DIGITAL VISUAL LOAD, ACCOMMODATIVE DISORDERS, AND COGNITIVE FATIGUE IN SCHOOL-AGED CHILDREN

Abstract

Objective. To assess the relationship between the level of digital visual load, the severity of Digital Asthenopic Syndrome (DAS), accommodative function parameters, and cognitive performance in school-aged children. Materials and Methods. This prospective analytical cohort study included 98 children (196 eyes) aged 8–16 years. Based on daily screen time duration, participants were divided into three groups: ≤2 hours/day (n=28), 2–4 hours/day (n=38), and ≥4 hours/day (n=32). DAS was assessed using a modified CVS-Q questionnaire. A comprehensive ophthalmological examination was performed, including measurement of relative accommodation reserve, accommodative stability after 40 minutes of visual load, near point of convergence, and tear film break-up time (TBUT). Cognitive performance was evaluated using tests assessing attention, working memory, and information processing speed. Statistical analysis was conducted at a significance level of p<0.05. Results. DAS was diagnosed in 42.9% of children, with its prevalence significantly increasing with longer screen time (p<0.05). High digital visual load was associated with decreased relative accommodation reserve (p<0.05), increased accommodative fatigue (p<0.05), and reduced TBUT (p<0.05). Moderate correlations were found between asthenopia severity and decreased attention stability (r=0.46), working memory (r=0.38), and information processing speed (r=0.42). The strongest association was observed between the duration of continuous visual work and the cognitive fatigue index (r=0.51). Conclusion. High digital visual load in children is associated with functional accommodative disorders, tear film instability, and reduced cognitive performance.