eye strain anatomy

Eye strain: a painful ailment all gamers face

Eye strain is a condition that occurs after long ours of strenuous activity for the muscles in your eyes. For gamers, this will occur after prolonged screen time—short, rapid movements of the eyes and focus only on the monitor.

What is eye strain?

Eye strain is exactly what it sounds like. After staring at your screen for hours on end, the muscles in and around your eyes become irritated. There are muscles on the outside of your eyes for eye movement, and there are muscles inside your eyes to contract or relax the lens and pupil. Each of these muscles have the potential to become strained.

Pertinent anatomy

It’s important to know some basic eye anatomy to understand eye strain. As previously mentioned, there are 2 groups of muscles.

The first group of muscles are located outside your eyeball and move your eyes in their sockets. These are called extraocular muscles

The second group of muscles are located inside your eyeball and contract or relax the lens and pupil. These are called intraocular muscles.

Extraocular muscles

There are 6 extraocular muscles that create all the movements of the eyes within the eye sockets. Four of these muscles are for basic movement:

  • Superior rectus: elevation of your eyes; looking upward
  • Inferior rectus: depression of your eyes; looking downward
  • Medial rectus: adduction of your eyes; looking inward
  • Lateral rectus: abduction of your eyes; looking outward

There are two additional muscles that create eye movement in the eye socket:

  • Superior oblique:
    • Torsion: if you rotate your head side to side, these muscles rotate your eyes to stay flush with the ground
    • Depression & abduction: looking downward & outward
  • Inferior oblique:
    • Torsion: if you rotate your head side to side, these muscles rotate your eyes to stay flush with the ground
    • Elevation & abduction: looking upward & outward
extraocular muscles of the eyes
The extraocular muscles of the eyes

Orbicularis oculi

Another extraocular muscle involved in eye strain is called the orbicularis oculi. This basic function of this muscle is to close your eyelids. More specifically, this muscle’s action can be described as narrowing the palpebral aperture, which is a fancy phrase for the action of squinting.

Intraocular muscles

There are 3 intraocular muscles that contract or relax the lens or the pupil. These muscles can be separated into 2 groups:

Ciliary muscles (intraocular)

The ciliary muscles are involved in the contraction & relaxation of the lens to allow focus on near or far objects.

  • Near focus: ciliary muscles contract and the lens becomes round
  • Far focus: ciliary muscles relax and the lens becomes flatter

Iris muscles (intraocular)

The radial muscles of the iris will cause dilation or widening of the pupil, and the circular (sphincter) muscles of the iris will cause constriction of the pupil.

These muscles will work to change the amount of light that enters the eye. When there is insufficient or dim lighting, the pupils will dilate, and when there is bright light, the pupils will constrict.

Ciliary muscles near and far
Ciliary muscles contract to release tension on the lens during near focus


Eye strain in gamers occurs when the muscles of the eyes become overworked due to playing video games. This is a combination of the limited area space where you focus your gaze and the static depth of focus.

Limited area of gaze

While gaming, most people use a monitor that’s in the range of 20-24 inches. During game play, your eyes will almost always stay within the frame of the monitor.

Exceptions include streaming or other activities where you have a dual monitor and your attention goes off screen, but the majority of your gaze will be within your gaming monitor.

In addition to the small area, many games will require your eyes to move rapidly around the screen. Whether searching for the enemy or tracking your character’s movements, your eyes will often move rapidly in this small space.

These rapid, small, repetitive movements can cause strain to the extraocular muscles.

Static focal distance

While gaming, your monitor will, hopefully, be approximately 24 inches from your face (check your setup!). During game play, your eyes will only ever focus to this distance—unless, of course, you move your body or monitor closer or further away.

Exceptions include streaming or other activities where you have a dual monitor and your attention goes off screen; however, your focal distance will still be relatively close.

Because your focal distance is static, or fixed, approximately 24 inches from your face, the ciliary muscles will hold a static contraction. Remember, the ciliary muscles are active to bend the lens for near focus.

