November 26, 2019
3 min read

Q&A: The rise of esports and its effect on vision

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Jesse L. Berry

Esports is quickly becoming one of the most popular global pastimes to play and watch, with its estimated audience already surpassing that of Major League Baseball.

The monthly size of competitive esports gamers worldwide is estimated to hit 276 million by 2022, up from 167 million as of year-end 2018, and in the United States the total number of minutes spent watching gamers on Twitch totaled 355 billion minutes by 2017, according to Forbes.

With so many watching and participating in esports, Healio/OSN asked Jesse L. Berry, MD, an associate professor of ophthalmology at Keck School of Medicine of USC and associate director of ocular oncology at USC Roski Eye Institute and Children’s Hospital Los Angeles, to give her opinion on the effects that esports and sustained video game participation can have on vision.


Q: Have any of your patients complained of vision problems related to esports ?

A: No, but I am often asked about the safety of video games and the eye, particularly because I treat adults and children who have often lost vision in one or both eyes due to an eye cancer, and they are clearly interested in protecting their vision. But they also want to get back to doing all the things they love after their cancer diagnosis, and this often involves video games for my young adult and pediatric patients.


Q: What vision risks are associated with esports?

A: There are no known permanent effects of esports, gaming, computer use or screen time on vision, but it is exceedingly common for patients to think that the computer causes permanent damage to the eye. Rather, extended screen time of any sort causes eye strain. This is due mainly to two things. First, we blink far less when we are focused on screens. This causes the eye to dry out, which can lead to burning, stinging or a sandy feeling and blurred vision. The second reason is that in order to focus on the screen, we have to accommodate or use the muscles in our eyes to focus at near, and after a long time, these muscles can fatigue. This can also cause the sensation of eye strain and blurred vision. While this can make your eyes feel tired, weak and blurry, there is no permanent damage.


Q: What advice would you give to those involved in the esports industry to protect their vision?

A: The best advice is to relax now and again. On the cement outside my hospital is a sign that reads: Heads Up, Phones Down. The same applies here — lift your head and take a break from the screen. The American Academy of Ophthalmology recommends the “20-20-20” rule, that is, every 20 minutes, shift your eyes to look at an object in the distance at least 20 feet away for at least 20 seconds. It is doubtful that my patients will do this every 20 minutes, but it is a helpful reminder. Preservative-free artificial tears can help with digital eye strain, too.

I tell my patients’ parents that when their children rub their eyes during screen time, it is time for a break. The American Academy of Pediatrics recommends no screen time for children younger than 1 year for developmental reasons.


Q: Do you have anything to add about digital eye strain and esports ?

A: I am often asked if people should buy blue light blocking glasses. Currently, there is no good science that specific blue light blocking glasses for use while gaming or on the computer are helpful. There are some early studies in animal models that suggest high-intensity levels of blue light and UV light may worsen macular degeneration. The most significant source of blue light is the sun, however, and I do recommend that all my patients wear sunglasses labeled UV400 or 100% UV protection in order to block the entire spectrum of damaging UV light.

There is good science to suggest that extended blue light from screens can affect our circadian rhythms; thus, limiting screen time before bed is a good idea to get a good night’s sleep. – by Robert Linnehan



Rapoza K. Global esports popularity give gamer companies reason to be bullish. Published May 29, 2019. Accessed Oct. 29, 2019.


Disclosure: Berry reports no relevant financial disclosures.