Experts call for reduced screen time as global myopia rates among children surge

Study shows that the number of cases increased 36 per cent from 2020 to 2023, with one in three under-18s now short-sighted

Online learning during the Covid-19 pandemic is said to have contributed to a surge in case of short-sightedness in children. Getty

One in three children are short-sighted, a major global study has found, prompting calls for health authorities and schools to take action to cut time spent in front of screens.

The report published in the British Journal of Ophthalmology projected global incidences of myopia to exceed 740 million by 2050. Researchers at Sun Yat-sen University, in Guangzhou, southern China, evaluated 276 studies that looked at two million cases of myopia in children living in 50 countries around the world.

Their analysis revealed a sharp increase in the number of cases, 36 per cent, from 2020 to 2023, compared with a 24 per cent increase from 1990-2000.

Myopia, a visual disorder affecting distance vision, has become one of the most common eye-related health issues seen in young people by ophthalmologists.

Although some diagnosis are hereditary, the majority are related to environmental and social factors, such as more time in front of screens at school, and at home.

The onset of the Covid-19 pandemic – when countries imposed lockdowns and screen time increased as pupils switched to remote learning – is believed to have exacerbated the problem.

“Recent concerns have been raised about the potential negative impact of prolonged lockdowns on eye health, specifically myopia,” the report stated. “This is due to the decrease in outdoor activities and increase in screen time that may result from extended periods of staying indoors.”

The study found myopia rates were far higher in Asian countries, including China and Singapore, where formal education begins at an earlier age.

“Conversely, African populations exhibit a lower prevalence of myopia, likely attributed to lower literacy rates and delayed initiation of formal education, typically occurring between the ages of 6 to 8 years for most children,” the report said.

Rise in eye health disorders

At RAK Hospital in Ras Al Khaimah, specialists at the eye clinic have observed an increase in cases with eye discomfort, fatigue, dry eyes, blurred vision, itching, in addition to shoulder and neck pain related to screen time.

Dr Archana Sood, specialist ophthalmologist and head of department at RAK Hospital, said steps could be taken to slow down progression of the condition.

“Progression of myopia can be slowed down by following the 20-20-20 rule, of frequent relaxing of focus and looking towards distance – preferably green trees,” she said.

“Blinking often and decreasing screen time as much as possible, especially for entertainment can also help.

“Up to 18 years of age, we use special relaxing eye drops called diluted atropine once at night for up to two years in indicated cases of rapidly progressive myopia.

“Since the end of Covid, things are better but still in schools we need to give feedback not to give too much digital homework and at least half of schoolwork should be on hard copy, rather than digital.”

Blinking patterns

Excess screen time obligates near vision for longer periods, decreasing normal blinking patterns, increasing the chance of developing myopia in younger children.

“Certainly more teenagers and young children than ever before are having to get glasses,” said Dr Julia Sempere Matarredona, a specialist in paediatric ophthalmology and glaucoma at Barraquer Eye Hospital in Dubai.

“The number of children aged between 13 and 16 who currently need glasses has doubled in the past 10 years.

“One of the main important vision problems we are facing currently, is the development of myopia in the teenager age due to the overusing of screens.”

The World Health Organisation recommends children and young people do not spend more than two hours a day in-front of screens outside of school hours, to maintain healthy vision.

Doctors encourage children to cut down the time watching tablets or phones, and to follow the simple rule of 20-20-20 rule of 20 minutes in screen and 20 seconds looking to 20 feet, with is around six meters, into the distance.

They also encourage the use of artificial tears, maintain a straight neck and back and avoid screen exposure and artificial blue light from devices for at least one hour before sleep.

“There are several studies that confirm that spending at least an hour a day outdoors reduces the development of myopia,” said Dr Matarredona.

“More than important, visual exams should be mandatory.

“These exams should include a complete study of the eye, measurement of maximum visual acuity with and without correction, refraction, pupil dilation for a complete study of the retina, optic nerve, and confirmation of graduation in children and young people, and this should be done at least annually.

“Corrective measures like glasses are completely effective, and often necessary. It should be inconceivable to have a child with visual problems and not treat them with corrective measures, in childhood and until the end of growth.”

Childhood vision

Globally, it's estimated the prevalence of myopia among 5 to 19 year olds will rise from 23 per cent in 2000 to 52 per cent by 2050, almost doubling the number of children needing corrective eyewear, according to a study published in the Journal of Ophthalmology.

This onset of myopia usually first occurs in children aged 6 to 9, with the earlier onset increasing the likelihood of high myopia, as the condition has more time to progress as vision develops.

Having a myopic parent increases a child’s chances of developing the condition by three times, and they are up to six times more likely to have the condition if both parents are diagnosed.

Without treatment, myopia can progressively worsen over time, impacting academic performance and quality of life. It also raises the risk of glaucoma, retinal detachment and myopic macular degeneration, potentially blinding conditions.

Eye tests

The gold standard for eye tests is to have children assess from the age of four. Effective screening can prevent causes of blindness, and correct visual impairments at an early age.

Blue light exposure from mobile devices and LED televisions can make it harder to focus, causing discomfort or eye strain.

“Digital devices have become an integral and unavoidable part of our daily lives, with most individuals spending 8-9 hours on average a day on screens for both work and entertainment,” said Dr Sood.

“We have also observed an increase in myopia among children over the past 2 to 3 years, likely due to changes in study patterns which started during the Covid-19 pandemic with the excessive use of mobile devices and tablets.

“I have also seen migraines, dizziness, and scrolling nausea triggered by increased use of digital devices, especially phones.”