The month of August is dedicated to saving children from eye injury and vision loss. Amidst the age group of 3 - 5, 1 in 20 children will suffer vision problems. Many a time eye injury is caused by playing or doing some physical activity. Care must be taken by wearing protective eyewear. This month we should start taking precautions as the pandemic has switched everything for online. The increased screen time is responsible for many eye concerns. We at Medicircle are observing Children’s Eye Health Safety Awareness, wherein we discuss different issues plaguing children’s vision. 

Dr. Rajeev Jain is the principal surgeon of ‘Save Sight Centre’ in Delhi. He has completed his MBBS from Maulana Azad Medical College. In 2007, he was appointed as a clinical lecturer at Australia’s University of Adelaide. He wrote his thesis in Age-related macular degeneration or AMD.

How to have Healthy Eyes despite Higher Screen Time

He answers, “I remember there was a time where our principal told us to stop the kids from using screens. Now the same person requests us to tell the kids to use screen time wisely. Things that we as parents should keep in mind is that this is not going to end. Kids are without a doubt going to use screens either for their studies or for games. We can’t stop them but we can teach them to effectively navigate this. We all know the Rule of 20. After 20 mins in front of the screen, you need to look for 20 seconds at anything 20 feet away. We do this because once in front of the screen our blink rate decreases. On average our blink rate is 15 - 16 times but in front of screens, it is 4 - 5 times per minute. This causes our eyes to go dry and increases Tear Film abnormality. Another thing is the bigger the size of the screen the lesser the strain on the eyes. The kids should also not sit in darkness while using the screens. A well-lit room causes less strain. Also, many devices come with Night-mode so the kids should use that. This night mode will not help with eye strain but help by maintaining sleep.” 

Can one’s spectacles go away?

He declares, “Having spectacles is not a disease. Earlier hardly 2 -3 students had glasses. Nowadays more than 90% have glasses. The reason behind this is because a lot of the activities are done on screen, like reading or playing. Time spent on screen is the stimulus for myopia especially for kids between ages 4 to 8. What we as parents can do is ask our kids to play outdoors instead of increasing their screentime with video games. As everything is digital, maybe in another 5 - 10 years every kid will have specs. Once you get spectacles, especially minus numbers, then that will never go away. Some kids develop plus numbers at age 4 - 6, so their number can go away as the eyeball grows till age 6 - 8. The minus number will increase in all most all cases. And this number growth will stop till they turn teenagers. Only in 10% of the cases their minus number keeps growing even after they have reached age 18 - 20.”

What are the protective measures?

He explains, “Genetics cannot be controlled when it comes to transferring susceptible eye genes from parents to children. But many reliable studies claim that there are only a few things that can be controlled when it comes to this. The first is the environment. Allow the kids to play outside to reduce screentime. Getting good exposure to sunlight also reduces their chances of getting glasses. Try and reduce any near sight activity.”

When do glasses become necessary 

He advises, “We can divide children based on their age. In group one there are children of age 1 - 3, who can’t say that they are having bad sight. Here, the parent would have to gather information indirectly. For instance, if your kid is standing close to the TV, the reason could be that he/she cannot see the screen properly. The other indicator is when the kid is squinting. If the baby cannot navigate without bumping into things then he may have bad vision. Also, the parent should check whether there are any white flecks in the middle of the eyeball which could be a tumor or a cataract. The parent should give the child a routine checkup at the age of five.”

How can one get good eyesight? 

He says, “A healthy lifestyle is a must. Have healthy food, a balanced diet. Colourful fruits and vegetables have vitamins in them that help us get good eyesight. Get adequate sunlight. Getting supplementary vitamin D is not enough. One also needs physical activity. If going out and playing is not important then do yoga, exercise or just take a walk. All this not only helps our body but also our eyes. One should also avoid near vision activities. This includes both books and screens. With this adequate sleep is a must.”

Blurred Eye Problem

Explaining cross-eyed or lazy eye problems, he tells, "Refractive error is when one gets numbers for specs. One can get plus numbers meaning hypermetropia or negative numbers that is myopia. The third problem is astigmatism. This results in either positive or negative numbers. All these are refractive errors. Our eyes function exactly like a camera. In the front, there is a cornea that makes an image on the back, on the retina. When there is a refractive error, the image forms not on the retina. It either forms before or after the retina. By using spectacles we are helping it create the image properly on the retina."

Adding to it, "The crossed eye is when the person's eye is titled. This could be temporary or permanent. This can be called squint or crossed eyes. The other is Amblyopia or lazy eye. Here one eye has a number and the other one doesn't. At around age 9, our brain and eye connection become mature. Since the eye has a number the image is not forming properly on the retina. If there are no glasses at that time then the brain makes the decision that this eye is weak or lazy. But if specs are administered beforehand then the connection between brain and eye will be strong. That is why we insist on getting a checkup at age 5 to make the connection strong. At this stage, we can cure most cases of lazy eye."

Advice for Parents

He recommends, "Please talk to your kids. Whenever you get time, have a conversation with your kid. The kids may not open up but the conversation will give them an idea to look for the right signs. Advise them how to lower screen time."

(Edited by Priyal Shah)