We can all agree that 2020 hasn't gone quite according to plan, right?

As the beginning of the school year approaches, parents, educators, and administrators everywhere are faced with tough choices.  Most schools are offering some version of virtual learning, or remote learning.  Most schools also have a plan for full time remote learning should it be needed during the school year.  Parents have questions about what this increased screen time can mean for their kids, and how to help avoid any possible negative effects.

Age-Based Recommendations

Curently, the American Academy of Pediatrics has a guideline of no screen time for kids under 2, and no more than an hour of screen time for kids ages 2-5.  Above age 5, there are no additional recommendations or restrictions.  See this article from the Mayo Clinic for more information.  We usually tell parents that screen time is a bit like dessert and is best in moderation.

2020 Rules

Let's face it- for most families, screen time has likely increased over the last few months.  Just as adults are working from home more and video conferencing, kids also have been using computers and tablets more frequently.  Whether it is for schoolwork, chatting with friends, or just entertainment, device use is up.

As we look toward the upcoming school year, we know this will probably increase even more.  Some schools are adopting synchronous virtual learning, which means that the child must be online at a certain time with the rest of the class.  Typically there is also independent work that will be done online as well.  This all adds up to more time in front of a computer than previously experienced in traditional classroom settings.  And of course should a school system move everyone to remote learning for a period of time, well....you get the picture.

Common Concerns With Screen Time

From an eye care standpoint, there are a few concerns with an increase in screen time.  We'll go over these briefly:

1. Blue Light: There's definitely buzz in eye care about blue light and what it can do to the eyes.  Quite honestly, opinions are divided on the amount of harm caused from blue light from devices.  We know that blue light can be damaging to the macula- the area of the retina responsible for your central 20/20 vision.  We also know that blue light exposure can distribute melatonin production and the sleep cycle.  The biggest source of blue light is the sun- so first and foremost we recommend sunglasses to be worn whenever outdoors-even on an overcast day.  
2. Dry Eye: Believe it or not, we are seeing an increase in dry eye syndrome in younger patients.  Increased screen time is definitely a contributing factor.  There are glands along our eyelids that produce the oil part of the tear film.  The oil must combine with the water component, otherwise our tears evaporate very quickly.  This makes our eyes burn, sting, and sometimes tear reflexively.  The way the oil is expressed from these glands is through blinking.  If we don't blink, the oil doesn't leave the gland properly.  Over time, this can actually irreparably damage the glands.  The best analogy, albeit a strange one, is milking a cow.  If you don't milk a cow, it dries up.  If you don't "milk" the glands with normal blinking, damage also occurs.  When we focus on something like a computer screen, our blink rate drops significantly.
3. Increased Nearsightedness: This is more of an issue for kids who are not already nearsighted.  The latest research into nearsightedness is showing that once nearsightedness has already begun, increased near work may not have much of an impact in worsening it.  However, for kids who are not already nearsighted- doing a lot of close work may actually increase the liklihood of developing nearsightedness.
4. Eye Strain- Uncorrected prescriptions can lead to mixing up letters and numbers, and strain.

What Can We Do?

We are realistic.  For some families, virtual learning is going to be the best option.  At some point, we may all be on remote learning.  So let's talk about what you can do to help!

1. In terms of device use, we tend to believe that blue light protection in glasses can help, can make the eyes feel less strained at the end of the day- and won't hurt anything.  Blue light protection can be accomplished in the type of lens, the coating, or a combination of the two.  They can be made in prescription, non-prescription, and even include a little bit of magnification to further reduce any eye strain.  We recommend talking with your eye care professional for further information about the best option for you.
2. Taking visual breaks can be so helpful for both kids and adults who are spending a lot of time looking at screens.  Even with synchronous learning, where students are online with their class at a set time, visual breaks can be done without interrupting learning.  We recommend focusing on something 20 feet away for 20 seconds, and doing this every 20 minutes.  This is called the 20-20-20 rule.  During this little break, we encourage awareness of blinking.  Also, if you know that you've got a 1 hour or longer session coming up, it can be helpful to put in an artificial tear before you start!
3. Have some outside and active time too!  Whether your child is already nearsighted or not, having active time is beneficial.  For those who are not nearsighted, outdoor time may actually decrease the risk of being nearsighted- bonus!
4. We recommend making sure your child's prescription is up to date for the best chance at successful learning, no matter the environment.  A comprehensive eye exam by an eye care professional can also detect issues with how the eyes are working together.

Keep in mind, this year is absolutely the strangest thing any of us have been through.  Parents who are working and also trying to help their kids learn at home may need to have a little more screen time involved than they would prefer.  Parents choosing virtual learning may not be crazy about the extra computer use if their kids aren't used to it.  We may all be in the boat together intermittently through the year- who knows.  We are optimistic that these measures are relatively short term (fingers crossed it is only for this school year!) and we believe families need to do what works for them.  No matter what happens this year, we are here to support you!