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EYE EYE CARE AND
EYE CARE ANDCARE AND
QUALITY OF LIFE QUALITY OF LIFE
QUALITY OF LIFE

Guidelines for Screen Time light exposure. The eyes work harder when there are more reflec-
The American Academy of Pediatrics (AAP) provides recommen- tions on the screen. The glare settings can be adjusted for comfort-
dations on screen time limits, some of which include eliminating or able viewing.
minimizing media exposure, other than video chatting, for children
under the age of 18 months. For older preschool-age children, there Sleep Habits
are appropriate media limits. Having a strategy and establishing clear The American Academy of Pediatrics (AAP) recommends that
guidelines for usage of screen time can reduce eye strain and fatigue children should not sleep with digital devices such as smartphones,
and other impacts on health. The AAP recommends families develop computers and televisions in their bedrooms. The AAP also recom-
their own personalized media use plans. mends no devices or screen exposure for one hour before bedtime.

Screen Position Outdoor Activities
The screen on your child’s laptop or desktop computer should be Encouraging outdoor time and activities exposes children to nat-
positioned slightly below the eye level. This should be in a way that the ural light, which is helpful for visual development and may help delay
child looks down on it and not up. Looking up at a screen can lead to the progression of myopia or nearsightedness.
dryness as it leads to a wider opening of eyes. Also, children should be Eye exams should be part of children’s regular healthcare schedules.
encouraged to work on a larger screen rather than a smaller phone as Children may not be forthcoming when they have vision issues or blur-
children’s eyes must work harder to focus on smaller screens and those riness. At a minimum, annual vision screenings at your pediatrician’s
Screen Time and the that are closer. Encourage your children to position the screen at least office during well checks should be ensured. If any issue or problem is
detected during these screenings, the child’s pediatrician may refer the
an arm’s length away. In fact, a 1-2-10 rule should ideally be followed,
implying the mobile phones to be positioned at one foot away, laptops
child to a pediatric ophthalmologist.
Impact on Children’s Eyes and desktops at two feet and televisions at 10 feet. This also helps in nities, but their pervasive use has raised concerns about the negative
Screens offer great educational value and entertainment opportu-
reducing neck and shoulder strain.
health. Fostering a balanced approach by combining the screen time
Screen Settings and Glare Elimination impact on children’s eyes and physical, cognitive, social and emotional
By Manpreet S. Chhabra, MD The font can be adjusted, especially on smaller screens, to about limits with outdoor activities, regular breaks and appropriate screen
twice as large as the child can read comfortably, and that can help positioning can help children safely navigate the highly digitalized
alleviate eye strain. Modifying screen settings, such as brightness world while mitigating the potential risks and preserving their eye
and color temperature, also helps in minimizing the effects of blue health and overall well-being.
n the current digital age, children are spending more and more of edness. Limited outdoor time, along with extended stretches of screen
their time with devices like smartphones, tablets, computers and usage, can lead to further progression of myopia that can have more
Itelevisions, whether for school, work, entertainment or exercise. visual consequences for these kids.
A study published in 2011 showed that about 47 percent of children
indulged in more than two hours of screen time for entertainment pur- Some of the Other Effects on Overall Health Include: References:
poses, but that number increased to 98 percent in the United States Sleep Disturbances 1. Maniccia DM, Davison KK, Marshall SJ, Manganello JA and 7. Foreman J, Salim AT, Praveen A, Fonseka D, Ting DSW,
in 2019. A lot of attention has gathered on the impact of screen time Sleep patterns are disrupted because of screen exposure before bed- Dennison BA. A Meta-analysis of Interventions That Target Guang He M, Bourne RRA, Crowston J, Wong TY, Dirani M.
on kids. time. There is suppression of melatonin, a hormone responsible for Children's Screen Time for Reduction. Pediatrics 128, e193-e210 Association between digital smart device use and myopia: a
sleep-wake cycle regulation, that disturbs the sleep cycle. Blue light 2. Madigan, S, Browne, D, Racine, N, Mori, C and Tough, S. Asso- systematic review and meta-analysis. Lancet Digit Health. 2021
Some of the Effects on Children’s Eyes Include: emitted from the screens alters the body’s natural circadian rhythm, ciation Between Screen Time and Children’s Performance on a Dec;3(12):e806-e818
Eye Strain or Fatigue which makes it more difficult for kids to fall asleep. Developmental Screening Test. JAMA Pediatrics 173, 244-250 8. Huang HM, Chang DS, Wu PC. The Association between Near
Extended use of screen time can lead to symptoms of eye fatigue or 3. Trott M, Driscoll R, Irlado E, Pardhan S. Changes and correlates Work Activities and Myopia in Children-A Systematic Review
asthenopia characterized by discomfort of the eyes, strain and head- Physical, Social and Emotional Health of screen time in adults and children during the COVID-19 and Meta-Analysis. PLoS One. 2015 Oct 20;10(10):e0140419
ache. There can be more strain on the eyes by any glare on the screen. Prolonged screen time use leads to a sedentary lifestyle that replac- pandemic: A systematic review and meta-analysis. EClinicalMed- 9. Harrington SC, Stack J, O'Dwyer V. Risk factors associated with
If kids are focusing on the screen from close distances, this can further es physical activities and can result in an increased risk of obesity and icine. 2022 Jun;48:101452 myopia in schoolchildren in Ireland. Br J Ophthalmol. 2019
aggravate the fatigue as the eyes need breaks especially when focusing other health issues. This also leads to lesser social interactions and more 4. Coles-Brennan C, Sulley A, Young G. Management of digital Dec;103(12):1803-1809
up-close for long periods of time. social isolation, and can interfere with the development of social skills. eye strain. Clin Exp Optom. 2019;102(1):18–29. 10.1111/
Excessive screen time can also impact the emotional health of children, cxo.12798
Dryness and Eye Irritation causing anxiety, stress and mood disturbances. 5. Nyugen P, Le LK, Nyugen D, et al. The effectiveness of sedentary
Prolonged periods of screen time can lead to dryness of the eyes behaviour interventions on sitting time and screen time in chil-
and eye irritation. Based on the studies, we tend to blink much less Strategies and What Parents Can Do: dren and adults: An umbrella review of systematic reviews. Int Manpreet S. Chhabra, MD, is a board-certified ophthalmologist
when focusing intently on the screen and that leads to eye dryness. The The 20-20-20 Rule J Behav Nutr Phys Act. 2020;17(1):117. 10.1186/s12966-020- with focus on Pediatric Ophthalmology and related conditions.
eyes need a clear tear film for clear vision. The eyes need a break since focusing on the near tasks can lead to 01009-3 He did his ophthalmology residency at the University of
discomfort. Encourage your children to follow the 20-20-20 rule — 6. Wang J, Li Y, Musch DC, et al. Progression of myopia in school- Cincinnati in Ohio and pediatric ophthalmology fellowship
Myopia take a 20 second break every 20 minutes to look at something 20 feet aged children after COVID-19 home confinement. JAMA at the Northwestern University in Chicago. Dr. Chhabra has over two
There have been several studies that have shown the correlation of away — and this leads to lesser eye strain. This approach can allow the Ophthalmol. 2021;139(3):293–300. 10.1001/jamaophthal- decades of clinical experience in his field. He practices at Alamo Pediatric
excessive screen time with the development of myopia or near sight- eyes to reset and refocus, alleviating eye fatigue. mol.2020.6239 Eye Center, and is a member of the Bexar County Medical Society.

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