The Pandemic Made Kids’ Eyesight Worse, Doctors Say

Many kids are emerging from the pandemic with vision problems, doctors say. A primary culprit, they believe, is increased screen time.

Eye doctors say they are seeing more children—many of whom were in virtual school—with new and worsening prescriptions for myopia, or near-sightedness. Rates of myopia in children were already increasing globally before the pandemic, but some research suggests the past year has exacerbated the problem. Doctors also report more cases of digital eye strain in kids.

A leading theory behind rising myopia rates posits that when children look at screens or books for prolonged periods, the eye adjusts to accommodate a close focus, which may change and elongate the shape of the eye, leading to myopia. Likewise, decreased outdoor time may increase and worsen myopia, as people tend to look farther away when they’re outside. Natural light and physical activity outside may also play a role. (Adults don’t tend to experience significant worsening of myopia because eye growth generally stabilizes after childhood.)

“We know that focusing up close and not being outside has increased the rate of myopia,” says Julia A. Haller, the ophthalmologist-in-chief at Wills Eye Hospital in Philadelphia. “There’s been a huge impact from the pandemic,” she says.

In a January study in the journal JAMA Ophthalmology, researchers in China looked at myopia rates in more than 120,000 homebound children during the pandemic and found the prevalence in children ages 6 to 8 increased up to three times compared with the previous five years.

Doctors in the U.S. report similar increases. Allison Babiuch, a pediatric ophthalmologist at the Cleveland Clinic in Ohio, says she’s had many kids coming in with worse vision. “We’re seeing a big jump in their prescriptions,” she says of her patients.

Some children are progressing to high myopia, which is when a prescription or the refractive error is minus six diopters or more. Children and adults with high myopia are at greater risk of developing retinal holes or tears, as well as conditions like glaucoma and cataracts. “There are reasons why we don’t want people to have high myopia,” says Dr. Babiuch.

There are some treatments for children who appear to be progressing toward high myopia, or have a family history of it, that involve wearing special contact lenses, as well as an experimental treatment that uses low-dose dilating drops, says Dr. Babiuch. “It doesn’t stop the progression of myopia, but it slows the progression,” she says.

Megan Collins, a pediatric ophthalmologist at the Johns Hopkins Wilmer Eye Institute in Baltimore, says the children she’s seeing with new or worse myopia are often the ones who are in virtual school.

“I’ve seen some younger kids that last year when I saw them they had no significant refractive error,” adds Dr. Collins. “Nothing that required glasses. Within a year they’ve had a pretty substantial change in their vision.”

The earlier one develops myopia, the greater the risk of developing vision-threatening eye conditions later, says Dr. Collins.

One recommendation for slowing the progression of myopia is for children to spend at least an hour a day doing a physical activity outdoors. “It can slow how rapidly your nearsightedness will progress,” says Dr. Collins.

Alongside myopia, eye doctors are also reporting more instances of digital eye strain in kids. Symptoms can include blurry vision, headaches and eye fatigue. Symptoms usually subside after a few hours, but it’s unclear if there are longer-term consequences, says Judith Lavrich, an assistant clinical professor at Wills Eye Hospital in Philadelphia.

Dr. Lavrich and colleagues surveyed 110 children in the first five months of this year. The children, ages 10 to 17 who hadn’t previously had vision problems, had virtual school ranging from three to 10 hours a day. “The majority of kids had acute eye symptoms,” she said. “That’s concerning.” Symptoms included eye aches, headaches, words moving around a page, blurry and double vision, and losing their place when they read. About half of children also said they had other ocular symptoms, such as tearing and burning, rubbing eyes more often, dryness, and the sensation of a foreign body in the eye. The data is preliminary and being reviewed for publication.

Dr. Babiuch recommends a 20/20/20 rule of thumb: take a 20 second break for every 20 minutes of screen time by looking 20 feet away. She also reminds people to blink more, as studies have shown most people blink at less than half the rate of normal when staring at a screen, causing eyes to be strained and dried out. For especially bad dry eye symptoms, she suggests artificial tear drops.

How to help your kids reduce screen-related eye problems

—Encourage children to spend more time outside. Some doctors believe outdoor time prompts the eye to look farther away, which may help reduce myopia risk. Outdoor light and physical activity may also contribute.

—Adopt the 20/20/20 rule of thumb: take a 20 second break for every 20 minutes of screen time by looking 20 feet away.

—Remind your kids to blink while they are looking at screens. Studies have shown most people blink at less than half the rate of normal when staring at a screen, which can strain and dry out eyes.

Adults are also experiencing more eye-related problems, doctors say.


Joe Librandi-Cowan for The Wall Street Journal

Pandemic-related eye problems hit adults, too

Adults are also reporting more eye symptoms, particularly dry eye, doctors say.

Sonal Tuli, an ophthalmology professor at the University of Florida in Gainesville and a spokesperson for the American Academy of Ophthalmology, says she’s seeing a lot more patients complaining of dry eye. “When people wear masks the air sort of blowing from their nose and mouths into their eyes can cause drying,” says Dr. Tuli.

Using a computer or screens more can also contribute to dry eye and inflammation of the eyelids because people tend to blink less when they look at screens. “When you blink it spreads the tears,” says Dr. Tuli. “With no oily layer, the tears will evaporate quickly.”

She advises patients to take more screen breaks, blink more, and use artificial tears. Scrubbing the lids with warm compresses to open up and drain the oil glands can also help. There are also oral and topical medications to decrease inflammation.

Write to Sumathi Reddy at [email protected]

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