Increase in computer time during pandemic is linked to worsening eyesight among children

Remote learning, other screen-based activities have led to a rise in myopia, doctors say.

Throughout the COVID-19 pandemic, the internet has been a technological necessity, allowing students to pursue their education and recreation from their laptops.

But the technology that helped ameliorate the ill effects of home seclusion appears to have spawned an epidemic of its own: widespread nearsightedness, or myopia – difficulty seeing distant objects – along with dry eyes, blocked tear glands, and eye strain among young people who have spent more than a year glued to their computer screens.

“Day in and day out, we’ve been seeing these cases for the past year,” said Dr. Monica R. Khitri, a Ronald Reagan UCLA Medical Center ophthalmologist and cutting-edge clinician. "There's probably a lot more kids out there that we're not catching right now with early myopia because they are not showing up to their normal vision screenings at schools and at their pediatricians’ offices. We may not know the full extent of the impact of this pandemic on myopia for quite some time, maybe even for five, 10 years down the road."

Dr. Khitri said emerging data is showing that younger children who focus for long periods of time on a computer screen or tablet are more susceptible to developing myopia with a faster rate of progression than what they would have normally.

"The kids who have to wear glasses right now, say at age four or five, can go on to develop really high amounts of myopia when they're teenagers or adults," Dr. Khitri said. "That can put them at risk of developing retinal problems and glaucoma, cataracts and so forth" when they're adults.

Dr. Monica Khitri

Like the COVID-19 pandemic, the spread of myopia is an international problem, Khitri said.

A Chinese study of 123,535 children on home confinement during the pandemic, published in January in the Journal of the American Medical Association, found the prevalence of myopia in young children increased significantly in 2020 compared to the previous five years.

“As more and more studies come out, we're probably going to see similar findings," Dr. Khitri said.

One of Dr. Khitri's patients, an 11-year-old boy who was prescribed glasses for his myopia a year earlier, returned recently with worsening blurred vision.

"We were a little bit surprised because it hadn't been too long since we had gotten his original glasses," said the boy's mother, Jane Park.

Since the pandemic started, the pre-teen's days had included many computer activities –distance learning, homework, guitar lessons, games with his chess club and video chatting with friends.

Dr. Khitri found that the not only had the boy's eyesight declined but that his tear glands appeared to be clogged, a problem she has found in other young patients during the pandemic.

"They're staring at a screen without blinking for so long, so their eyes can dry out and their tear glands can get sluggish," Dr. Khitri said. "Children can also get what we call computer vision syndrome or digital eye strain. That's where they get headaches or strain and become generally inattentive to the screen or Zoom just because their eyes don't feel comfortable."

In addition to prescribing new lenses, Dr. Khitri suggested that Park administer eye drops to her son, who now has partly returned to school. So far, the boy's eye issues seem to be stabilizing.

Dr. Khitri and her UCLA colleague Stacy Pineles, MD, an associate professor of ophthalmology and residency program director at the UCLA Stein Eye Institute, are advocating the 20-20-20 rule for all people who spend a lot of time in front of a computer.

Dr. Stacy Pineles

"So 20‑20‑20 means every 20 minutes you take a 20-second break and you look 20 feet away as a break from the near work," Dr. Pineles said. "I've been telling kids who are still in homeschool that they don't have to even turn their Zoom off or stop what they're doing, just look away from the screen and look 20 feet away, out the window. Just set a timer, and every 20 minutes look 20 feet away for 20 seconds. That's the main thing."

Drs. Pineles and Khitri both urge parents to work outdoor activities into their children's schedules.

"Even before COVID, there was more and more myopia because kids are spending more time inside reading and playing on screens," Dr. Pineles said. "Instead of having them do games on the screens that they might have done in a normal year when they're in school all day, it's probably better to send them outside to play."

Dr. Khitri worries, though, that even those efforts may not forestall the anticipated long-term impact on youngsters’ eyes as the result of extensive distance learning during the pandemic. She urges parents to watch to see if their children are squinting, rubbing their eyes frequently or having difficulty seeing. Even though some people have forgone doctors' appointments during the pandemic, she says, it's important to schedule annual physicals which include vision screening.

“I think just as years go on and these kids grow to become teenagers and adults, we're going to see what are the consequences,” Dr. Khitri said. “Right now it may not seem like a big issue to have children wear eyeglasses, but what is this going to mean for these children’s vision when they are 20 or 30 or so? I think we're probably going to be following this group of kids for quite some time to see what happens to them.”

Learn more about research and treatment at the UCLA Stein Eye Institute.

Tina Daunt is the author of this article.