Screen Time

Everything in Moderation

Is There A Problem? Yes!

The science is pretty clear about screens and computers.

It can be bad if used too much. Excessive computer and screen use has been shown to be associated with a greater risk of developing short-sightedness, as well as with increased symptoms of eyestrain, headaches, blurred vision, dry eyes, and neck and shoulder pain, due to our eyes focusing and aiming close-up for very long periods.

Most studies on the effects of screen time in children indicate that the odds of visual symptoms increase after 2–4 hours of use [1]. Reading from electronic devices requires more effort and is more fatiguing than from hard copy such as books[2, 3].

Recommendations

NOTE: Recommendations are for recreational screen time. Exposure for school, studies and work should also be considered carefully

0 - 2 Years

Exposure - None

None, with the possible exception of live video-chatting (e.g., Skype, Facetime) with parental support, due to its potential for social development.

2 - 5 Years

Exposure - 1 hour per day or less

Programming should be age-appropriate, educational, high- quality, and co-viewed, and should be discussed with the child to provide context and help them apply what they are seeing to their 3-dimensional real-world environment. Excessive screen time before the age of 5 may cause delays in development, cognitive delays and poorer academic performance [3]

Screens & Short Sight

Children who spend more time outdoors are less likely to be, or to become short-sighted (myopic), irrespective of how much near work they do, or whether their parents are myopic [4].

Outdoor time has a significant protective effect against developing some types of myopia [5].

Increased study time of more than 2.5 hours per day can increase the risk of myopia [6] [7]

Half of children and youths exceed the public health screen time recommendation of 2 h per day or less [8].

5 - 18 Years

Exposure - 2 hours per day or less

Ideally recreational screen time should be limited. Individual screen time plans for children between the ages of 5–18 years should be considered based on their development and needs.

Tips for Screens

ACBO recommends the following guidelines to help prevent vision and other problems from excessive screen use:

Encourage moderation in near vision screen time

Studies show that children who spend more than 2 hours a day on screens, and less than 1 ½ hours outdoors, are more likely to become shortsighted. Consider reducing your own screen time as an example to your children.

Ensure Good Posture

Your child’s posture and working distance are so important as they grow, and device should be no closer than the distance to your elbow. Never read lying on your stomach, as the viewing distance will be much closer[i]. Excessive, extremely close smartphone use can cause severe eye coordination problems

Change Focus

When reading an electronic document or book, encourage your children to look up and away as they turn the page.

Take A Break

When using screens, have a short break at least every hour.

Avoid using computer, phones or tablets outside or in brightly lit areas, as the lighting and glare differences can create strain.

Consider Lighting

Take Care in Cars

Limit the use of computers, phones or tablets while traveling in a car – use the opportunity to look further away, play games and enjoy your surroundings.

Not Too Bright

Adjust the brightness of the device your child is using for the light and circumstances.

Use a Clock or Timer

Remind them to take a break. We recommend looking away every 20 minutes of continuous near focusing, and a physical break every hour for children under the age of 9 years of age.

Distract

Create a distraction that causes your child to look up every now and then. Interrupt them with (healthy) snacks occasionally.

Stop Screen Use 1 Hour Before Bed

Studies show that screen use just before bed can increase the risk of a child failing to fall asleep and staying asleep [9].

References

1. Coles-Brennan C et al. Management of digital eyestrain. Clinical & Experimental Optometry 2019;102:18-29

2. Hue JE, et al. Reading from electronic devices versus hardcopy text. Work 2014;47:303-7.

3. Madigan S, Browne D, Racine N, Mori C, Tough S. Association Between Screen Time and Children’s Performance on a Developmental Screening Test. Journal of the American Medical Association - Pediatrics. Published online January 28, 2019. doi:10.1001/jamapediatrics.2018.5056

4. Xiong S, Sankaridurg P, Naduvilath T, Zang J, Zou H, Zhu J, Lv M, He X, Xu X. Time spent in outdoor activities in relation to myopia prevention and control: a meta-analysis and systematic review

5. Huang HM, Chang DS, Wu PC. The Association between Near Work Activities and Myopia in Children-A Systematic Review and Meta-analysis. PLoS One. 2015 Oct 20;10(10):e0140419. doi: 10.1371/journal.pone.0140419

6. Po-Wen Ku et al The Associations between Near Visual Activity and Incident Myopia in Children - A Nationwide 4-Year Follow-up Study. Ophthalmology. 2018 Jun 19. pii: S0161-6420(17)33464-4. doi: 10.1016/j.ophtha.2018.05.010.

7. Gopinath B et al. Influence of physical activity and screen time on the retinal microvasculature in young children. Arterioscler Thromb Vasc Biol. 2011 May;31(5):1233-9. doi: 10.1161/ATVBAHA.110.219451.

8. Saunders TJ, Vallance JK. Screen Time and Health Indicators Among Children and Youth: Current Evidence, Limitations and Future Directions. Appl Health Econ Health Policy. 2017 Jun;15(3):323-331. doi: 10.1007/s40258-016-0289-3.

9 Cheung, C. H. M. et al. Daily touchscreen use in infants and toddlers is associated with reduced sleep and delayed sleep onset. Sci Rep 2017;7:

Behavioural Optometry

Evidence-based practice is a important principle for ACBO Member optometrists. They undertake rigorous and extensive post=graduate training and consider the latest in research and evidence from the leaders in the fields of optometry and medicine.