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<article xml:lang="EN" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" article-type="methods-article">
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Bohr. Croo.</journal-id>
<journal-title>Bohr International Journal of Current Research in Optometry and Ophthalmology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Bohr. Croo.</abbrev-journal-title>
<issn pub-type="epub">2583-4975</issn>
<publisher>
<publisher-name>BOHR</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.54646/bijcroo.2023.25</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Methods</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Accommodative facility and vergence facility after mobile gaming</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>Janagi</surname> <given-names>S.</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>Ikram</surname> <given-names>Syeda Sadiya</given-names></name>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<xref ref-type="corresp" rid="c001"><sup>&#x002A;</sup></xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Puri</surname> <given-names>Sanjeev Kumar</given-names></name>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
</contrib>
</contrib-group>
<aff id="aff1"><sup>1</sup><institution>Department of Optometry, Saveetha College of Allied Health Sciences</institution>, <addr-line>Tamil Nadu</addr-line>, <country>India</country></aff>
<aff id="aff2"><sup>2</sup><institution>Department of Ophthalmology, Saveetha Medical College &#x0026; Hospital</institution>, <addr-line>Tamil Nadu</addr-line>, <country>India</country></aff>
<author-notes>
<corresp id="c001">&#x002A;Correspondence: Syeda Sadiya Ikram, <email>sadiyaikram20@gmail.com</email></corresp>
</author-notes>
<pub-date pub-type="epub">
<day>15</day>
<month>03</month>
<year>2023</year>
</pub-date>
<volume>2</volume>
<issue>1</issue>
<fpage>12</fpage>
<lpage>14</lpage>
<history>
<date date-type="received">
<day>12</day>
<month>02</month>
<year>2023</year>
</date>
<date date-type="accepted">
<day>23</day>
<month>02</month>
<year>2023</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2023 Janagi, Ikram and Puri.</copyright-statement>
<copyright-year>2023</copyright-year>
<copyright-holder>Janagi, Ikram and Puri</copyright-holder>
<license xlink:href="https://creativecommons.org/licenses/by-nc-nd/4.0/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p></license>
</permissions>
<abstract>
<sec>
<title>Aim</title>
<p>This study aimed to access the changes of accommodation and vergence before and after mobile gaming.</p>
</sec>
<sec>
<title>Settings and Design</title>
<p>This was a comparative study conducted in the outpatient department of ophthalmology. Accommodative facility and vergence facility were measured using flippers.</p>
</sec>
<sec>
<title>Materials and methods</title>
<p>A comparative study was conducted on 50 healthy subjects, in both males and females, with age groups ranging between 18 and 30 years. This study has been approved by the IRB Committee; 25 young emmetropic patients and 25 young myopic patients were included. The comparison of accommodative facility and vergence facility before and after mobile gaming for 1 h was measured to determine the level of changes in accommodation and vergence. All patients were undergone comprehensive ophthalmic examination including vision, subjective/objective refraction, anterior segment examination, and accommodative and vergence facilities measured using accommodative and vergence flippers.</p>
</sec>
<sec>
<title>Results</title>
<p>The mean and standard deviation value significantly increase before and after mobile gaming in the right eye, left eye, and both eyes in case of accommodation facility, and there is a decrease in the mean and standard deviation value in case of vergence facility in both eyes before and after mobile gaming.</p>
</sec>
<sec>
<title>Conclusion</title>
<p>The mean and standard deviation value significantly increase before and after mobile gaming in the right eye, left eye, and both eyes in case of accommodative facility, and there is a decrease in the mean and standard deviation value in case of vergence facility in both eyes before and after mobile gaming.</p>
</sec>
</abstract>
<kwd-group>
<kwd>accommodative facility</kwd>
<kwd>vergence facility</kwd>
<kwd>myopia</kwd>
<kwd>emmetropia.</kwd>
</kwd-group>
<counts>
<fig-count count="2"/>
<table-count count="3"/>
<equation-count count="0"/>
<ref-count count="8"/>
<page-count count="3"/>
<word-count count="1462"/>
</counts>
</article-meta>
</front>
<body>
<sec id="S1" sec-type="intro">
<title>Introduction</title>
