Intraocular pressure change during reading or writing on smartphone

Purpose To investigate the effect of reading or writing on a smartphone in terms of intraocular pressure (IOP) changes. Design Prospective, comparative case series. Participants Thirty-nine (39) healthy young (age < 40) volunteers. Methods The participants were requested to conduct standardized work (i.e., read a sample text on single mobile device and subsequently type it on the same device) under daylight [300 lux] and low-light [100 lux] conditions independently on consecutive days. On each day, three sets of IOP measurements (total: 7) using a rebound tonometer (iCare PRO; Tiolat, Helsinki, Finland) were performed: (1) pre-work (baseline) [2 measurements], (2) during smartphone work [5, 15, and 25 minutes], and (3) post-work [5 and 15 minutes]. Main outcome measures Changes in IOP at different check-out points. Results Under the daylight condition, the mean baseline IOP was 13.7 ± 1.8 mmHg, and the mean IOP increased after 5 minutes of work (14.1 ± 1.8 mmHg; +2.0 ± 1.9%; P < 0.001). When the smartphone work lasted for 15 minutes, the IOP showed a further significant increase (15.5 ± 1.7 mmHg; +12.9 ± 4.4%; P < 0.001), which persisted over the course of the 25 minutes of smartphone work (15.3 ± 1.8 mmHg; +11.1 ± 3.9%; P < 0.001); then, after stopping work for 5 minutes, the IOP was restored (13.9 ± 1.7 mmHg; +0.9 ± 2.1%; P = 0.220). Under the low-light condition, the mean IOP was significantly increased immediately after 5 minutes of smartphone work (from 13.9 ± 1.9 to 15.6 ± 1.8 mmHg; +12.1 ± 4.8%; P < 0.001); this IOP increase continued: 17.3 ± 1.9 [+24.7 ± 10.3%] at 15 minutes’ work, and 17.0 ± 1.7 mmHg [+23.1 ± 9.5%] at 25 minutes’ work ( P < 0.001 at both check-out points). Five minutes after stopping the smartphone work, interestingly, the IOP significantly dropped, to a level even lower than that of the pre-work (12.8 ± 1.9 mmHg; -8.1 ± 3.0%; P < 0.001), and at post-work 15 minutes, the IOP returned to the baseline (13.9 ± 1.8 mmHg; -0.3 ± 2.6%; P = 0.360). Conclusions In healthy young subjects, reading or writing on smartphone significantly increased IOP, and the changes of IOP were faster and greater under the low-light condition. Smartphone users who are concerned about IOP fluctuation are advised to (1) take a break if they read or write on smartphone for more than 5 minutes, and (2) avoid using smartphones wherever possible in dark places.