The effect of digital devices screen use on intraocular pressure: A systematic review and meta-analysis.

Purpose: The widespread adoption of digital screens has raised concerns about potential impacts on ocular health, particularly intraocular pressure (IOP). This systematic review and meta-analysis aimed to examine the association between digital screen use and changes in IOP.

Methods: We conducted a comprehensive search across multiple electronic databases through January 2024, and reported adhering to PRISMA guidelines. Eligible studies included clinical trials published in English, evaluating the effects of digital screen use on IOP. Statistical analyses were performed with Stata software, calculating the overall effect size using the weighted mean difference (WMD) of IOP changes among healthy and glaucomatous participants before, during (5, 15, 25, 30, 45, and 60 min), and after screen exposure.

Results: Nine studies involving 675 eyes were included. Among healthy participants, IOP significantly increased at 25 min, with an increase of 1.53 mmHg [0.83, 2.24] (p = 0.00). Other time intervals (5, 15, 30, 45, and 60 min) showed no significant changes. Post-exposure, IOP returned to baseline levels without any significant change from baseline (p > 0.05). In glaucomatous individuals, IOP rose by 1.13 mmHg [0.46, 1.80] at 5 min (p < 0.001) and 2.49 mmHg [0.33, 4.65] at 25 min (p = 0.02), with no significant changes at other intervals.

Conclusion: Screen exposure can lead to temporary IOP increases, especially in individuals with glaucoma. Larger, well-designed clinical trials are necessary to confirm these findings, understand underlying mechanisms, and identify risk factors. This study highlights the potential ocular health risks associated with prolonged screen use.

Key Messages: What is known Using digital screen has been associated with various ocular effects including eye strain, dry eye, and changes in Intra ocular pressure (IOP). Previous studies have suggested temporary IOP changes with digital screen use, however findings were inconsistent. What is new This systematic review and meta-analysis highlights that digital screen exposure leads to significant IOP increases at specific intervals, in both healthy and glaucomatous individuals. Glaucomatous participants experience more pronounced IOP elevations, emphasizing the need for tailored recommendations for this group. The study identifies potential mechanisms, including accommodation, postural influences, and blue light exposure, that contribute to these changes, underscoring the complexity of digital screen use's impact on ocular health.