Pediatric eye health and digital media: adverse effects

Research on the excessive use of digital media finds that pediatric vision suffers adverse effects

Pediatric eye health is important in all aspects of a child’s life and development. Not simply represented by clarity, vision is a functional system that, when operating at its best, is flexible and efficient.

Sight is a primary sensory input that influences a child’s learning, development, behavior and endurance, and is biologically unsuitable for the excessive demands of the digital culture in which children find themselves.

Families today face the challenges of managing a digital media assault in their lives. Digital media includes a child interfacing with television content, mobile phones, tablets, computers, etc.

The digital media devices and the technology they provide have many benefits, including the expansion of communication tools, easy and immediate access to information, and the ability to accommodate both our children’s strengths and challenges.

As with all things, the benefits of technology are outweighed by the risks.

Current exposure to digital media has a profound effect on children. We have never had a generation of babies and toddlers with such heightened visual demands and sensory stimuli caused by the cell phones and tablets they interact with on a daily basis.

The excess demands experienced by children of all ages creates a fatigued visual system unable to function efficiently.

Common Sense Media Research reported in 2021 that the use of entertainment media alone approached 9 hours a day in teens and 6 hours a day in teens.1 For both preteens and teens, on-screen media use has increased by 17% since the start of the pandemic.1 These statistics are astounding and often lead to parents feeling helpless and out of control when dealing with the habits of screen time and their children.

Excessive use of digital media has also been shown to risk addiction in children. Device addiction, social media addiction and gambling addiction are very real and serious consequences that are seen in the pediatric population.

In 2018, the World Health Organization added a gambling disorder to the international classification of diseases.2 MRI studies reveal that gaming and smartphone addictions change the physical structure of the brain in a way that parallels drug and gaming additions.

Related: (VIDEO) The negative effects of digital media on pediatric development

Effect of Screen Time on Visual Efficiency

As optometrists, we know that the power of the accommodative (focus) system depends on age. Excessive use of this system without adequate visual hygiene wears down the strength and endurance of the housing.

Today’s optometric practices diagnose many patients with accommodative insufficiency due to a world driven by excessive digital demands. These excessive demands closely reveal significantly reduced accommodative clinical outcomes, including reduced and variable visual acuity and detection of low amounts of contrary-to-the-rule astigmatism.

Recognizing these clinical findings, in addition to the asthenopia, headaches and fatigue that accompany accommodative problems, is critical to properly treating our patients.

In addition to the accommodative system, we see inherent stress placed on the binocular vision system. The development of binocular vision begins in the brain, and there are valid neurological concerns that screen-based activity stimulates visual processing more heavily than even sensory processing systems, thus disrupting the development of binocular vision.

In our practices, we see binocular vision dysfunctions in the form of excess convergence and insufficient convergence that are affected by the excessive screen time of today’s youth.

A close viewing distance when looking at digital devices also affects the onslaught of visual symptoms.

Clinical studies reveal that the close viewing distance that often accompanies the use of portable digital devices becomes even closer with prolonged use.3 One of the main complaints of parents who take young children for an eye exam is the observation of how close the child sees a mobile phone or tablet.

The closer the viewing distance, accompanied by overuse, the more likely it is to increase diagnoses of accommodative and binocular vision problems and accompanying visual symptoms.

Several treatment options are available for accommodative and binocular vision problems. Reading glasses and bifocal lenses are prescribed to support the visual systems and aim to reduce the patient’s visual symptoms. Vision therapy is another treatment option for accommodative and binocular vision problems, aimed at improving the efficiency of all aspects of visual function.

It is known that the progression of myopia is influenced by genetic and environmental factors, but digital media also influence the progression of the development of myopia.

Today’s emphasis on treating myopia, with the goal of minimizing progression, forces an optometrist to examine our patients’ screen time habits. We know that there are modifiable behaviors that influence the development of myopia.

Scientific research shows that increased outdoor exposure positively affects the development of myopia.4 The exact cause of this is not fully understood, but outdoor weather is likely to help limit close requests and will have a more positive impact on the visual system.

One January 2021 JAMA the article shares, “Home imprisonment due to coronavirus disease [in] 2019 appeared to be associated with a substantial myopic change in children. “5 This observation demonstrates the effect of excessive screen time on the development of myopia.

Effect of time on the screen on the development of the child

In addition to affecting a child’s visual system, digital media also have a significant impact on the overall development of our pediatric population.

