Smartphone addicts may require cycloplegic refraction for accommodation spasm. Photo: Getty Images.

Smartphone use and device use, in general, are known to have certain undesirable psychological and physiological effects such as depression, myopia, musculoskeletal problems and headache. Previous studies have reported weakness in accommodation after just 20 minutes of smartphone use. Researchers investigated the impact of smartphone use on the eye’s accommodative state. Their results, published in BMC Ophthalmology this month, found that those who report heavy smartphone use experience accommodative spasm. 

In the cross-sectional study, adults aged 18 to 35 were given a smartphone addiction questionnaire and categorized as smartphone “abusers” (n=40) and non-users (n=40). The median age of smartphone abusers was 26 compared with 31 for the non-user group. There were 16 females (40%) in the smartphone abusers group and 22 (55%) in the non-users group.

To evaluate each participant’s state of spasm of accommodation, the researchers measured autorefraction pre-cycloplegia and post-cycloplegia at distance. They also assessed ultrasound biomicroscopy parameters such as anterior chamber angle.

Mean smartphone use was 6.6 hours among heavy users, who scored an average of 73.35 on the questionnaire. The researchers reported a mild median and a mild mode among this group. Additionally, “Anxiety and depression scores had non-significant differences between the two groups,” the researchers noted in their paper. “Therefore, the influence of the limbic system on accommodation was similar.”

The researchers found a significant difference in the likelihood of having a spasm of accommodation between the two groups. Heavy smartphone users had a significantly greater superior anterior chamber angle median of 30.45˚ compared with non-users’ 26.75˚ pre-cycloplegia at distance. Post-cycloplegia, the superior anterior chamber angle medians measured 31.7˚ and 31.45˚ for heavy users and non-users, respectively. The researchers also noted a significantly higher difference in pre-cycloplegic and post-cycloplegic nasal anterior chamber angle at distance in heavy users vs. non-users.

They concluded that smartphone abusers “are in a condition of accommodation spasm,” they wrote in their paper. “As a result, cycloplegic refraction should be routinely done for these patients."

Kashif RF, Rashad MA, Said AMA, et al. Ultrasound biomicroscopy study of accommodative state in smartphone users. BMC Ophthalmol. August 3, 2022. [Epub ahead of print].