Young boy looking at laptop screen There are many reasons to set limits on your child’s screen time: To encourage outdoor play and healthy activity, to foster healthy sleep habits and to promote in-person social relationships. Eye health is another.

As many families zoom into a virtual school year, screen use will likely increase, risking greater strain on children’s developing focus systems.

Ayesha Malik, OD, pediatric optometrist at Children’s Hospital of Philadelphia (CHOP), helps us understand the risks of too much screen time on children’s vision, and what parents can do to help their kids practice healthy habits during virtual schooling.

Eye problems caused by excessive screen time

Many parents ask if looking at screens can negatively affect their children’s eyes. Here are some of the ways screen time can affect kids’ eyes.

Eye fatigue

Eye fatigue — called asthenopia — is characterized by eye discomfort, dimness of vision and headache. Asthenopia can be caused by overuse of the eye, such as during periods of prolonged focus on a screen. Any glare on the screen further strains the eyes.

Children with eye fatigue may complain of feeling tired or may show loss of interest in tasks such as reading. They may also experience headaches or even eye pain.

Dry and irritated eyes

Long stretches of screen time also cause the eyes to get dry and irritated. Studies show that people of all ages blink far less often when concentrating on a screen, which in turn causes the eyes to dry out. A clear and stable tear film on the surface of the eye is essential for clear vision. The problem can be worse for children who look up at a screen that is positioned for adult use.

Loss of focus flexibility

When their eyes stay focused close-up for long periods, children can also find it difficult to adjust to distance vision. That’s generally a short-term problem, and the eyes adjust back to their normal flexibility within a few hours or, at most, a few days.

Help your child practice good eye habits

Even with increased screen time related to virtual schooling, you can help protect your child’s eyes by encouraging them to practice the following healthy habits.

20-20-20-2

Anytime your child is focused on a “near task,” such as reading, writing or staring at a screen, the demand on their eyes’ microscopic focusing system is increased. Additionally, we tend to blink less when focusing on something up close, which can cause eye dryness and contribute to overall eye strain.

Children (and adults) can give their eyes a break and reset their focusing systems by practicing the 20-20-20-2 rule. During any concentrated visual task, encourage your child to break focus every 20 minutes, focus on something at least 20 feet away for 20 seconds, and blink 20 times. This allows the eyes to relax and to return to their natural position and baseline settings.

Although the demands of virtual school require increased time in front of the computer, consider using a timer to encourage breaks, particularly during recreational screen use.

The final “2” suggests 2 hours of outdoor play each day. Studies show that 2 hours of outdoor light is essential to the healthy development of the focusing system of children's eyes and protective against the onset and progression of myopia (nearsightedness).

In a traditional school year, children are exposed to outdoor light during activities such as recess and afterschool sports. Without these activities, it’s even more important to schedule breaks during your child’s virtual school day and encourage your child to spend those breaks outdoors.

To help increase exposure to outdoor light, Dr. Malik suggests setting up your child’s workspace near a window, taking care to ensure this doesn’t create a glare on the computer screen.

Screen size and distance

The smaller and closer a screen is, the harder your child’s eyes have to work to focus on it. If at all possible, encourage your child to work on a larger screen, such as a laptop or desktop computer, rather than a small phone screen. Many schools are providing loaner laptops for family use during virtual learning. If your child doesn’t have access to a laptop or desktop computer, speak to your child’s teacher or principal about borrowing one.

Dr. Malik suggests that a screen be positioned at least an arm’s length away in order to avoid eye strain. Consider following the 1/2/10 rule when it comes to screen positioning: hold phones 1 foot away; sit 2 feet away from laptop and desktop computers; and encourage your child to sit 10 feet away from the television.

If your child persists on being closer to the screen, consider consulting an eye doctor to rule out an underlying vision problem.

Eliminate glare

The more reflection on your child’s computer screen, the harder their eyes have to work. Make sure to lower the brightness settings on your child’s computer and other devices, and watch for glare on the screen in order to ensure comfortable viewing.

Blue light filtering

You may have heard about blue-light filtering glasses and wonder if they are necessary to protect your child’s eyes. The American Academy of Ophthalmology (AAO) contends that there is currently no scientific evidence that demonstrates that blue light from electronic devices is harmful or damaging to one’s eyes. Therefore, the AAO does NOT support the use of "blue light blocking" lenses. Instead, practice consistent, healthy habits like the ones listed above to protect your child’s eyes during virtual learning.

Have your child’s eyes examined

Make regular eye exams a part of your child’s healthcare schedule. “Your child’s vision is a rapidly developing sense,” says Dr. Malik. “It deserves screening for problems and timely treatment to ensure best outcomes.”

Without the annual vision screening provided during the school year, it’s important to opt in to the vision screening available at your pediatrician’s office during your child’s next well check.

Even children with a normal vision screening, however, can experience asthenopia. If your child complains of ongoing headaches, dry or irritated eyes, or eye pain, it’s important to schedule a comprehensive eye exam with a pediatric ophthalmologist or optometrist. Unlike vision screenings, comprehensive eye exams evaluate not only the focusing system of the eye but its structure and overall health, checking for any underlying problems that may manifest during periods of high stress.

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