Ophthalmologists anticipate virtual learning will drive increase in eye strain

When coronavirus disease 2019 (COVID-19) initially closed classrooms in the spring and sent students to a virtual setting in front of computer screens, Americans got a glimpse into the digital challenges of distance learning.

One key point learned is that children are not immune to developing tired, dry eyes from concentrating on laptops and tablets for extended periods of time. The discomfort drove some of them to their ophthalmologist, looking for relief.

To prepare students and their families for the new school year, the American Academy of Ophthalmology (AAO) is sharing a back-to-online school checklist to help prevent digital eye strain.

“I was a digital eye strain naysayer prior to recent events,” Stephen Lipsky, MD, a pediatric ophthalmologist and clinical spokesperson for the AAO, said in a statement. “But in my practice, I really have seen a marked increase in kids suffering from eye strain because of increased screen time. Good news is most symptoms can be avoided by taking a few simple steps.”

The simple fact behind the headaches, blurry vision, and tired, dry eyes is that people don't blink as often while using computers and other digital devices, leaving eyes dry and irritated. And when individuals focus at the same distance for a long time, it can cause their vision to blur temporarily, and the muscles around the eye to tire, which can cause headaches. Extended reading, writing or other intensive near work can also cause eye strain.

To fix this problem, ophthalmologists recommend their patients take a 20 second break from near work every 20 minutes.

Ophthalmologists also can offer some pearls for parents to remind their children to follow this vital rule:

• Set a timer. Whether a kitchen timer or a smart device, use it to remind your child to take a break every 20 minutes.
• Alternate reading an e-book with a real book. Encourage children to look up and out the window every two chapters or simply shut their eyes for 20 seconds.
• Pre-mark books with paperclips every few chapters. When they reach a paper clip, it will remind them look up. On an e-book, use the "bookmark" function for the same effect.

Good ergonomics is as important as resting the eyes periodically. Individuals tend to use digital devices at less than ideal distances and angles, which leads to eyestrain. To encourage good posture and better habits, set up a "home office" for students. Follow these tips to -optimize their workspace:

• Make sure they view laptops at arm’s length, about 18 to 24 inches from where they are sitting. Ideally, they should have a monitor positioned at eye level, directly in front of the body. Tablets should also be held at arm's length.
• To reduce glare, position the light source behind the back, not behind the computer screen.
• Adjust the brightness and contrast on the screen so that it feels comfortable for them.
• Do not use a device outside or in brightly lit areas; the glare on the screen can cause eye strain.
• Avoid using a device in a dark room. As the pupil expands to accommodate the darkness, the brightness of the screen can aggravate after-images and cause discomfort.
• Put down the device 30 to 60 minutes before bedtime. Blue light may disrupt sleep. For your procrastinating teens, switch to “night mode” or a similar mode to reduce blue light exposure.

Lastly, ophthalmologists should urge parents to ensure their children spend some time outside. Increased computer use and other near work activities could drive an epidemic of nearsightedness in children. While this is not yet proven, several studies suggest that spending time outdoors, especially in early childhood, can slow the progression of nearsightedness.