Children and Screen Time

Digital Eye Strain

Digital eye strain is the range of vision problems experienced with extended use of digital devices.¹ These problems include symptoms such as headaches, blurry vision, double vision, tired eyes, sore eyes, itchy eyes, burning eyes, and dry eyes.¹

Handheld devices such as phones and tablets, and other devices that are used at a close range require the eyes to focus in order for us see the screen clearly. The ability for us to focus on near objects is automatically controlled by muscle contractions in our eyes. Staring at screens for a prolonged period of time can cause these muscles to become tired and lead to symptoms of digital eye strain such as headaches and blurry vision.²

A common symptoms of digital eye strain is dry eyes. This is caused by a decrease in blinking when they are concentrated in watching a show or playing video game. On average, we blink about 17 times per minute and when we stare at a screen it drastically decreases our blink rate to about only 4 times per minute.³ Over time, the decreased blink rate will cause the front surface of the eyes to dry out. If your child presents with excessive eye rubbing or blinking, this could be a sign that they are experiencing dry eyes.⁴

Poor Sleep

When the sun rises, blue light rays from the sun is detected by our eyes alerting us that it’s time to wake up. Exposure to blue light is important in regulating our circadian rhythm and has been beneficial evolutionarily.⁵ However, screens from digital devices also emit the same wavelength of blue lights that keep us awake.⁶ Naturally, excessive screen time, particularly during the evening, suppresses melatonin production and is associated with poorer sleep.⁶ In addition, screen time is generally sedentary and displaces other activities that are beneficial for sleep such as physical activities.⁶

Other Problems

With the boom in the use of digital devices, recent studies focused on screen time and children revealed critical outcomes. Children who spend more time on screens showed poorer performances on developmental screening, reduced vocabulary and communication skills, lower motor skills, and are more prone to psychiatric problems.^7-8 Recent studies have found that children who have a lot of screen time are more likely to show symptoms of attention deficit hyperactive disorder (ADHD).^6,9-11

In addition to regular breaks, remind your child to blink and sit further away from the screen. Blinking can help alleviate dry and tired eyes. Increasing the distance from screens can help reduce digital eye strain by relaxing their eyes from over-focusing. If your child persists in using digital devices from a short distance, schedule an eye exam for them with the optometrist, as children who like to sit too close to the screen may be nearsighted.

Make playrooms eye-friendly by reducing glare and offering soft overall lighting. Discourage playing video games in a dark room, as the harsh contrast between the screen and the surrounding area may cause uncomfortable viewing. When the room is softly illuminated, undesirable contrast is kept to a minimum. Keep the screens free of fingerprints and dust, as both can reduce vision clarity.

If your child has a prescription, such as nearsightedness, farsightedness, or astigmatism, it is important to wear the appropriate glasses so your child’s eyes are not exerting extra focusing and working harder to maintain a clear image when viewing screens. To learn more about your child’s vision, visit your local optometrist for an eye exam.

References

1. Sheppard AM et al. Digital eye strain: prevalence, measurement and amelioration. BMJ Open Ophthalmol. 2018 3(1):e000146.
2. Mohan A et al. Prevalence and risk factor assessment of digital eye strain among children using online e-learning during the COVID-19 pandemic: Digital eye strain among kids (DESK study-1). Indian J Ophthalmol. 2021;69(1):140-144.
3. Bentivoglio AR et al. Analysis of blink rate patterns in normal subjects. J Mov Disord. 2004;12(6):1028-1034.
4. Coats DK et al. Excessive blinking in childhood: a prospective evaluation of 99 children. Am J Ophthalmol. 2001;108:1556-1561.
5. Wahl S et al. The inner clock – blue light sets the human rhythm. J Biophotonics. 2019;12(12):e201900102.
6. Lissak G. Adverse physiological and psychological effects of screen time on children and adolescents: literature review and case study. Environ Res. 2018;164:149-157.
7. Madigan S et al. Association between screen time and children’s performance on developmental screening test. JAMA Pediatr. 2019;173(3):244-250.
8. Madigan S et al. Trajectories of screen use during early childhood: predictors and associated behavior and learning outcomes. Comput Hum Behav. 2020;113:106501.
9. Tamana SK et al. Screen-time is associated with inattention problems in preschoolers: results from CHILD birth cohort study. PLoS ONE. 2019;14(4):e0213995.
10. Ra CK et al. Association of digital media use with subsequent symptoms of attention-deficit/hyperactivity disorder among adolescents. JAMA. 2018;320(3):255-263.
11. Nikkelen SWC et al. Media use and ADHD-related behaviors in children and adolescents: a meta-analysis.
12. Canadian Paediatric Society. (2022). Screen time and young children. Retrieved from https://caringforkids.cps.ca/handouts/behavior-and-development/screen-time-and-young-children
13. Hill D et al. Media and young minds. Pediatrics. 2016;138:e20162591.