According to a 2016 report from the American Academy of Pediatrics, 17% of children age 6 to 17 are exposed to six or more hours of digital media per day, and 36% use digital media for two to four hours a day. Those of us who are parents of young teens can provide evidence that our children seemingly never take their eyes off their phones.

Combine kids’ recreational screen time with classroom use (tablets, electronic whiteboards, and laptops are ubiquitous in many schools), and it becomes a lot of staring at screens. And it’s taking a toll on children’s eyes in terms of digital eye strain (DES).

According to The Vision Council’s 2017 report on DES, 56% of parents say their children experience symptoms of digital eye strain after only two hours of screen time. Here, two O.D.s share what’s happening in their exam rooms and their strategies for talking to young patients and their parents about protecting young eyes from DES.

DIGITAL EYES

“There are known issues that occur when being subjected to digital screens, and one of the top ones is productivity—your eyes get tired,” notes Linda Chous, O.D., owner of the kid-focused practice The Glasses Menagerie in Minneapolis. “Your accommodative muscles aren’t able to hold that focus for long periods of time.”

Thomas Gosling, O.D., owner of Optical Matters in Littleton, CO, says he is seeing an increase in DES symptoms in his young patients, most notably in blurred distance vision. “As the focusing system locks onto the near screen for long periods of time, the accommodation system locks up and blurs out the distance vision,” he says.

Also on the menu of symptoms he and Dr. Chous see in patients:

Headaches: Especially frontal and temporal.

Light Sensitivity: Especially at the end of the day, which can also affect night vision.

Reduced Concentration: The need to look away to give the accommodative system a rest will also result in breaking the child’s focus and concentration.

Eye Rubbing: Rubbing a stressed muscle feels good (but we know it’s not good for the eye).

Body Fatigue: By the end of the day the accommodative system is so tired that it feels good to just close the eyes.

Dry Eye: An ocular problem that usually doesn’t show up until later in life is now being exhibited in young patients, both O.D.s report. Blink rates are reduced when staring at screens, which decreases the amount of tear film produced and oils secreted (both are a young eye’s natural protection against dry eye).

Are our children more susceptible to DES than adults? Not necessarily, says Dr. Chous, but the cumulative effect of screen time is worthy of concern.

“They’re going to be exposed to this a lot longer than anybody else ever was,” she says, noting that kids today can start their digital screen exposure as young as age 2.

FAMILY MESSAGING

By now, questions about digital screen exposure should be on everyone’s lifestyle questionnaire that’s filled out during intake. That provides a jumping-off point to begin a conversation with parents about DES in the exam room.

“I invite the whole family into the exam room…it’s an educational time for everybody,” Dr. Chous says. “A lot of times parents just aren’t aware of how much their children are on their screens. They see them at home, but they’re not seeing them at school where they may be doing a lot of their work on an iPad or screen.”

Including the whole family in the discussion provides an opportunity to educate even emmetrope siblings about “smart” digital use (ergonomics, 20-20-20 rule, etc.) and suggest solutions such as plano eyewear with something like a Prevencia coating or BluTech lenses.