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home : columns : ask the doctors June 24, 2019

5/13/2019 7:39:00 AM
Retinal artery occlusion not necessarily from gaming

Dear Doctor: I read that a girl went blind in one eye after playing video games on her phone for an entire day. Is this even possible? Should I be worried about my kids, who are video game addicts?

Dear Reader: You're referring to a news story from China that made headlines a few years ago. The woman in question, who was 21 at the time, reportedly spent an entire day playing an online video game and suddenly lost the vision in her right eye.

Doctors diagnosed her with retinal artery occlusion, a blockage in the main vessel that supplies blood to the retina. The retina is the layer of light-sensitive tissues at the back of the eye that translate the energy from incoming light into impulses. These impulses then travel via the optic nerve to the brain, where they are interpreted as visual images.

When the retinal artery becomes blocked, oxygen-rich blood can't reach the retina. This can result in cell death and vision loss. The speed at which the cells of the retina die and the extent of the damage depends on the degree of arterial blockage and how long it lasts.

Retinal artery occlusion usually occurs in people 60 and older, and it is slightly more common in men. The cause of the blockage is usually a blood clot or an embolus, which is a bit of foreign matter in the bloodstream, such as an air bubble or a bit of fatty deposit. Risk factors for the condition include high blood pressure, diabetes, heart arrhythmias, carotid artery disease, the use of oral contraceptives, faulty heart valves and blood platelet abnormalities, to name just a few. It is not known which specific risk factors applied to the woman in the story.

At this time, there are no reliable treatments for retinal artery occlusion. Most involve procedures to somehow dilate the affected artery, dislodge the blockage and restore normal blood flow.

Regarding the claim that the young woman's marathon gaming session caused the arterial blockage, there turns out to be a bit more to the story. With an estimated 2.3 billion-with-a-B people worldwide regularly playing online games, addiction has become a serious concern. In China, authorities have identified online gaming addiction as a public health crisis. Stories of gamers forgetting to eat, skipping school, getting fired from work and even wearing disposable diapers in the pursuit of their online gaming passions abound.

The patient in the news story had been playing a hugely popular game known as Honor of Kings. The parent company claims to have more than 80 million daily active users, and 200 million players per month. Some observers believe that, despite the lack of an established medical connection between extreme eye strain and retinal artery occlusion, authorities have used the patient's medical emergency as a vivid cautionary tale to fellow gamers.

When it comes to your own kids, it's highly unlikely that their gaming habits will physically blind them. However, any time a single activity takes precedence over daily activities and other life interests, we believe there is cause for concern.

Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health. Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.





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