Questions and Answers about Video Games and Vision

I was originally asked these questions by email for an interview about video games and vision.  I was excited because there are a lot of myths and misconceptions about how video games can affect your eyes. Unfortunately,  the interview was not published, so I decided to print them here. If you have questions like this, please let me know. -Dr. Nate

Does playing video games cause more stress to the eyes than watching tv?

Playing video games is considerably more stressful for the eyes than watching TV, but it depends a lot on which form the games take. Games on the TV like Playstation and Xbox are different than games on the computer, such as World of Warcraft, which are different than handheld games like those for Nintendo DS (and soon 3DS).

The visual system is designed for looking at things far away without effort, assuming the eyes are healthy and, if needed, the correct glasses or contacts are being worn. When looking up-close, the eyes have to change focus and position.  The, over time, adds up in a big way. If the visual system is overwhelmed, gamers can have blurry vision, eye strain or headaches. If the eyes are too stressed to move properly, double vision and reduced performance can result. All this is made worse under stressful situations, overall fatigue, and times of extended mental concentration.

As a former gamer (before I had kids), I know that an awesome video game is much more likely to generate stressful situations, require extended mental concentration, and lead to fatigue from sleep deprivation than a random TV show. So gamers are already predisposed to have eye and vision problems.

But here is an additional twist: When we are under stress we have a "fight or flight" response. In this situation, our eyes are evolutionarily adapted to focus in the distance. This was useful when we were hunters and gatherers to help us see what we were hunting and what was hunting us. But it’s counter-productive when at the computer.

Finally, it’s known that people blink much less at the computer than at other times – as much as 60% less. When people don't blink, the moisture on their eyes evaporates leading to dry, burning, irritated eyes and blurry vision. All of these things together are referred to as Computer Vision Syndrome (CVS.) Although CVS gets more attention in the workplace, it applies to recreational computer users, too.

What's the best advice for video gamers regarding eye fatigue?

Hands down, the best advice is to take frequent breaks. There is a rule of thumb that eye doctors tell patients called the "20/20/20 Rule." This means that every 20 minutes, look away from the screen at something specific at least 20 feet away for at least 20 seconds, like a clock or a picture.  When looking away blink your eyes several times and take deep, relaxing breaths.

When looking away, take note if the object you’re looking at in the distance starts off blurry and then slowly gets clear, as this is an indication that your eyes are working too hard and that you should take a longer break. Unfortunately, that is much easier said than done, because video games are extremely engaging. When gamers are "in the zone" they often don't stop to eat or drink, let alone take a 20/20/20 Rule break. Some people will put post-it notes on the monitors or set alarms to remind them.

Also, set up your gaming environment ergonomically. Make sure that your monitor is approximately two feet away from your eyes and not at an unusual angle. It’s best if there are soft lights on in the room so there’s not a big brightness difference between the screen and the surrounding space.

Remember to talk to your eye doctor during your annual exam about your computer use - both work AND at home. Let him or her know if you experience blurriness, fatigue, double vision, burning or discomfort at the computer. Some people think those things are just "normal" and ignore it, but that isn't a good idea. Sometimes these symptoms are the sign of more significant underlying problems. Your doctor can do specialized testing to determine the problem. You may be given a prescription for special eyeglasses for the computer, eye drops to use, or a recommendation for therapeutic techniques called vision therapy.

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.