Eye Care for Children in Covid Times

Children wearing glasses is a common sight nowadays. We see far more children, some as young as 2-3 years old, wearing glasses as compared to a decade ago. Increased awareness among parents and improved access to healthcare has resulted in more children being examined and diagnosed with refractive errors at an early age. But still, it cannot be denied that there is a definite and substantial increase in the incidence of refractive errors in children.

There are many causes behind this but one of the most important factors appears to be the increased amount of near activity in children. Children are now initiated into schooling at a younger age (as early as two and a half years); reading, writing, drawing and other forms of near work are introduced early in the curriculum. The amount of time spent in outdoor activity by children is very less. Added to this is the fascination with gadgets like mobile phones, tablets, laptops and video-games which exposes children to an unacceptable level of screen-activity.

The Covid pandemic has added to this challenge because education has now moved online. With schools closed and absence of clarity on when physical teaching may resume, classrooms have now become virtual. This means that a certain amount of screen-time is now unavoidable. Children are confined to their homes, outdoor activities and games are restricted. This has resulted in more time being spent in scrolling mobile phones, playing video-games and watching television. In short, the level of eye strain in children has increased greatly.

This is definitely a cause for concern because it may result in development and progression of refractive error in children. I am listing down a few things which, as parents, we should do for eye care in our children.

• First and foremost is that children who have been prescribed glasses must wear them all the time. Glasses in children are not the same as glasses in adults which can be used according to convenience. Children with refractive error must wear glasses throughout their waking time, not just while studying or watching television.
• It is very important to minimise unproductive screen-time. Online school and assignments, in view of this pandemic have become unavoidable or essential screen-time in children. Since, this activity itself constitutes a good 2-3 hours, all other screen-time must be considered unproductive and curtailed or stopped.
• For online classes, it is better to make the child use a large screen device like a desktop or laptop. Use of small screen devices like tablets and mobile phones are best avoided as they cause more eye strain.
• Children should sit comfortably at distance of around 1 foot from computer with the device placed at their eye-level.
• Continuous screen-time of more than half an hour in small children and one hour in older children should be avoided.
• For watching videos, films and cartoons it is better to use the television which has a larger screen and can be watched from a distance as opposed to a small screen device like mobile or tablet which is watched from near.
• Outdoor activities which can be done individually like running, skipping and cycling should be encouraged. This ensures some sun-exposure which is very important in children along with physical exercise. Time spent outdoors takes the child away from the different types of indoor activities which entail near work. The importance of outdoor activity and sun exposure in decreasing incidence and progression of refractive errors in children is well-documented in studies conducted in South-east Asian countries.
• It may also be worthwhile to try and develop some hobbies in children like music, dancing, cooking and gardening. They not only serve as a refreshing change, they take the child away from the usual recreation activities like story books and board-games which are also forms of near work.

I  do agree that all that I have listed is easier said than done. With pressures of work from home jobs and household chores it is difficult to devote so much of time to children, monitor what they are doing and engage them in activities which do not involve near work or screen- time. Times are challenging, no doubt, but it is important that we must make a conscious effort to adapt to what is going to be the ‘new normal’ for months to come and do everything possible to ensure good health for ourselves and our children.

Dr Sudha Seetharam

Consultant Ophthalmologist, Laxmi Eye Institute, Maharashtra

Teleconsultant on Med India

Author: “Self-assessment and Review of Ophthalmology” for MBBS students