COVID-19 Resource Center
COVID-19 Resource Center
Source/Disclosures
Source:

References:

Argilés M, et al. Invest Ophthalmol Vis Sci. 2015;doi:10.1167/iovs.15-16967.

Lawrence AC, et al. JAMA Pediatrics. 2020;doi:10.1001/jamapediatrics.2020.0129.

Madigan S, et al. JAMA Pediatrics. 2019;doi:10.1001/jamapediatrics.2018.5056.

Twengea JM, Campbell WK. Prev Med Rep. 2018;doi:10.1016/j.pmedr.2018.10.003.

Disclosures: No products or companies that would require financial disclosure are mentioned in this article.
May 01, 2020
4 min read
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Optometrists warn about digital eye strain during COVID-19 quarantine

Source/Disclosures
Source:

References:

Argilés M, et al. Invest Ophthalmol Vis Sci. 2015;doi:10.1167/iovs.15-16967.

Lawrence AC, et al. JAMA Pediatrics. 2020;doi:10.1001/jamapediatrics.2020.0129.

Madigan S, et al. JAMA Pediatrics. 2019;doi:10.1001/jamapediatrics.2018.5056.

Twengea JM, Campbell WK. Prev Med Rep. 2018;doi:10.1016/j.pmedr.2018.10.003.

Disclosures: No products or companies that would require financial disclosure are mentioned in this article.
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One of the most important ways to reduce the potential spread of COVID-19 is to remain at home and minimize physical proximity. This, however, has led to an increased use of digital devices and screen time for both work and recreation, which may lead to an increase in eye strain or other ocular complications.

Jonathan Andrews, OD
Jonathan Andrews

“During this time of social distancing and stay-at-home orders, it is important for us as eye health physicians to keep the big picture in mind,” Jonathan Andrews, OD, of Optometric Associates, New Holland, Pa., told Primary Care Optometry News. “The much-needed rest and relaxation that this pandemic is forcing upon all of us could easily be taken away by nonhygienic digital device practices. We must continue to educate and interact with our patients now more than ever.”

Andrews explained that, as many people are sitting at home doing indoor work and watching over their children, blue and violet light emitted from high-energy visible (HEV) light spectrum devices can disrupt normal circadian rhythm circles.

“It is important to refrain from using digital devices within 2 hours of bedtime,” he said. “Doing this enables our bodies to secrete the normal levels of melatonin from the pineal gland. Melatonin is an important hormone for our circadian rhythms and is disrupted by HEV light.”

He also emphasized that outdoor time and direct contact with sunlight is helpful for the synthesis of vitamin D, and more than 2 hours of average UV exposure is helpful in the reduction of myopia progression.

“It is well known that prolonged near work and decreased outdoor activities can increase myopic progression in children,” Andrews said.

Quote from Glen T. Steele, OD, FCOVD, FAAO
From Glen T. Steele, OD, FCOVD, FAAO: "With the pandemic, all kids have for communication is through screens ... It's important for parents to help kids learn to take breaks for the future of their vision."

Increased time on digital devices and near work with screens can be even more dangerous for children than adults, according to Glen T. Steele, OD, FCOVD, FAAO, from the Southern College of Optometry in Memphis, Tenn.

“For an adult with eye strain, we will most of the time get up and move around. Children will push on through that,” Steele said. “Now with the pandemic, all kids have for communication is through screens. I think there are things beyond eye strain that we have to watch out for, one of which is helping kids regulate when do they take breaks. It’s important for parents to help kids learn to take breaks for the future of their vision.”

Steele said recent findings (Lawrence et al.) showed that children had worse self-regulating skills regarding digital screen and media devices regardless of family income or race and ethnicity. Additionally, children as young as 2 years old who spent significant time on digital devices showed developmental delays within a year (Madigan et al.).

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“During this time, there are parents who may use devices as a babysitter because they have work they need to get done, too,” he said. “This is a generation that grew up with easy access to digital devices. They’re using them for schoolwork, for social interaction. We really have to watch this carefully. It’s important for optometrists to be at the table for this.”

With this “new norm” for children, the Vision Impact Institute and the Cooper Institute collaborated to provide parents with healthy tips to incorporate into a child’s day, they announced in a press release.

These tips include:

  • Take a break from digital devices or other near work, such as the 20/20/20 rule of looking away from the screen every 20 minutes and focusing on an object at least 20 feet away for at least 20 seconds.
  • Ensure the child maintains an appropriate distance from the screen, using the 1/2/10 rule — mobile phones ideally 1 foot, desktop devices and laptops at 2 feet, and TV screens at roughly 10 feet depending on the size of the screen.
  • Designate a “sleep time” for screens, with most experts recommending between 5 p.m. and 7 p.m.
  • Encourage movement, physical activity and time spent outdoors within the bounds of quarantine recommendations.
  • Create a family media plan, including the adults regulating time spent using digital devices.
Thomas Aller, OD, FBCLA
Thomas Aller

Thomas Aller, OD, FBCLA, who practices in San Bruno, Calif., and specializes in myopia control, also mentioned that recent data (Argilés et al.) showed a relationship between hours of near work on digital devices and symptoms included in the broad category of eye strain, including a reduction in blink frequency and incomplete blinking.

“Since working at home likely will involve digital devices, probably to greater degrees than at work (with no breaks to talk to fellow humans), there may be more dry eyes from remote work,” Aller said. “The other interactions might involve lower quality equipment at home, worse lighting, worse ergonomics, etc. So, remote work may just not be as comfortable.”

Andrews noted that being online is still a great option to keep in touch with patients.

“During this unprecedented time of social distancing, how are you communicating with your patients?” he said. “It is important to stay in front of your patients. Give them useful tools to best use this time safely and efficiently while practicing good digital eye health. Social media platforms are extremely useful to reach out to your patients on a personal level.” – by Talitha Bennett

References:

Argilés M, et al. Invest Ophthalmol Vis Sci. 2015;doi:10.1167/iovs.15-16967.

Lawrence AC, et al. JAMA Pediatrics. 2020;doi:10.1001/jamapediatrics.2020.0129.

Madigan S, et al. JAMA Pediatrics. 2019;doi:10.1001/jamapediatrics.2018.5056.

Twengea JM, Campbell WK. Prev Med Rep. 2018;doi:10.1016/j.pmedr.2018.10.003.

Disclosure: No products or companies that would require financial disclosure are mentioned in this article.