01/9​​Increased incidence of smartphone usage​


Digital eye strain or computer vision syndrome affects individuals of all age groups and is characterized by visual and ocular symptoms due to prolonged use of digital electronic devices. The recent outbreak of COVID-19 has caused an upsurge in the use of digital electronic devices. Several countries including India had declared lockdown which made most people resort to digital devices to communicate, interact and continue with their job responsibilities from home . While there is a rise in adults and working class people’s use of online learning services and video conferencing platforms like zoom and Google meet during the pandemic, children too are using these platforms for study material and lectures. Other than that, time spent on social media by children has increased drastically.

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02/9​​What are the ill effects of prolonged digital device usage?​

​​What are the ill effects of prolonged digital device usage?​
Dr. Sujal Shah, Director of Opthalmology at Sir HN Reliance Foundation Hospital says, “The children often present with ocular symptoms such as dryness, itching, redness, watering and visual symptoms like blurred vision. The main reason for the ocular symptoms is due to the reduced blink rate which affects the ocular surface. Decreased blink rate results in dry eyes which is the primary cause of eye fatigue in the form of heaviness and tiredness of eyes. Increased digital screen time causes accommodative spasm. This causes the vision to blur when children are attempting to view distance objects. Extraocular symptoms such as headache, neck stiffness, shoulder and back pain are also commonly seen in children with excessive digital screen time.”
Since digital devices have become an essential part of our kids' lifestyle, there is a need to create more awareness about digital eye strain. Awareness campaigns should be carried out to target at-risk populations. COVID-19 pandemic has resulted in an increase of digital eye strain amongst the children due to online teaching. Hence, teachers can play a crucial role in creating awareness and also in early detection of digital eye strain among children. It is also important to counsel the parents to monitor their child’s digital devices usage and encourage children towards outdoor recreational activities.

Ways to prevent digital eye strain are as follows :
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03/9​​Reduction in average daily screen time ( less than 4 hours daily)​

​​Reduction in average daily screen time ( less than 4 hours daily)​


Use of digital electronic devices under proper ambient lighting and adjusting the image parameters (resolution, contrast and font size) to improve the conditions for visual perception and thus relieve eye strain. Parents must ensure that kids follow a 20/20/20 rule. After every 20 minutes of screen time, a break of 20 seconds during which the subject needs to focus at a distant object which is at a distance of 20 feet.

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04/9​​Use of lubricants​

​​Use of lubricants​


Preservative free lubricant eye drops help to keep the ocular surface and prevent dryness due to the reduced blink rate. Use of digital screens with inbuilt anti reflective coating and polaroid glasses to reduce strain on the eyes. Special lens tints and coatings can reduce the harmful impact of blue light.

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05/9​​Limit screen time and positioning​

​​Limit screen time and positioning​


Use of screen time tracking to control excessive screen usage and softwares to remind the user to blink or take breaks during the work. Proper body positioning which includes chair comfort, location of study material and position of the monitor must be followed. Improved ergonomics reduces discomfort and increases productivity.

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06/9​​Check for refractive errors in eyes​

​​Check for refractive errors in eyes​


Uncorrected or under corrected refractive errors can be a major contributing factor to digital eye strain. Even small refractive errors can aggravate the symptoms of computer vision syndrome. Hence, every individual must undergo detailed ocular examination yearly to rule out any refractive error and correction if required.

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07/9​​Avoid smartphone use before sleep​

​​Avoid smartphone use before sleep​


Use of blue light before sleep time must be reduced to avoid alteration of the sleep cycle and circadian rhythm. Software’s to change the colour of the desktop screen according to the time of the day are available and thus to possibly promote circadian rhythm. Avoid environmental factors such as dry air, ventilation fans, airborne paper dust and building contaminants which aggravate dryness of the ocular surface.

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08/9​​Use lubricating eye drops​

​​Use lubricating eye drops​


Contact lens users are more likely to suffer a higher severity of ocular discomfort following prolonged work periods on a digital screen. Hence, they must use lubricating eye drops regularly to keep their ocular surface moist.

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09/9​​The takeaway​

​​The takeaway​


To summarise, a holistic approach must be advocated to the treatment and management of the ocular symptoms of digital eye strain in children. The treatment must be multi directional which includes modifications in the ergonomics of the work station, refractive error correction, lighting and environmental factors, frequent play breaks and management of the underlying ocular and systemic pathologies. This will ensure better care and prevention of further deterioration of eye health in kids.

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