Monitores e oftalmologia pediátrica

Monitors and children

Social interaction, leisure, study or work: nowadays, all of these activities rely on device usage. It is thus normal and acceptable for parents to question themselves about the time span they allow children to be exposed to screens and monitors. The main concern is related to possible visual health consequences.

On the other hand, long screen periods have been associated to obesity, poor sleep quality and changes in eye development. World Health Organization has recently released some guidelines suggesting total exposure absence for children with less than 12 months of age and very limited exposure for older children.

American Academy of Pediatrics recommends digital device absence (except in video calls) for children between 18 and 24 months of age, suggesting parents to stick to educational contents when starting exposing them to monitors.

What are the effects of monitors and screens on children’s eyes?

American Academy of Ophthalmology has no specific recommendations regarding maximum screen time per day for children. Nevertheless, parents must be aware about possible effects of screens and monitors in children as well as about global health concerns in general.

Myopia, working and near-vision reading

Myopia’s prevalence is growing worldwide. In Asia, by involving inter-study variability and different populations, reports mention that 90% of adolescents and adults are now suffering from this condition. It represents a substantial increase among recent generations.

A study published in May 2018 in Ophthalmology’s magazine – the American Ophthalmology Academy’s magazine – brings some evidence about the possible relation between myopia’s increasing and near-vision overwork. But not only digital monitors affect eye development: traditional books are also responsible for this situation, together with spending too much time indoors. The study also reports that spending some time outdoor – especially in early childhood – may delay myopia progression. This means that screen itself is not the main responsible for myopia’s developing and evolution; the problem is related to the number and intensity of near-vision working hours, especially in cases with no outdoor activities (which prevents benefiting from sun exposure protecting effect).

Digital asthenopia – “Eye Fatigue”

Digital eye fatigue is not a unique clinical entity like glaucoma or conjunctivitis. It is the name given to a group of symptoms developed by people when spending too much time in front of a screen or monitor (new technologies) – eye discomfort feeling, dry eyes (and, paradoxically, spontaneous lacrimation), itching, blurred and jumpy vision as well as cephalea (headaches). This range of symptoms reflects a transitory functional and discomfort condition and not a long-term damage in eye structure. Nevertheless, complaints are generally lasting when people are still exposing their eyes on a daily basis. An easy way of avoiding digital eye fatigue (or any other type of eye fatigue caused by near-task activities like reading) is focusing a 6-meter (20 feet) target every 20 minutes for 20 seconds (20-20 rule). This strategy allows ciliary muscle (responsible for near focus) relaxation. Obviously, this rule is directed for people depending on computer work (professional adult use); children and adolescents using tablets, mobile phones and computers must have some mandatory breaks and be encouraged to develop some outdoor group activities.

Sleep Disorders

Using screens just before sleeping may damage sleep quality. Sleep is fundamental for child development – low sleep duration was associated to greater adiposity, emotional regulation decrease, growth disorders, screen overexposure and greater risk of injuries. For this reason, and once more, WHO includes sleep in one of its main recommendations.

Eye comfort and security tips for children

The best way to deal with possible deleterious effects is to help children in defining good habits and structuring proper behaviors:

  1. Using 20-20-20 when applicable.
  2. Making frequent pause while playing videogames or setting limits and goals for each session.
  3. Avoiding outdoor monitor usage or using it in very bright areas, where reflected brightness causes discomfort.
  4. Adjusting screen’s brightness and contrast
  5. Adopting a proper posture. Bad posture may contribute to fatigue and cervical or lumbar muscle contractures, as well as cephalea associated to eyestrain.
  6. Encouraging and remembering your children to get 45 to 60 cm away from monitors: this is the optimal pattern.
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