The ciliary muscles will maintain this contraction for the duration of your game play, which will lead to strain during long gaming hours.

close up photo of eyes

Signs & symptoms

The most common symptoms of eye strain include irritation of the eyes:

  • Fatigue
  • Pain in or around the eyes
  • Blurred vision
  • Headaches
  • Occasional double vision

Another common symptom of eye strain is dry eyes, which is more than just lack of moisture on the surface of your eyeball. Symptoms may include:

  • Stinging or burning
  • Sensitivity to light
  • Redness of the sclera
  • Straining nighttime vision
  • Blurred vision

Common mechanism of injury

The mechanism of eye strain in gamers is partially explained in Pathophysiology above.

  • Limited area of gaze
  • Static focal distance

Moving your eyes quickly and rapidly in a small space combined with a short, static focal distance leads to eye strain, but there is also one more concern with gaming: blinking!


Blinking provides hydration to the eyes using moisture from tears and mucous secretions. In a normal, resting state, the average number of blinks per minute is 15-20.

However, while gaming, this number may be less than half. During the hypervigilance of intense gameplay, you may only blink 5-10 times, leaving your eyes at risk for becoming excessively dry.

Eye strain in gamers
Screen time without breaks can lead to eye strain!

Prevention & rehabilitation

Prevention of dry eyes is pretty straight forward. In short, take breaks!

While gaming…

  • Every 5-10 minutes
    • Blink! Blink your eyes and hold them shut for 3 seconds, 5 times
    • Do this every 5-10 minutes or after each game/match you play
  • Every 20-30 minutes
    • Take a 5-minute break to look away from your screen
    • Since the ciliary muscles relax during far focus, you’ll want to look at something far away
    • If you’re able to, look outside; if not, look as far as you can within your home.
  • Every 30-60 minutes
    • Perform smooth pursuit OR target gaze (listed below) to help reduce the strain on the extraocular muscles

Lastly, don’t forget the power of a good night’s sleep. If you’re constantly grinding to become the best, you will most certainly experience eye strain, and sleep is your best tool for recovery to continue gaming tomorrow.

Eye exercises

Near-to-far focus

Near-to-far focus
  1. Hold an object (for example, a pencil or your thumb) in front of your nose, approximately 12 inches away from your face
  2. Hold the object in front of a background target at least 10 feet away (for example, the wall of your room or any object outside your window)
  3. First, focus your eyes on the object (the pencil eraser or your thumb nail). Then, focus your eyes on the background target
  4. Repeat step 3 for a total of ten (10) repetition

Smooth pursuit

Smooth pursuit
  1. Hold an object (for example, a pencil or your thumb) in front of your nose, approximately 12 inches away from your face
  2. Without moving your head, slowly move the object back and forth, up and down, or diagonally
  3. Move the object in H-pattern and/or an X-pattern, moving it as far as your eyes can gaze without the need to move your head. Try to reach all four corners of your gaze

Target gaze

Target gaze
  1. Choose any focal point directly in front of your face; for example, a point on your computer screen
  2. Without moving your head, look directly upward as far as you can, as if you were looking at 12 on a clock. Then, return your gaze to the starting point in front of you
  3. Repeat this gaze pattern for each of the remaining 11 numbered positions on a clock in a clockwise pattern
  4. Repeat step two in a counter-clockwise pattern, beginning again with 12 o’clock


  1. Freddo TF, Chaum E. Anatomy of the Eye and Orbit: The Clinical Essentials. Lippincott Williams & Wilkins. 2017.
  2. Coles-Brennan C, Sulley A, Young G. Management of digital eye strain [Review]. Clinical and Experimental Optometry. 2019;102:18–29
  3. Sheppard AL, Wolffsohn JS. Digital eye strain: prevalence, measurement and amelioration. BMJ Open Ophthalmology 2018;3:1-10.
  4. Rosenfield, M. Computer vision syndrome (a.k.a. digital eye strain). Optometry in Practice. 2016;17(1):1-10.

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This information is for educational purposes only and is not intended to replace the advice of your doctor. Esports Healthcare disclaims any liability for the decisions you make based on this information.

The information contained on this website does not establish, nor does it imply, doctor-patient relationship. Esports Healthcare does not offer this information for diagnostic purposes. A diagnosis must not be assumed based on the information provided.

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