As more children get prescription glasses due to quarantine myopia, experts share eye care tips

Kids use screens for academics and entertainment

Last March, when schools went online overnight, little did Vile Parle resident Niral Satra know that her six-year-old son Shaurya would start wearing glasses in due time. By March this year, she noticed him squinting while watching TV and during online school. When they consulted an ophthalmologist, the Satras learnt that their boy required vision correction.

In a similar case for Santacruz-based Seema Vadiwala, her eight-year-old was finding it difficult to read a signboard at the doctor's clinic, and hence was tested. The world over, 2020 was declared as the year of quarantine myopia. According to studies from The Netherlands and China, as a result of Covid-19 restrictions, myopia has increased drastically, especially in children between the ages of six and eight. In this age group, visual acuity shifted by a substantial 0.3 diopters towards myopia, an eye disease that leads to poor vision at a distance, while the near vision is clear. Severe myopia can lead to eye disorders and diseases such as cataracts, macular degeneration and glaucoma, leading to blindness. It is caused due to both genetic and environmental reasons.

Niral Satra ‘s son Shaurya now spends time in the outdoors, playing and riding his bicycle

Vision woes

With a second academic year in virtual classrooms, Dr Vandana Jain, regional head, Dr Agarwal Eye Hospital, says, "I would extend that age 14 because we are seeing an increase in the number of cases of those who already have glasses and the numbers are increasing even with new cases. We see about 50 cases per week; however, this number is not representative of the actual problem because the overall number of patients that come to the hospital for non-urgent cases has decreased dramatically. Parents are worried about bringing children to the hospital these days because everyone is worried that the third wave is going to impact children"

Dr Neepa Thacker Dave, consultant paediatric ophthalmologist and strabismologist, SRCC's Children's Hospital, says, "We are seeing an increase in myopia in Indian children in two forms. There is new myopia in children who did not have refractive error earlier and second is increase in myopia (numbers) in children who were already myopic. The rate of increase or progression was higher than previously documented for the same child." The hospital has initiated a study to assess the exact percentage of increase but on an average, the new myopia cases are now six out of 10 versus an earlier number of three out of 10."

Dr Vandana Jain

The reasons are straightforward: children are spending more time at home using the online medium to attend classes, do homework and engage in entertainment like games, chatting with friends, and watching videos. She adds, "The factors we think contribute to this increase is due to this increased indoor time, lack of outdoor time in sunlit hours and increased ‘near activity' from screen use' this has been happening since the pandemic began." Dr Jain adds, "The eyes elongate when they are focused on items that are near - such as computer monitors, tablets or smartphones - children are doing this for longer duration while studying virtually at home. Due to no outdoor time with friends, they are socialising on these same screens. Due to this scenario, where the eyes are able to look at a distance, the chances of myopia development or progression increases tremendously. Since it is a progressive eye disease, it is best to get the child's vision tested as soon as possible."

Set the rules

While prescription glasses would be required for vision correction, Dr Dave believes it's important to set some rules for screens and reading. "The bigger the screen, the better it is because the bigger the device, the further away you can sit from the screen: so TV is better than the laptop, better than the cellphone. Mobile phones for young children are a strict no-no. Ideally for school work, we recommend a middle-level screen like a desktop or laptop that can be kept an arms' length away. We discourage the use of small screens like mobile phones and iPads. Children need some recreation after long school hours so we suggest a break from screens for a few hours." She also suggests using screens in a well-lit, preferably naturally lit room. "The position of the screen should be in such a way that each time the child looks up from the screen, he looks at an empty room or out of the window versus a table which faces the wall. Distance viewing relaxes the eye muscles." Satra has reduced her son's online activities to a bare minimum of school time and one hour of virtual play. Weather-permitting, she takes her son down for cycling and makes sure that he gets enough physical outdoor activity.

Eating a well-balanced diet rich in vitamin A is imperative. Dr Dave recommends "Anything that is green and orange in colour naturally - carrots, papayas, beetroot, mangoes, green leafy vegetables and nuts must be consumed daily." In addition, Satra makes her son wear rose water-soaked cotton eye-pads and cucumber disc pads for a couple of minutes a day. "Even though there is no link to it in correcting numbers, as long as it relaxes the eye muscles for a while, it's worth it. Also, since it is difficult to make kids drink carrot or leafy vegetable juice, I disguise the veggies in their meals so that they get the right nutrition," Satra signs off.

The 20-20 rule for reading

Avoid reading books on Kindle and insist that children read physical books in a well-lit room with natural light. Take frequent breaks. After every 20 to 25 minutes, make children take a break or walk around for a bit. For screens, the 20-20 rule states that for every 20 minutes, look away for 20 seconds (or more).

Spot the signs
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