January 30, 2020
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Smartphone work, low light associated with increase in IOP

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Working on a smartphone in low-light conditions can induce elevated IOP in patients with normal tension glaucoma, according to findings published in the British Journal of Ophthalmology.

In patients who had undergone trabeculectomy, changes in IOP were lower under similar conditions.

Ahnul Ha, MD, and colleagues investigated the effect of reading or writing on a smartphone in terms of IOP change in eyes with glaucoma as well as determining whether previous glaucoma filtering surgery can affect IOP fluctuation during the work.

“While viewing smartphones, sustained effort accommodation and ocular surface changes such as dry eye have been known to occur,” Ha, of the Department of Ophthalmology at Seoul National University in South Korea, and colleagues wrote. “Ocular changes related to near vision are believed to cause temporary, but meaningful, fluctuations in intraocular pressure as well.”

The researchers examined 40 eyes of 40 medically well IOP-controlled normal tension glaucoma (NTG) patients and 38 eyes of 38 NTG patients who had successful trabeculectomy.

Participants in the study were required to read sample text and then type the text on a smartphone under low-light conditions, Ha and colleagues wrote. IOP measurements were gathered – baseline, during smartphone work (5 to 25 minutes) and post work (5 to 15 minutes).

The researchers identified that baseline IOP did not differ between the trabeculectomy and medication groups (13.6 mm Hg vs. 13.9 mm Hg).

The medication group showed a significant elevated mean IOP after 5 minutes of smartphone work (15.5 mm Hg + 11.5%; P < .001) with additional increases over the course of 25 minutes (17.5 mm Hg +25.9%, P < .001). Five minutes after the end of work, IOP decreased below the baseline (13.1 mm Hg).

Ha and colleagues wrote that the trabeculectomy group saw an elevated IOP after 5 minutes of work (14.9 mm Hg + 9.4%; P < .001), but there was no further increase over the course of 25 minutes of work (15 mm Hg; +10.3%). Five minutes after cessation, IOP returned to pre-work levels (14 mm Hg + 2.8%; P = .053).

“Further studies determining whether smartphone-associated IOP fluctuation can affect glaucoma progression, and whether there are any additional benefits of the surgical approach for daily IOP changes, are warranted,” the researchers wrote. – by Earl Holland Jr.

Disclosures: The authors report no relevant financial disclosures.