When I was in school in the 1990’s, we would take great pride in walking to the staff room to get chalk pieces of various colours at the request of our teachers.

Most classes were taken in a naturally ventilated room with lights coming in from the outside besides the tubelights inside which we rarely used to switch on as the natural light was more than sufficient.

Cut to the millennia, many schools in the name of a hi-tech upgrades have shifted to smart boards and sharing homework on tablets or on smart phones.

This has lead to a plethora of eye disorders that’s bringing down the overall visual quality of a growing child. Let’s look at the huge impact the shift to digital domain has created in children.

Devi, a 7-year-old child wakes up in the morning to get ready to go to school. She’s got a routine every day. As soon as she wakes up, she takes her mother’s phone and watches her favourite anime while she brushes her teeth.

After her morning chores she heads for breakfast and continues watching the rest of the anime. She wants to finish the whole episode so she can discuss it with her friends. She’s so engrossed that she looks at it without blinking her eyes as she’s catching all the plot points. Once she’s in her school bus she grabs her tablet and starts watching the episodes that she had downloaded.

Once in school she pulls out her tablet and her teacher transfers all the notes for the current class over the air and she switches on the 4K smart board.

Devi finishes her class and sits for lunch with her friends who all pull out the tablet again and she continues watching her anime along with another friend.

Same routine in the bus back home. Once back home, she freshens up and opens her tab to complete her work sheet. After school chores, she begs her mother to play video games on her home’s new 8k tv. And she goes to bed around 11, the same time her parents come to bed.

Do you realise that this child has clocked close to 8 plus hours of device time? This is actually the working hours of a IT professional. Most IT professionals come to me with complaints of eye fatigue, redness (congestion) , excessive watering (Epiphora) some even have diminition of vision (Refractory error) , neck pain (spondylosis). Children nowadays are coming to me with the same conditions as seen in the adults.

As per a study, it was found post Covid these numbers rose massively due to remote access classes. The schools found it convenient to have online classes still or to be paperless and send homework on the E readers.

Most of them suffer from the following.
Myopia
This is a refractory error wherein the image of a subject falls in front the retina. This can be familial or acquired as in the case of device usage. The reason being children placing the devices close to the face and using them.

This can be corrected by prescribing glasses and a more current research states that applying eye drops like Atropine 0.01% over a period of 6 months. This is not an over the counter (OTC) drug and should be prescribed only by a registered ophthalmologist (not even optometrist).

There are also Myopia reversing or slowing glasses that big lens brands give out. A child would require a complete cylcoplegic refraction to arrive at the precise lens power value. The child needs to be checked once in every 6 months as their powers change dynamically as they age.

Lasik or SMYLE is not an option at this age. And avoid contact lenses as they can damage the cornea if not used meticulously.

Computer Vision Syndrome
This is a complex disease and requires immediate attention.
The eye secretes tears that act as a lubricant, nutrition provider and protector against pathogens.

The tear film contains 3 layers. An A lipid (fat), Aqueous (water) and a Mucin layer. The fat prevents the water from evaporating and the Mucin is responsible for both the fat and aqueous layer from sticking to the eye so the tear film can lubricate, nourish, protect the cornea, maintain PH so there is no bacterial overgrowth. Any problem in the above three can cause various diseases ranging from Computer Vision Syndrome to Corneal Ulcers to foreign bodies getting entrapped or Allergic Conjunctivitis.

When we look at a device, we might stop blinking and the tear film breaks up due to evaporation. This creates a reflux tearing and the eyes start to secrete more tears. This is called Epiphora. If this goes on for a few days, the eyes’ lacrimal apparatus exhausts its potential. This lack of tears causes friction between the eye lid and eyeball. Leading to an inflammatory disease called Dry Eye Syndrome. The patient needs to be treated with steroids, cyclosporines and tears substitutes. These are evaluated by your optometrist by tests like Schirmer, Tbut (Tear film breakup time) and most recently Meibography by optical coherence tomography.

Neck pain and headaches
Most children sit in an uncomfortable posture to study ignoring ergonomics and sitting or lying on sofa beds and sofas can trigger neck pain and headaches. This can strain the neck in severe cases trigger spondylosis which has pain radiating to the head and shoulders that could be very excruciating. An orthopaedic intervention and correction of posture would be required.

Eye Fatigue
Extensive use of devices can also cause fatigue of the ocular muscles. This can reduce a child’s productivity in school and other activities.

Dark circles and facial tanning
The digital devices derive light from LEDs that throw out a cool white colour. It’s around 3000-5600 kelvin and also known as daylight. And it’s mostly blue light unlike sunlight.

So lack of sleep and close proximity use of devices can push pigmentation around the eyes and can tan your face. So, it’s mandatory to apply a blue light filter to the display light settings and get a good quality blue filter glasses.

Final word
In a digital world, it’s hard to go back to the era of gurukuls and blackboards. We need to prioritise digital screen usage optimally. Enable blue tone on your devices so they cut the blue tone.

Eat a good balanced diet of almonds and fish to replenish omega fatty acids that form the building block of the fat layer. Drink close to 4 litres of water a day, exercise at least 45 mins outdoors. Get a good 8 hrs of sleep. Be a morning person. Avoid alcohol and smoking.

Most of all shut off all, digital displays 2 hours prior to sleep. Have a warm bath. Sip a glass of chamomile tea. Read a book and slip into a good night’s sleep.