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Save Your Children’s Eyes: Don’t Overdo it with Electronic Devices During Vacation

SHENG, Hui, Section Chief of Eye Clinic, Ophthalmologist

Whenever vacation ends, at the beginning of the new semester, there is almost always a few students with a new pair of glasses perched on the bridge of their noses, or classmates who originally wore glasses come back with thicker lenses, adding 200 to 300 degrees to their nearsightedness. What is going on? Are holiday breaks killing our children’s eyesight?

The culprit – electronic devices!

Before final exams, some parents make promises to their children. As long as they get excellent results on their finals, they will receive an iPad or other tablet as a reward. If they place in the top three of their class, they will be allowed to play video games for as long as they want during the break. Eventually, the children spend their entire holidays on their iPads or other electronic devices.

As electronic devices such as TVs, computers, game consoles, tablets, and smartphones become ever more popular, gorgeous graphics and addictive gameplay will continue to fascinate children; almost no child can resist the temptation to play or watch. In addition, with the continued development of educational software, parents are utilizing electronic equipment for early education and after-school enrichment programs. However, excessive use of electronic devices can lead to myopia (nearsightedness), or will worsen existing myopia.

When children look at electronic screens, due to the short distance, both eyes are in a state of constant adjustment. This will result in temporary myopia, which we call pseudomyopia. At this point, if the child takes a rest, looks outside and relaxes immediately, the pseudomyopia will disappear. However, if the eyes are in a constant state of pseudomyopia without regular rest and relaxation, this will become permanent myopia.

In addition, when children stare with intensity at a screen, the frequency of blinking decreases and the breakdown time of the tear film shortens. This makes the tear film unstable and causes excessive tear evaporation, which can lead to dry eyes, making visual fatigue even worse.

In 2015, it is almost impossible to have zero contact with electronics. So, how can the damage these electronics cause to our children’s eyes be minimized? When using electronic devices, please pay attention to time, distance, position, and light.

Time: Children should not use electronic devices for more than 20 minutes at a time, and total time spent should add up to no more than 1 hour a day. After using these devices, they should look off into the distance, try to identify a distant object, relax the eye muscles, or go outdoors to relax.

Distance: The recommended distance between your eyes and the screen of an electronic device is 3 to 5 times the length of the diagonal of the screen. For example, an iPad’s screen diagonal is about 25 cm, so the child should use it at a distance of 75 cm or further away from his/her eyes.

Position: The electronic screen should be slightly below eye level. If the screen is too high, children need to look up, and more of the surface of their eyes will be exposed to the air. In addition, the frequency of blinking often decreases and the breakdown time of the tear film shortens. This can lead to dry eyes and visual fatigue. If the screen is too low, it is easy to develop neck and shoulder problems, such as muscle ache or injury.

Light: If the surrounding environmental light is too bright or too dark, visual fatigue is more likely to occur. The electronic device display should not be too bright either.

In addition to electronics, what other factors might cause myopia?

The genetic factor: For nearsighted parents, especially those with high degrees of myopia, the risk of their children developing myopia will increase. However, this does not mean that myopic parents will have nearsighted children. In general, the risk of myopia increases as the degree of corrective lenses increases. There is low correlation for genetic myopia in children when the parents have a low refractive degree of myopia (less than -3.00D). The major contributing factor is non-genetic, such as improper eye use. Genetic factors do play a role in moderate myopia (-3.00– -6.00D) and can play a very important role in high degree myopia (>-6.00D).

Lifestyle: This includes using the eyes at a near distance for long periods of time, inadequate outdoor activities, unhealthy posture, improper pen holding posture, unbalanced diets, excessive intake of sweets.

To prevent childhood myopia, what else do we need pay attention to?

Enough outdoor activities: Having 2-3 hours of outdoor activities each day can help prevent childhood myopia.

Correct posture and pen holding: Ensure correct posture when reading and writing – keep  books about 30cm away from the eyes. Don’t read and write while leaning on the desk or lying down. Don’t read while walking. Make it a habit to hold pens correctly.

Good lighting: the light in the room should be gentle; not too bright or too dark. The light source should be stable without any flickering.

Eating a balanced diet and decreasing intake of sweets: Children should eat a balanced diet rich in dairy products, egg yolk, carrots, mushrooms, seaweed, celery, oranges, etc. Foods high in sugar contribute to the development of myopia. Reducing the intake of sweets may help prevent myopia.

Regular visual acuity check-ups: Parents should take their children for a visual check-up every six months. Six years old and below is the prime time for vision correction. Parents should pay more attention to children’s vision and take them to an eyesight check-up on a regular basis. This will help discover any problems early so they can be corrected as soon as possible.

When you see these signs in children, they may already have myopia

During the early stages of myopia, a child’s behavior, study habits, and grades might change. Attentive parents should notice the signs of possible myopia and take their children for a vision check immediately.

Reluctance to go out: Because distance vision becomes worse and the near vision is not affected, children can’t see road signs and scenery clearly in the distance when they go out. They enjoy outdoor activities less and are more willing to stay at home.

Grades decline: Children with myopia can’t see the blackboard clearly in the classroom. This will affect their note taking and their ability to keep up with lectures. In addition, difficulty in concentrating in the classroom contributes to the drop in the academic grades.

Stay close to the television screen: When children with myopia watch TV, they will often unconsciously leave their original seats and move nearer to the TV screen.

Squinting:  When looking at a distance, children will frown, squint, and tilt their heads.

Now there are many different kinds of vision correction methods and lenses on the market, such as vision protection lamps, eye massage machines, and eye drops. However, the most reliable methods to treat myopia are:

Proper optometric exams and corrective lens: Through an ophthalmologist’s pupil dilating examination, the right myopia degree can be obtained, reasonable corrective lenses can be worn, and regular checks can be performed.

References:

1. Ramamurthy D, Lin Chua SY, Saw SM.A review of environmental risk factors for myopia during early life, childhood and adolescence.Clin Exp Optom. 2015 Nov;98(6):497-506.

2. Rudnicka AR, Kapetanakis VV, Wathern AK,et al.Global variations and time trends in the prevalence of childhood myopia, a systematic review and quantitative meta-analysis: implications for aetiology and early prevention. Br J Ophthalmol. 2016 Jan 22