Is it Bedtime ... Or Am I Being Chased By a Tiger?

MICHAEL COLE, OD Child and Family Eye Care Center

The autonomic nervous system regulates our body, balancing our normal bodily functions to maximize performance in varying situations. The sympathetic nervous system causes an increase in heart output, blood pressure, and sensory awareness (our fight or flight response). The parasympathetic nervous system stimulates digestion, secretions, and makes us tired (rest and digest).

The eyes are directly affected by these systems. When faced with a threat or stressful situation, sympathetic innervation causes the eyes to defocus, dilate pupils, and increase peripheral awareness. When driving a car in a blizzard it is advantageous to gather as much information as possible so that we may assess the situation quickly, which is why our visual system responds in this way.

Parasympathetic influence causes the eyes to pay more attention to detail. It causes the eyes to increase near focus, pupils shrink for better clarity, and the lacrimal gland boosts tear production. When we curl up to sleepily read a good book after a large meal our parasympathetic nervous system is in full control. (Side note: The new eye drop “vuity” that has been in commercials lately stimulates the parasympathetic actions of the eye, constricting pupils to reduce blur when looking up close).

Video games have an unusual effect on our visual systems, particularly in children who are still learning and developing visual skills. When we spend time viewing near objects such as screens, the normal visual response would be parasympathetic in nature. We need to increase near focus and constrict our pupils for the best visual performance up close. Video games present a unique situation because this type of activity rewards peripheral awareness, quick reflexes, and high information intake which are all sympathetic influenced behaviors. It is inherently exciting and stimulating, further stimulating our sympathetic nervous system. This leads to conflicting inputs and goals for the developing visual system to achieve. Our visual systems should be focusing in and clearing up the details with near work, but video games encourage and reward the opposite.

What we see increasingly in our clinics are young people with vague complaints of blur. Kids are often unable to articulate their experience — vision is blurry up close, far away, sometimes clear, sometimes not, fluctuating often. Our examinations show poor ability to shift focus, unusually large and dilated pupils, and poor visual acuity with or without glasses. These findings are visual manifestations of an overall phenomenon — over-stimulation of the sympathetic nervous system. This situation has caused the normal physiological processes in the eyes to be impeded, leading to temporarily reduced visual clarity as well as interrupting normal vision development.

The National Institute of Health recently estimated that youth spend 5 to 7 hours per day on digital devices during leisure time, not including time spent on the computer in schools. Numerous studies have shown links between early excessive screen usage and poor fine motor skills, shorter attention spans, increased anxiety and depression, and poorer early developmental scores.

With so much time spent on screens providing contradictory sensory input, young bodies are not sure whether to prepare to run from a tiger or to relax and wind down for bedtime. Often parents and children are frustrated when visual concerns cannot be resolved with glasses. However, in these cases the solution is just as simple — less time spent on screens. Screen time and video games don’t need to be avoided completely, but when overdone they can become detrimental.

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