<p>The eyes have been provided with a mechanism called accommodation, which results in a change in dioptric power of the eye to see near objects clearly (<xref ref-type="bibr" rid="B1">1</xref>, <xref ref-type="bibr" rid="B2">2</xref>). Convergence is a disconjugate movement that allows bifoveal single vision to be maintained at any fixation distance (<xref ref-type="bibr" rid="B3">3</xref>). The accommodation and vergence functions of visual reality cause a reduction in visual performance (<xref ref-type="bibr" rid="B4">4</xref>). This study aimed to measure the accommodation and vergence measurement after 1 h of mobile gaming.</p>
</sec>
<sec id="S2">
<title>Subjects and methods</title>
<p>A comparative study was conducted on 50 healthy subjects, in both males and females, with age groups ranging between 18 and 30 years. This study has been approved by the IRB Committee; before the beginning of the study, informed consents were obtained and the procedure was explained clearly; 25 young emmetropic patients and 25 young myopic patients were included. All subjects underwent a comprehensive ophthalmic examination, including vision, subjective/objective refraction, anterior segment examination, accommodation, and vergence parameters, which were assessed before and after playing mobile games for 1 h. The accommodative and vergence facilities were measured using accommodative and vergence flippers. Patients with a history of glaucoma, external eye disease, intraocular or corneal refractive surgery, corneal or intraocular trauma, ocular pathological changes, connective tissue disorders, nystagmus, and other ocular diseases were excluded from this study.</p>
<table-wrap position="float" id="T1">
<label>TABLE 1</label>
<caption><p>Descriptive statistics of age.</p></caption>
<table cellspacing="5" cellpadding="5" frame="hsides" rules="groups">
<thead>
<tr>
<td valign="top" align="left"></td>
<td valign="top" align="center">N</td>
<td valign="top" align="center">Minimum</td>
<td valign="top" align="center">Maximum</td>
<td valign="top" align="center">Mean</td>
<td valign="top" align="center">Std. deviation</td>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">Age</td>
<td valign="top" align="center">50</td>
<td valign="top" align="center">17.00</td>
<td valign="top" align="center">29.00</td>
<td valign="top" align="center">21.72</td>
<td valign="top" align="center">2.79</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn><p>Primary data.</p></fn>
</table-wrap-foot>
</table-wrap>
</sec>
<sec id="S3" sec-type="discussion">
<title>Discussion</title>
<p>Accommodation refers to a change in the dioptric power of the eye. Clinically, this is measured either monocularly or binocularly, usually by having the subject fixate on a small target alternately through plus and minus lenses, which are interchanged as soon as the target appears clear. Vergence facility is a simultaneous movement of the pupil of the eyes toward or away from one another during focusing, where movement of one eye is related to the movement of the other. Through analysis, it was concluded that the accommodative facility after playing mobile games has increased significantly than the accommodative facility in both eyes. However, the vergence facility decreased significantly after playing mobile games, and the result was similar to a study done by Uma Mageswari Batumalai et al., who investigated the accommodative response and vergence status by phoria and AC/A ratio method after using virtual reality headset for 30 min and found that there was a significant increase in the accommodative facility and a decrease in the vergence facility after a time of 45 min of virtual reality games (<xref ref-type="bibr" rid="B5">5</xref>, <xref ref-type="bibr" rid="B6">6</xref>). Hasebe et al. underwent a study on prolonged exposure of near tasks via virtual reality by headset that may trigger the accommodation. They understood that changes of apparent viewing distance through virtual reality may elicit the level of accommodative response based on apparent stimulus distance(<xref ref-type="bibr" rid="B7">7</xref>, <xref ref-type="bibr" rid="B8">8</xref>).</p>
</sec>
<sec id="S4" sec-type="conclusion">
<title>Conclusion</title>
<p>Exposure to virtual reality gaming tends the subjects to focus more and has effect on both accommodation and convergence. Playing for an hour results in lead of accommodation and lag in vergence.</p>
</sec>
<sec id="S5" sec-type="results">
<title>Results</title>
<sec id="S5.SS1">
<title>Changes in accommodative facility (OD),(OS),(OU) before and after playing mobile games</title>
<p>In this study, 50 subjects were included, and their accommodative facilities were recorded. This section is intended to test whether the change in accommodative facility (OD),(OS),(OU) before and after playing mobile games is significant or not. For this purpose, a paired samples <italic>t</italic>-test is applied. The results are shown in <xref ref-type="table" rid="T2">Table 2</xref>.</p>
<table-wrap position="float" id="T2">
<label>TABLE 2</label>
<caption><p>Accommodative facility (OD),(OS),(OU) before and after playing mobile games.</p></caption>
<table cellspacing="5" cellpadding="5" frame="hsides" rules="groups">
