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  • Writer's pictureVesna Pejic

Vision in time of COVID-19

A new meta-analysis in the journal JAMA Pediatrics finds that more overall time on screens each day, regardless of its quality, is linked to lower language development and we may add vision underdevelopment as well.

"What we do see is, as the number of hours increases, so too does the risk for problematic outcomes," said lead researcher Sheri Madigan of the University of Calgary in Canada. "What this work suggests is that the quality of screen-viewing matters, but I think it all needs to be used in moderation."

The American Academy of Pediatrics recommended back in 2016 that screen time of any kind be limited for those ages 2 to 5 to co-viewing with parents who can explain what is going on and for no more than 1 hour per day of high-quality educational programming. It had not put hard limits on screen time for school-age children ages 6 and up, but the academy said limits should be made and screen time should not interfere with children's sleep or exercise habits.

Yet in the years since, research has suggested older children may also be affected by long periods online or in front of the television. A long-term, ongoing study of pre-adolescents shows those who spend hours of screen time a day across phones, tablets, and video games had lower cognitive skills, particularly in translating two-dimensional to three-dimensional objects. And studies of older adolescents and adults suggest reading in digital formats over long periods of time may reduce reading flow and comprehension, particularly for longer texts.

You may wonder how this prolonged exposure to electronics affects children and adults too?!

Here are some of the ways, some to be expected others more surprising screen time can affect kids or/and adults eyes:

Too much screen time or time spent indoors can lead to near-sightedness (myopia)

“Use it or lose it” is the way body and brain work. With too much time spent indoors and in front of the screens kids have lost their ability to see far and wide, because they have not looked, being too engrossed at near point or too lost in thought which keeps the eyes focused at near, really.

Full-time near work will dim down the peripheral awareness. So, we need balance. Children cannot spend hours staring at a screen or a book and have reciprocal visual processing automatically developed.

This loss of swift change of focus, tracking and ambiental awareness can lead to myopia, underdeveloped oculomotor skills and problems with eye teaming or/and eye-hand coordination.

Moreover, the researchers believe that UV light (providing the eyes are protected from intense sunlight) plays an important role in healthy eye development.

Loss of focus flexibility-dysfunctional accommodation

When their eyes stay focused close-up for long periods, children can also find it difficult to adjust to distance vision. The ciliary muscle loses its flexibility and ability to shift focus from one viewing distance to another while maintaining clear image. Focusing and convergence need to be coordinated at the same place in space, such a page of book, to create clear, single, binocular vision.

Therefore, a number of children who have been put on computers at early age or for prolonged hours are developing negative functional adaptations to the pressure of immature focusing system. The problem is not just focusing too close too young. It is that the vision is learned in real space where light bounces off objects. The computer or screen is backlit and that is not natural for developing eye. Please take note that not only the computers are part of the problem. It is all unnecessary near work without proper brakes, font size, lighting, ergonomics, and opportunity to learn through movement.

Signs of poor focusing are many but most prominent are:

  • Headaches with near work

  • Itchy watery eyes that are not caused by allergies

  • Covering one eye while reading

  • Poor head/body posture.

How does this loss of ability to shift focus from one viewing point to another affects learning?

You should look for:

  • Difficulty copying from the board

  • Skipping/repeating of lines when reading

  • Up/downhill writing

  • Taking more time to finish the assignments.

Sometimes addiction to screens causes focusing problem learning how to write. The eyes fixed to the TV or computer screen are not used in the activities involving the body, eyes, and hands. Frequently, the child will have poor handwriting, even though he/she may have a proper pencil grip, a good teacher, and parents ready to help. Or child might dislike reading because it makes him feel tired. Or the effort of keeping his eyes on the page is so great that he/she won’t remember what is read.

A child with such a background needs to have vision therapy to regain his binocularity, eye teaming and eye hand coordination as well as to integrate visual and vestibular which will lead to the sensory integration.

We could say that vision therapy - Integrated Cognitive Orthoptic Remediation helps to recover from this one-eyed computer myopia or beginning of a wandering eye.

Computer vision syndrome

The coronavirus pandemic is remaking the way children learn, and it could have an impact on their eyes.

With schools shifting to online lessons at home, children are spending more time in front of computer screens, and many parents are relaxing screen-time rules for TV and video games to keep kids occupied while social distancing. Amid the crisis, many children are spending less time playing outdoors.

Which brings us to inevitable computer vision syndrome. Trigger factors for computer vision syndrome together with prolonged stare at the screen are compromised visual acuity, accommodation, convergence, and overall eye teaming.

Digital and visual fatigue can cause following symptoms:

  • Dry and red eyes

  • Blurred and/or double vision

  • Headaches

  • Neck or back pain.

It is easy to get absorbed by computer work and to lose track of time. Eyes get tired with prolonged close-focus attention, especially when the lighting around the screen causes glare and extra eye strain. Long stretches of screen time also cause the eyes to get dry and irritated.

Studies show that people of all ages blink far less often when concentrating on a screen, which in turn causes the eyes to dry out. A clear and stable tear film on the surface of the eye is essential for clear vision. The problem can be worse for children who look up at a screen that is positioned for adult use.

Impact on sleep

The other problem with screen time for kids is its effect on sleep. Research shows that the blue light from computer and device screens, when used in the evening, alters the brain’s sleep rhythms. The brain reads the screen light as “daytime” and shifts the body’s circadian rhythm. The exciting content of many video games and movies can also wind a child up when they should be winding down for bed or for a nap.

How parents can help their children

It is important to build eye-healthy lifestyle at home. Parents can help by carefully managing their children’s screen time to support educational use while limiting cartoons and video games. They can also encourage more outdoors activities while maintaining social distancing; which is becoming easier with relaxation of safety measures.

Having clear rules, setting limits on screen time and parents’ communication style have been associated with less screen time among children. Parental modelling also influences how much time children spend watching TV. However, some children need more than parental guidance and change of lifestyle.

Developmental Visual Cognitive Assessment and in-house vision therapy - Integrated Cognitive Orthoptic Remediation is often needed to identify the problem and to learn how to use eyes in effective way.

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