies of an intense nature or use a larger screen size. 

“Viewing with [blue blocking] glasses may alleviate the discomforts, however it was useless in lowering IOP,” the study authors explain. “What is more, interval rest from intense movies is critically important for IOP stability.”

Study limitations include a small sample size and single center design.


Zhuang H, Zheng N-X, Lin L. Watching intense movies increase IOP of primary open angle glaucoma patients: a prospective study. J Fr Ophtalmol. Published online April 19, 2023. doi:10.1016/j.jfo.2023.01.011