Dr Shamala Ganesan, Consultant Ophthalmologist at Prince Court Medical Centre

When the Covid-19 pandemic hit, countries went into lockdown leading to schools closing and classes being moved online. This meant that children were facing electronics for a significant portion of their day – not just for educational purposes, but for entertainment as well – which can take a toll on their eye health as it strains their vision.

Even as countries begin to lift their lockdowns, there has been an undeniable shift towards an increased dependency on digitisation as the world enters a ‘new normal’. Therefore, this interview with Dr Shamala Ganesan, Consultant Ophthalmologist at Prince Court Medical Centre aims to learn more about the health symptoms that may arise in children from prolonged exposure to electronics and ways to mitigate this.

What is the optimal time children can spend on electronics before they experience eye strain?

There is no doubt that computers provide convenience and are a necessity in providing education, supporting social development, and being a source of entertainment. Therefore, prolonged use can pose problems to the eye. The effects of exposure can be accumulative and span an individual’s lifetime.

It is a serious issue as today’s age of digitisation has seen children from as young as 6 suffer from eye strain. In 2006, The American Journal of Ophthalmology published a study in which 1448 children aged 6 were evaluated and an estimate of 12.6 per cent were found to have eye strain. Besides that, the BMC Ophthalmology journal reported that 18 per cent of students aged between 11 – 17 experienced eye strain at the end of the day after working on digital devices.

However, no research has confirmed that there is an optimal time children can spend on electronics before they experience eye strain, also known as asthenopia.

What are some symptoms of eye strain?

The symptoms can include:

• blurred fluctuating vision
• double vision
• dry eyes
• red eyes
• irritated eyes
• itchy eyes

Besides eye strain, what other symptoms may arise from prolonged exposure to electronics in the long run?

Children may experience headaches; tiredness; sleep disturbance; concentration and memory disorders; dizziness; neck and back pain; and Attention Deficit Hyperactivity Disorder.

Has there been a rise in cases of children having eye strain in the past months? (for eg. have you treated more kids with eye strain during the Covid-19 period?)

Yes, there has been a rise in dry eye cases in the form of allergic conjunctivitis and bacterial conjunctivitis. When the eye is dry, it is more sensitive to the surrounding dust and pollution. Frequent eye rubbing can also lead to the transfer of bacteria and viruses from the hands to the eyes.

Given that digitisation is inevitable, what tips would you have to help prevent eye strain in children?

• Place laptops, tablets, and handphones on a desk or table – having these devices a feet away can decrease the electromagnetic field radiation (damaging to the eye) by 80 per cent.
• Ensure your kid’s room has good lighting to reduce the effects of the brightness of the screen. In a dark room, pupils will dilate – leading to more radiation entering the eye to reach the retina and this can tire the eye.
• Reduce the brightness and contrast in the computer settings to minimise the glare and keep font size optimal for viewing at a distance so there is no straining when trying to read.
• Use a computer screen filter. This is more effective than getting blue light protective glasses as there has not been any clear evidence that supports the claim such glasses are beneficial to the retina.
• Ensure your child’s glasses are updated so that the refractive error is optimal. This way, your child will not need to place the screen too close to his or her face to read.
• Rearrange your child’s desk. The best position for the monitor is 10 – 15 degrees below eye level. When the eyes look downwards, the lid aperture is less wide. This decreases the rate of evaporation of tears and lessens the risk of dry eye.
• Adhere to the 20-20-20 rule. Look away from the screen every 20 minutes and look at something else 20 feet away for about 20 seconds.
• Blink often to keep the eyes moist and if they are dry, use preservative-free artificial eye drops as and when necessary.
• Take a 15-minute break every 2 hours spent on the computer and switch the setting on devices to night mode for late evening reads.
• Ensure your child gets 8 hours of sleep to allow healing of the eye surface at night so as to prevent dry eye.

Are there any vitamins or supplement children can take to maintain a healthy vision or minimise the risks of eye strain?

Children must have a balanced diet with adequate vegetables and fruits to overcome oxidative damage to the eyes. They also need to exercise to enhance fitness and circulation of blood to the entire body including the eye – allowing the replenishment of nutrition together with oxygen and removal of waste material. This is crucial in ensuring optimal quality of tears as well as the repair of the ocular surface, which is subjected to a lot of oxidative damage due to long hours spent on the computer by children today.