Ultrasound biomicroscopy study of accommodative state in Smartphone abusers

Background: Addiction to Smartphone usage has psychological and physical impacts. However, the state of spasm of accommodation is unclear in Smartphone abusers. Methods: We performed a cross-sectional study among adults aged 18–35 years between October 2016 and December 2018. Forty participants were Smartphone abusers according to the Smartphone addiction questionnaire, and 40 participants were non users. We measured auto refraction precycloplegia and postcycloplegia at far for all participants to evaluate the state of spasm of accommodation. We assessed the ultrasound biomicroscopy (UBM) parameters including anterior chamber angle (ACA). Results: There was a significant difference in the odds of having spasm of accommodation between Smartphone abusers compared to non-users (OR = 6.64, 95% CI = 1.73–25.47; adjusted OR = 14.63, 95% CI = 2.99–71.62). The Smartphone abusers and non-users groups had a superior ACA median of 30.45 ± 8.3 vs. 26.75 ± 6.6 (P = 0.04) precycloplegia at far and 31.70 ± 11.8 vs. 31.45 ± 8.3 (P = 0.15) postcycloplegia at far, respectively, demonstrated by the Mann-Whitney U test. There was significant higher difference in the precycloplegic nasal ACA at far in the Smartphone abusers group than the non-users group (mean precycloplegic nasal ACA difference = 3.57, 95% CI = 0.76 - 6.37), demonstrated by the independent t test. Similarly, there was significant higher difference in the postcycloplegic nasal ACA at far (mean postcycloplegic nasal ACA difference = 4.26, 95% CI = 1.33 - 7.19). Conclusions: Smartphone abusers are in a condition of accommodation spasm. As a result, cycloplegic refraction should be done for Smartphone abusers.