<thead>
<tr>
<td valign="top" align="left"></td>
<td valign="top" align="left"/>
<td valign="top" align="center">Mean</td>
<td valign="top" align="center">Std.<break/> deviation</td>
<td valign="top" align="center"><italic>t</italic>-value</td>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">Accommodative<break/> facility (OD)</td>
<td valign="top" align="left">Before mobile<break/> gaming</td>
<td valign="top" align="center">12.38 cpm</td>
<td valign="top" align="center">4.169</td>
<td valign="top" align="center">17.205&#x002A;&#x002A;<break/> (<italic>p</italic> = 0.000)</td>
</tr>
<tr>
<td valign="top" align="left"/>
<td valign="top" align="left">After mobile<break/> gaming</td>
<td valign="top" align="center">14.48 cpm</td>
<td valign="top" align="center">4.021</td>
<td valign="top" align="center"/></tr>
<tr>
<td valign="top" align="left">Accommodative<break/> facility (OS)</td>
<td valign="top" align="left">Before mobile<break/> gaming</td>
<td valign="top" align="center">12.82 cpm</td>
<td valign="top" align="center">4.054</td>
<td valign="top" align="center">17.982&#x002A;&#x002A;<break/> (<italic>p</italic> = 0.000)</td>
</tr>
<tr>
<td valign="top" align="left"/>
<td valign="top" align="left">After mobile<break/> gaming</td>
<td valign="top" align="center">14.64 cpm</td>
<td valign="top" align="center">4.429</td>
<td valign="top" align="center"/></tr>
<tr>
<td valign="top" align="left">Accommodative<break/> facility (OU)</td>
<td valign="top" align="left">Before mobile<break/> gaming</td>
<td valign="top" align="center">15.16 cpm</td>
<td valign="top" align="center">3.644</td>
<td valign="top" align="center">14.983&#x002A;&#x002A;<break/> (<italic>p</italic> = 0.000)</td>
</tr>
<tr>
<td valign="top" align="left"/>
<td valign="top" align="left">After mobile<break/> gaming</td>
<td valign="top" align="center">16.94 cpm</td>
<td valign="top" align="center">3.666</td>
<td valign="top" align="center"/></tr>
</tbody>
</table>
<table-wrap-foot>
<fn><p>cpm, cycle per minute.</p></fn>
<fn><p>Computed from primary data.</p></fn>
</table-wrap-foot>
</table-wrap>
<p>From <xref ref-type="table" rid="T2">Table 2</xref>, the <italic>t</italic>-value of 17.205 (<italic>p</italic> = 0.000) in OD, the t-value of 17.982 (<italic>p</italic> = 0.000) in OS, and <italic>t</italic>-value of 14.983 (<italic>p</italic> = 0.000) in OU confirm that there is a significant change in the accommodative facility before and after playing mobile games. The comparison is shown graphically in <xref ref-type="fig" rid="F1">Figure 1</xref>.</p>
<fig id="F1" position="float">
<label>FIGURE 1</label>
<caption><p>Accommodative facility before and after playing mobile games.</p></caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="bijcroo-2023-25-g001.tif"/>
</fig>
<p>From <xref ref-type="table" rid="T3">Table 3</xref>, the <italic>t</italic>-value of 4.451 (<italic>p</italic> = 0.001) confirms that there is a significant change in the vergence facility before and after playing mobile games. This shows that vergence facility after playing mobile games has decreased significantly than vergence facility before playing mobile games. The comparison is shown graphically in <xref ref-type="fig" rid="F2">Figure 2</xref>.</p>
<table-wrap position="float" id="T3">
<label>TABLE 3</label>
<caption><p>Vergence facility before and after playing mobile games.</p></caption>
<table cellspacing="5" cellpadding="5" frame="hsides" rules="groups">
<thead>
<tr>
<td valign="top" align="left"></td>
<td valign="top" align="center"/>
<td valign="top" align="center">Mean</td>
<td valign="top" align="center">Std.<break/> deviation</td>
<td valign="top" align="center"><italic>t</italic>-value</td>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">Vergence facility</td>
<td valign="top" align="left">Before mobile<break/> gaming</td>
<td valign="top" align="center">14.88 CPM</td>
<td valign="top" align="center">3.595</td>
<td valign="top" align="center">4.451&#x002A;&#x002A;<break/> (<italic>p</italic> = 0.001)</td>
</tr>
<tr>
<td valign="top" align="left"/>
<td valign="top" align="left">After mobile<break/> gaming</td>
<td valign="top" align="center">13.38 CPM</td>
<td valign="top" align="center">2.381</td>
<td valign="top" align="center"/></tr>
</tbody>
</table>
<table-wrap-foot>
<fn><p>Computed from primary data.</p></fn>
</table-wrap-foot>
</table-wrap>
<fig id="F2" position="float">
<label>FIGURE 2</label>
<caption><p>Vergence facility before and after playing mobile games.</p></caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="bijcroo-2023-25-g002.tif"/>
</fig>
</sec>
</sec>
<sec id="S6" sec-type="author-contributions">
<title>Author contributions</title>
<p>All authors have contributed equally.</p>
</sec>
</body>
<back>
<ack><p>The necessary facilities for this work was provided and supported by Saveetha Medical College and Hospital.</p>
</ack>
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</article>
