Screen Time Vs Eyesight: Myopia Concerns for Kids

Recent studies carried out on young children under COVID-19 lockdowns during 2020 have revealed results that suggest that 50% of the World’s population could have myopia by the year 2050. The studies also showed faster and higher progression levels, and a big rise in onset among 5-6 year olds. 

I have broken it down for you so you can get answers to your questions on myopia in kids

What is Myopia?

Image Source: https://www.essilor.co.uk/

Myopia is the inability to see things clearly unless they’re relatively close to your eyes. Also called near-sightedness or short-sightedness. myopia occurs when the eye grows too long from front to back, causing light to come to a focus in front of the retina instead of directly on it. 

No One In My Family Wears Glasses. Why Did This Happen To My Child?

Researchers aren’t sure why myopia is becoming so common, but many eye doctors attribute it to eye fatigue from close-up work including reading, studying, using computers and portable electronic devices (including tablets and smartphones) and reduced time spent outdoors. 

Heredity is a factor, but not the only one. In other words, if both parents are near-sighted, there is a greater risk their children will be near-sighted, too. But you can’t predict who will become near-sighted by simply looking at their family tree.

The other risk factors for developing myopia include

• History of Prematurity
• History of Laser for Retinopathy of Prematurity
• Post Cataract Surgery Myopia
• Down’s Syndrome
• Autism Spectrum disorders
• Developmental delay

Why Is It Important To Treat Myopia?

Myopia is often a progressive eye disorder that allows near vision while making distant vision blurry. And because of its common-sounding and unthreatening other name, “Near-sightedness,” many people think that it is not a serious problem. 

Childhood Progressive Myopia can lead to a long list of other eye diseases like glaucoma, cataracts, retinal detachment, and macular degeneration, which in turn can lead to blindness unless early treatment is administered.

That is why, especially given the possible implications on your child’s future vision health, it is immensely important that myopia is detected and treated early. Once detected, 6 months follow up is recommended till 8 years of age and then once yearly or as per your doctor’s advice.

Treatment Options. What Can I Do? 

If your child is near-sighted, glasses are the answer. They need to wear it during all their waking hours. Irregular use and subsequent blurry vision can induce faster progression in power.

They can switch to contact lenses when they’re mature enough to take care of them but that won’t be before they reach their teens, because of the fear of corneal infection/s due to improper hygiene. 

Single Vision glasses though the most common solution prescribed by most eye-care professionals, may not be enough. Studies suggest that combining bifocals/ progressive glasses with eye drops that have low dose atropine can slow down the progression. Axial length- is a treatment that shows promise. Discuss these options with your child’s eye doctor.

Role of Outdoor Activities in Myopia Control

Doctors recommend parents take their children outdoors for 60 to 90 minutes per day to give the eye muscles a chance to relax. Also outdoor light stimulates the production of retinal dopamine (a chemical messenger for light adaptation in the eyes), which can help to slow down eye growth. 

Therefore, I recommend moderation (not >1–2 hrs/day) in the use of electronic devices for recreation, but I insist on at least 2 hours every day of outdoor activity. I also tell the parents to make sure that they tell the children to read and write in good lighting, develop a hobby, start playing more outdoor games, and reduce screen activities.

This will not only protect against myopia but also will promote fitness and take care of Vitamin D deficiency. One of the best things to tell your child to reduce his or her risk of myopia is, “Go outdoors  and play to keep Myopia at bay!” 

How Much Screen Time Is Ideal For My Child? 

• Children under 2 years of age – No screen time
• Children 2 – 5 years – Children who are toddlers and pre-schoolers should have a maximum of 1 hour of screen time a day
• Children 5 – 17 years – (Guided Screen time ) Should be limited to 2 hours of recreational screen time per day. 

Recent evidence suggests that prolonged near work ( distance < 33 cm) may be more damaging. So the “3 Key Rules” are:

1. 20/20/20 Rule: Take regular breaks from reading – every 20 minutes take a 20-second break to look at something at least 20 metres away.
2. Elbow Rule: Don’t hold reading material or screens too close – Your child should try to keep an elbow-to-hand distance between anything they are viewing up close, and their eyes. Show them and explain.
3. Two Hour Rule: This means we try to limit leisure screen time – when used for entertainment, outside of school work – to less than two hours per day.

Can Vitamin A And Dietary Supplements Control My Child’s Myopia? 

Despite evidence that insufficient vitamin A negatively affects eye health, there is currently no research supporting an association between insufficient vitamin A and myopia.

Recent investigations have shown a higher prevalence of myopia in individuals with vitamin D deficiency, and consumption of highly refined carbohydrate foods such as sugar, rice, pasta, sugar and snacks as compared to children having a high protein-rich diet. Omega-3 polyunsaturated fatty acids like fish oil have shown a suppressive effect against myopic refractive error. Although so many food groups containing various vitamins, minerals, and nutrients help preserve eye health, there is no current vitamin that prevents or cures myopia completely. 

A Balanced Healthy Nutrient-dense Diet

• Encourage your child to eat a variety of fresh or dried fruits – rather than fruit juice.
• Serve a variety of fresh vegetables – green, red and orange, beans, peas, beetroot, carrots – all possible colours.
• Choose whole grains, such as whole-wheat bread, oatmeal, popcorn, quinoa, or brown rice. Limit refined grains such as white bread, pasta and rice.
• Encourage your child to eat and drink fat-free or low-fat dairy products, such as milk, yoghurt, cheese or fortified soy beverages.
• Encourage snacking on fruits and vegetables instead of chips and cookies, to limit your child’s calories from added sugars and saturated fats. 
• Look for ways to replace saturated fats with vegetable and nut oils, which provide essential Omega 3 fatty acids and vitamin E, naturally present in flax seeds, olives, walnuts, avocados and seafood.

Most importantly, all vitamins and supplements should only be taken under the advice of your healthcare professional.