Is computer use a risk factor for myopia?

Many patients who become myopic or who undergo increases in myopia as adults have concerns about whether the use of video display terminals (VDTs) contributes to these changes in refractive error. This paper is an overview of the current literature on topics concerning VDTs and factors related to proposed etiologies for myopia.Selected literature is reviewed on the relationship between VDTs and asthenopia, fatigue, accommodation, and vergence. Clinical studies of myopic progression and transient myopia among VDT users are considered, as is television viewing as a risk factor for juvenile myopia.Reports of asthenopia are common with VDT use by a factor of 1.4 to 1.5, compared to conventional office work. Questions of comparability remain between VDT users and nonusers with respect to confounding variables such as the number of work hours. Proofreading on a VDT appears to be less efficient than using printed copy. Despite screen flicker and reflections, the accommodative response appears to be accurate to a VDT. Transient, fatigue-induced changes in accommodation and vergence may occur after work with VDTs. Despite these near point changes, there is no compelling evidence in the literature that suggests there is a significant increase in the risk of myopia onset or progression from the use of VDTs by adults compared to other forms of near work.