Sunanda Krishna, a 32-year-old resident of Hyderabad, would often give her phone to her three-year-old toddler to keep her occupied while she finished her work and chores around the house.
The toddler loved watching nursery rhymes, cartoons, and animal videos on YouTube. She would laugh and clap her hands while watching her favourite videos. She enjoyed learning new things from the videos and her mother was happy to see her child engaged and cheerful.
However, Sunanda soon started to notice that her daughter would often rub her eyes, blink frequently, and complain of headaches. Also, the toddler would find it difficult to look at objects at a distance. Whenever Sunanda tried to take the phone away from her daughter, she would get irritated.
Visit to the ophthalmologist
Sunanda then took her child to an ophthalmologist and the diagnosis was asthenopia and digital eye strain, commonly known as computer eye syndrome.
“When there is prolonged or excessive use of the eye by any individual without taking a break, the eye starts to get strained and starts to experience visual fatigue. This is called asthenopia,” said Hyderabad-based ophthalmologist Dr Usha Narayan Prasad.
Dr Usha said that this is not the only such case. “Very young kids are coming with eye problems these days. Many parents give smartphones and tabs to their toddlers and kids to keep them occupied. It’s an easy way to put your kid in one place so that you can do the work you want to do,” said Dr Usha.
The symptoms of asthenopia may include:
- Eye discomfort or pain
- Blurred or double vision
- Dry eyes
- Burning or itching sensation in the eyes
- Sensitivity to light
- Difficulty focusing
The American Academy of Pediatrics recommends that children aged two to five should not have more than one hour of screen time per day and children under the age of two should not have any screen time at all.
This is because excessive screen time can lead to eye strain, fatigue, headaches, and other vision problems.
Digital eye strain
Digital eye strain, also known as computer vision syndrome, can occur in children as young as three years old, especially if they are exposed to electronic devices for extended periods.
“The eyes can also get dry and irritated during long stretches of screen use. People of all ages blink less often when concentrating on a screen, which in turn causes the eyes to dry out. Blinking clears out the dirt and external agents from the cornea. This problem can be worse for children who may have to look up at a screen that’s positioned for adult use,” said Dr Usha.
The blue light emitted by electronic devices could also affect the quality of sleep in young children. “This is because blue light suppresses the production of melatonin, a hormone that regulates sleep, making it harder for children to fall asleep at night,” said Hyderabad-based paediatrician Dr Chandna Lakshmi.
Affects more than just eyes
She added that toddlers who watch videos on smartphones before bedtime have difficulty falling asleep and staying asleep, which can negatively impact their mood and behaviour.
“You can see children getting irritated easily when they are not given the phone to watch videos. These kids also have attention problem. They may become easily distracted, have difficulty focusing on tasks, and exhibit impulsive behaviour,” said Dr Lakhsmi.
She added that parents can encourage children to take regular breaks from electronic devices and engage in activities that promote physical activity, such as playing outdoors, drawing, reading books, or playing with toys. These activities can help reduce eye strain and promote healthy eye development in young children.
Dr Usha added that parents and caregivers can also take steps to protect their child’s eyesight by adjusting the lighting and positioning of electronic screens. Electronic screens should be positioned at a comfortable distance, at least 18 to 24 inches away from the child’s face, and the brightness level should be adjusted to reduce glare.
“Always remember 20-20-20-2 rule — for every 20 minutes spent looking at a screen, the child should take a break and look away for at least 20 seconds, focusing on an object that is at least 20 feet away. The “2” refers to taking a two-minute break from the screen after every 20 minutes of use,” said Dr Prasad.
Dr Prasad added that as a responsible adult, it is important to monitor a child’s screen time and limit their exposure to electronic devices, especially at a young age.
“While it is tempting to use technology to keep children entertained, it is important to recognise the potential harm that excessive screen time can cause. It is essential to set boundaries and monitor a child’s screen time to prevent them from developing vision problems,” said Dr Usha.
Studies have also found that kids who spend time indoors are more likely to develop nearsightedness (myopia).
The psychological impact
Prolonged exposure to screens doesn’t only cause eye problems in children but has a psychological impact on them as well.
“Toddlers who spend a lot of time watching videos on smartphones may become addicted to the screen. This can lead to behavioural problems and withdrawal symptoms when the device is taken away. Kids who spend too much time watching videos on smartphones may become irritable and aggressive, and may have more frequent tantrums,” said Dr Lakshmi.
Children who spend too much time on smartphones may struggle with social skills, including the ability to interact with others, make friends, and communicate effectively.
“Overuse of smartphones can lead to difficulty with attention and concentration, which can impact academic performance and daily functioning. The end-goal of the kid remains to watch another video or something on a smartphone,” said Hyderabad-based psychiatrist Dr Srinivas Naik.
He also adds that children who spend a lot of time watching videos on smartphones may become more impulsive, making decisions without considering the consequences.
“It’s not only mental health, kids need a lot of activity to understand things around themselves. Spending too much time on smartphones leads to a sedentary lifestyle, which contributes to obesity and other health problems,” said Dr Naik.
Dr Naik added that it all starts with the parents. “Toddlers imitate parents, they observe them, what they do, how they walk, how they call names…all of it. Similarly, when parents use smartphones in front of their kids, these kids also observe it and similarly imitate it. So parents should avoid using phones for long hour in front of their kids,” adviced Dr Naik.
He added that parents need not completely remove the devices from the lives of these kids. “These are parts to live in the modern world. You just have to teach the kid to have a healthy screen time,” said Dr Naik.