Attention to Children's Eye Health in Online Education

Remote online education has made it inevitable for children to spend long hours in front of screens. Drawing attention to proper screen use, the Turkish Ophthalmological Society warned that prolonged periods in front of screens can cause digital eye strain in children and rapid increases in myopia. Emphasizing that eyes are most strained by smartphones, the society called for adherence to the 20-20-20 rule and stepping away from screens during class breaks. The Turkish Ophthalmological Society, representing Turkish eye doctors, pointed out that in the new digital-focused education period, the most important task for parents regarding eye health is to manage children's screen use consciously. According to Prof. Dr. Nazan Bengüdeniz, Head of the Strabismus Unit at the Turkish Ophthalmological Society (TOS), prolonged screen time has become a common cause of digital eye strain and rapid increases in myopia in recent years. However, noting that "it is neither possible nor necessary to keep children completely away from screens, as they need digital skills," Bengüdeniz shared the effects of intensive screen use and what precautions should be taken.

Do screens damage vision?

Prof. Dr. Nazan Bengüdeniz pointed out that among screens, smartphones are the devices that strain the eyes the most, stating: "Looking at a very small screen from very close for prolonged periods, focusing intensely, can trigger myopia, astigmatism, and even strabismus in predisposed children. Since smartphones have been used for long periods by children, we can observe various forms of eye strabismus in children. In recent years, the age of myopia onset has dropped significantly. For this reason, children must definitely be kept away from smartphones."

Television is the safest option

The Head of the TOS Strabismus Unit, who said "tablets and computers are relatively less tiring than phones, provided they are not approached closer than 45 cm. But if conditions permit, using a television screen at a distance is the safest option," stated: "There is no research showing that television causes vision problems when viewed from a distance. In this regard, cause-and-effect relationships are usually misinterpreted. Children's vision does not deteriorate because they approach the television; in most cases, due to myopia or astigmatism, they approach the television because their eyes cannot see distant objects clearly."

Hyperopic children

Prof. Dr. Nazan Bengüdeniz said the situation is different in hyperopic children. Bengüdeniz stated: "In children with good near and distance vision, parents may think their child's eyes are healthy. However, eye examinations in these children sometimes reveal hidden hyperopia that can only be detected through dilated examination. Hyperopic children can see both near and distance well, but especially to see near objects clearly, they must use accommodation through eye muscles, which can lead to earlier fatigue compared to children without refractive errors, headaches, reluctance to work and read, and concentration problems. For this reason, children should undergo eye examinations and, when necessary, be prescribed glasses to increase their comfort in front of screens," Bengüdeniz concluded.

Reduced blinking causes dry eyes

Prof. Bengüdeniz, who noted that "dry eye is actually rare in children," stated that prolonged screen time reduces the blink rate in children, causing dryness and related symptoms such as redness, burning, foreign body sensation, itching, and blinking, and can even create conditions for tics. Bengüdeniz said: "In these cases, eye examination should be performed, the ocular surface should be evaluated, and appropriate treatment should be started if there is any additional pathology."

Computer screen should be at eye level

Prof. Bengüdeniz, who advised that "if a computer screen is used, care should be taken that it is not above eye level, as this position causes the palpebral fissure to widen due to the upward gaze position, leading to more dry eye," stated: "In today's world where prolonged periods in front of screens are unavoidable, when these complaints appear, support through artificial tears will provide some relief to the eyes." The 20-20-20 rule for eye health Regarding screen time and eye rest, the Head of the TOS Strabismus Unit stated: "After 20 minutes of screen work, during breaks, eyes should be rested with an activity that does not require near focus. For example, during class breaks, children should not leave the screen and switch to their mobile phones or turn to computer games. For screen use outside online classes, the universally accepted duration worldwide is the 20-20-20 rule. That is, every 20 minutes, one should look at something 20 feet or 6 meters away or farther for 20 seconds." Lighting and daylight are very important Prof. Bengüdeniz noted that larger screens should be preferred from as far a distance as possible, and that room lighting should be compatible with screen brightness. Bengüdeniz said: "During class breaks, children should be directed to activities away from screens. Recent studies show that viewing daylight for 1.5-2 hours per day slows the progression of myopia. For this reason, outside of class hours, children should be directed to outdoor activities."