Written by Marcela Frazier, OD, pediatric optometrist at UAB Callahan Eye for Birmingham Mom Collective.

We are now living in a digital age where our children’s eyes are constantly glued to iPads, tablets, and other digital devices. Although this may be the new “normal,” eye care providers worry about the long-term effects this can have on children’s eyes.

Children are now complaining of symptoms that used to be particular to adults working on computers all the time (computer-vision syndrome), symptoms such as:

Headaches
Excessive blinking
Eye pain
Eye discomfort
Distance blur after being on devices for an extended time

During the pandemic quarantine, screen time increased for many children, and, even post-pandemic, when we ask parents how long their children are spending on screens, parents’ responses vary from one hour a day to (shockingly) 16 hours a day! This excessive amount of screen time can have many long-term effects on your children’s eyes.

For instance, we now see many children and teenagers with severe dry eyes.
Studies have confirmed that blink rate is decreased during device use, and this may interfere with tear film dynamics, which can cause dry- eye symptoms. In addition sustained periods of looking at a device up- close can take a toll on the eyes’ focusing system.

Another concern is that the use of devices can take children away from spending time outdoors.
The rates of nearsightedness (myopia) have increased rapidly around the world, and many children with myopia have been rapidly progressing into high myopia. This can be detrimental to their eye health as it increases the risk of retinal detachments, glaucoma, and other sight-threatening diseases. Even though it has not been proven that increased electronic time causes nearsightedness, the consensus among experts is that increased outdoor time is effective in preventing the onset of myopia.

The American Academy of Pediatrics (AAP) and The World Health Organization (WHO) recommend these acceptable amounts of screen time:

None for children under two years of age
One hour per day for children two to 12 years
Two hours per day for teens and adults
Limiting screen time can be challenging, but it is necessary to protect your child’s eyes.

Set a screen time limit on their devices with a parental code (and change it periodically in case they see it).
Create a schedule that balances screen time with outdoor play, ensuring children have dedicated time to explore and engage in physical activities outdoors.

Promoting outdoor activities for kids is a wonderful way to encourage physical activity, exploration, and a deeper connection with nature. Here are some strategies to promote outdoor activities:

1. Be a Role Model: Children often mimic the behaviors they observe. Demonstrate your own enjoyment of outdoor activities by participating in them yourself. Show enthusiasm, engage in outdoor hobbies, and make it a regular part of your family’s routine.

2. Create an Outdoor-Friendly Environment: Make your outdoor space inviting and accessible. Set up a backyard play area with age-appropriate equipment, such as swings, slides, or a sandbox. Consider planting a garden or creating a space for outdoor crafts and activities.

3. Plan Family Outings: Organize regular family outings that involve outdoor activities. This could include trips to parks, nature reserves, hiking trails, or nearby beaches. Engage your child in the planning process, allowing them to choose destinations or activities they find exciting.

4. Organize Playdates: Encourage your child to spend time outdoors with their friends. Coordinate playdates at local parks or arrange outdoor games and activities in your backyard. Socializing and having fun with peers in an outdoor setting can make outdoor activities more enjoyable.

5. Integrate Outdoor Learning: Combine outdoor activities with learning opportunities. take nature walks and point out different plants, animals, or natural phenomena. Teach children about the environment, ecosystems, and the importance of conservation. Consider visiting local science centers, botanical gardens, or nature centers for educational experiences.

6. Provide Outdoor Toys and Equipment: Equip your child with outdoor toys and gear that encourage active play. This could include bicycles, scooters, balls, frisbees, jump ropes, or outdoor games like badminton or soccer. Having the right equipment readily available can make outdoor play more enticing.

7. Join Community Programs: Look for community programs, clubs, or sports teams that focus on outdoor activities for children. These could include organized sports, scouting groups, nature clubs, or outdoor adventure programs. Participation in such programs can foster a sense of community and provide structured outdoor experiences.

8. Embrace Seasonal Activities: Encourage participation in outdoor activities that vary with the seasons. This could involve building snow forts and going sledding in winter, flying kites in spring, swimming in summer, or jumping in piles of leaves during autumn. Emphasize the unique joys and opportunities presented by each season.

9. Be Flexible and Fun: Allow children to explore and engage in unstructured play outdoors. Let them use their imagination, build forts, climb trees, or engage in creative outdoor activities. Encourage fun and adventure while ensuring their safety.

Getting your kids involved in regular outdoor activities, as part of a healthy
lifestyle, is also important for their eye health!

References:
Bridget M. Kuehn, MSJ. Increase in Myopia Reported Among Children During COVID-19 Lockdown. JAMA. 2021;326(11):999.doi:10.1001/jama.2021.14475

Chidi-Egboka, NC, Jalbert I, and Golebiowski B. Smartphone gaming induces dry eye symptoms and reduces blinking in school-aged children. Eye volume 37, pages 1342–1349 (2023) https://www.wspos.org/swdcore/uploads/WSPOS-Myopia-Consensus-Statement-2023-1.pdf

French A.N.Ashby R.S.Morgan I.G.et al. Time outdoors and the prevention of myopia. Exp Eye Res. 2013; 114: 58-68

Holden B.A.,Fricke T.R.,Wilson D.A., et al.Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016; 123: 1036-1042

World Society of Paediatric Ophthalmology Strabismus. Myopia Consensus Statement 2023. Interventions To Slow The Progression Of Myopia https://www.who.int/news-room/detail/24-04-2019-to-grow-up-healthy-children-need-to-sit-less-and-play-more