We know that early exposure to digital media negatively affects a child’s intellectual, social and emotional development. The high use of digital media translates more specifically into a decrease in cognitive and linguistic abilities. Furthermore, the way children use digital media has a strong correlation with their mental health.

Quality of sleep

One area to look into is the influence of technology on sleep quality among young people.

In the Journal of clinical sleep medicineit was noted that “adolescent poor sleep quality was consistently associated with cell phone use and the number of devices in the bedroom, while in preteens, Internet use and shutdown time.”6

Children and adolescents with devices in the bedroom experience reduced sleep duration, increased daytime sleepiness, and reduced school performance. Bad sleep habits align with further problems in the mental health realm.

Unhealthy online habits lead to a high incidence of diagnoses of anxiety, depression and hyperactivity. Structural changes in the brain related to cognitive control and emotional regulation are associated with an addiction to digital media.7 Neurological changes detected with digital media addictions are clinically related to drug behavior addiction patterns.

The path of excessive and unhealthy use of digital media can lead to mental health problems and addiction in our teenage population. This is a path that every family wants to avoid.

Establish boundaries

The best way to achieve balance in your family regarding the use of digital media is to develop rules and boundaries. Each family can strive to create a system that works for them.

The use of digital media can be classified into three categories, known as the “3 Cs of media”:

1. Consumption: Assumption of means in a passive manner
2. Creation: active involvement and skills development
3. Communication: Using media to connect with another person

A balanced approach to digital media limits consumption and communication to 1-2 hours a day. However, it is clear that schools rely heavily on digital devices in their educational model, and this contributes to the stress on the visual system and the impact on development.

Parents need to focus on what they can control and create a home environment that supports the benefits of technology and balances screen time in a way that has a positive effect on all aspects of their child’s life.

Like Catherine Steiner-Adair, EdD, author of The big disconnectsays, “Parenting in the digital age challenges in ways that the human brain, AND the heart, can hardly process fast enough. We don’t want to indisputably give up to adapt to technology.”

Valerie M. Kattouf, OD, FAAO, is an associate professor at Illinois College of Optometry where she teaches classroom and clinic, works with residents, and conducts clinical research. After graduating from Illinois College of Optometry, Kattouf completed a residency in Pediatrics and Binocular Vision at the State University of New York Optometric Center. She has years of clinical experience in the areas of vision care for infants and young children, strabismus and amblyopia, concussion and binocular vision disorders in adults. Kattouf is currently the head of the Lewenson Pediatrics and Binocular Vision Center at the Illinois Eye Institute. She is a member of the American Academy of Optometry and the College of Optometrists in Visual Development which she teaches nationally and internationally. She can be contacted at: [email protected] or (312) 949-7279.
  1. Two years after the start of the pandemic, media use has increased by 17% among preteens and teens. Common sense media. March 23, 2022. Accessed August 12, 2022. – adolescents
  2. Inclusion of “play disturbance” in the ICD-11. World Health Organization. September 14, 2018. Accessed August 12, 2022.
  3. Long J, Cheung R, Duong S, Paynter R, Asper L. Viewing distance and eyestrain symptoms with prolonged smartphone viewing. Clin Exp Optom. 2017; 100 (2): 133-137. doi: 10.1111 / cxo.12453
  4. Lingham G, Mackey DA, Lucas R, Yazar S. How does spending time outdoors protect against myopia? A review. Br. J Oftalmolo. 2020; 104 (5): 593-599. doi: 10.1136 / bjophthalmol-2019-314675
  5. Wang J, Li Y, Musch DC, et al. Progression of myopia in school-aged children after COVID-19 home confinement. JAMA Ophthalmol. 2021; 139 (3): 293-300. doi: 10.1001 / jamaoftalmol.2020.6239
  6. Bruni O, Sette S, Fontanesi L, Baiocco R, Laghi F, Baumgartner E. Use of technology and sleep quality in pre-adolescence and adolescence. JClin Sleep Med. 2015; 11 (12): 1433-1441. Published December 15, 2015. doi: 10.5664 / jcsm.5282
  7. Lissak G. Adverse Physiological and Psychological Effects of Screen Time on Children and Adolescents: Literature Review and Case Study. Res. environment. 2018; 164: 149-157. doi: 10.1016 / j.envres.2018.01.015

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