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  • How the COVID-19 Lockdown Changed Children's Eyes

    Reviewed By K. David Epley, MD
    Published Jul. 02, 2021

    Some ophthalmologists around the country are noticing a spike in children’s vision problems as Americans emerge from the COVID-19 pandemic.

    When schools closed down and switched to distance learning in early 2020, many young students stayed indoors and spent longer than ever staring at screens up close. In a recent parent survey, 70% of mothers and fathers reported that their kids spend at least four hours a day on electronic devices.

    Many children use devices around the clock for both school and play. This, combined with delayed vision screenings during the pandemic, has created a heap of issues for children’s eyesight.

    Here are some common problems eye doctors are reporting as children catch up on their pediatrician and eye clinic appointments. Find out what parents should watch for and how everyone can help get kids’ eyes back on track.

    Distance Learning and Nearsightedness (Myopia)

    Eye doctors in some states have suggested a possible uptick in new cases of nearsightedness, or myopia. What’s more, some children who were already nearsighted now seem to experience worsening vision at a faster-than-expected rate. China also reported a possible rise in myopia cases after COVID-19.

    Children who spend long hours engaged in close-up work such as reading or writing may be more prone to myopia, some studies suggest. By keeping children indoors, the pandemic also limited one factor thought to lower the risk of myopia: time outside.

    Symptoms of myopia include squinting, rubbing eyes frequently and complaining of blurry vision. It’s important to watch for the signs because kids often adapt to vision changes and may not complain.

    Preventing or keeping myopia from progressing is important because the condition can lead to more serious eye problems later in life, such as cataracts and glaucoma. Their performance in school can also start to decline.

    Screen Time Increased Eye Strain, Dry Eye and Headaches

    Dry eye and headaches are common side effects of staring at phones, laptops and tablets for long periods of time. When children and adults use digital devices, we tend to slow down our blinking, preventing moisture from lubricating the surface of our eyes.

    Symptoms of strain include eyes that feel tired, achy or dry.

    Dry eye can show up as frequent blinking, irritation in and around the eyes, blurry vision, or even tearing excessively. Headaches caused by eye strain tend to be felt in front of the head or around the eyes, and most often come on toward the end of the day. A few changes to your daily routine may help alleviate dry, achy eyes.

    Many Children Stopped Wearing Eyeglasses During COVID-19

    A number of children stopped wearing their eyeglasses for near or distance vision during the pandemic.

    Some broke their glasses and didn't replace them. Other families tried to order replacement lenses online, but weren't able to find the correct power. Sometimes, glasses ordered online just didn't fit well.

    Early childhood is the most critical time for a child's vision development. Blurry vision can prevent the visual system from developing properly, leading to permanent problems later in life. That’s why it’s essential that children get back on track with their glasses.

    Getting Lazy About Amblyopia Treatments

    Some children with lazy eye, or amblyopia, stopped using their eye patches or special eyeglasses during COVID-19. As the pandemic wore on, many families missed appointments.

    Without regular follow-up with an ophthalmologist, many of these children lost the progress they'd made before COVID-19. Resuming treatment, including patching, eyeglasses and regular appointments, is key to treating lazy eye.

    Some Eyes Lost Alignment

    Ophthalmologists are noticing more problems in children who have strabismus, or misaligned eyes. Kids seem to have less control of eyes that turn inward and/or outward, and misaligned eyes are “drifting” more visibly. Doctors aren’t exactly sure of the cause, but believe these changes could be related to eye fatigue and prolonged time looking at screens up close. These children likely need adjustments in lens strength to accommodate for the additional misalignment they’re experiencing.

    Getting Kids' Eyes Back on Track After the Pandemic

    Pediatric ophthalmologist David Epley, MD, prioritizes three things when he talks to parents about optimizing kids’ eye health during the pandemic:

    • Use bigger screens and position them farther away from children's eyes. A monitor placed at arm’s length from the head is better than a phone or tablet held close to the face. Avoid using digital devices while lying down or reclining, which can cause neck and back aches, and can bring screens too close to children's eyes.

    • Follow the 20-20-20 rule. Take breaks every 20 minutes, shifting eyes to look at an object at least 20 feet away for at least 20 seconds.
    • Get outside for at least an hour per day. Exercise gives children’s eyes a break from digital devices. It’s a chance to focus on different distances and be in the sunlight.

    A growing body of research supports the link between time spent outdoors and lowered risk for myopia.

    “It can be a pain to police screen use, so use rules and games to help kids give their eyes a break," Dr. Epley says.

    "Have kids get up and run a circuit of all the rooms in the house in between virtual classes. Or ask them to look outside the window, find five objects and write them down. Consider tracking these eye breaks with a chart or setting up a reward system. Alarms and timers are great tools to help busy families keep up with these healthy intermissions."

    Other strategies to help prevent eye problems include:

    • Blink often to keep eyes moist. Put a sticky note on kids’ digital screens to remind them to blink.

    • Adjust screen brightness to match the level of light in the room. Increasing the screen contrast to help reduce eye strain.
    • Limit blue light at night, which can make it harder for children to fall asleep. Turning off devices one hour before bedtime also may help.
    • Visit an ophthalmologist. Good vision is key to a child’s physical development, success in school, and overall well-being. Don’t skip regular vision screenings. If you see any signs of impairment or suspect vision problems in your child, find an ophthalmologist right away.