How the Covid-19 pandemic led to the negative impact of children’s vision

Remember those lockdown days spent confined to homes and away from friends? Even if those times feel far away now, they've left a mark on our lives, especially on kids. Something all parents may have failed to notice is the impact of the pandemic on children’s eyes. Let's explore the pandemic’s negative impact on children’s vision.

As the world grappled with the problems that arose with COVID-19, children were more vulnerable to its effects. This public health emergency may have caused some children to show inhibited behavioural problems such as feeling lost or dazed, doing less in their daily activities, avoiding communication with others, and being lazy in their personal life. Most importantly, the routines of our youngest generation were upended, a perfect storm of factors responsible for the negative impact of children’s vision.

From increased screen-time due to schools shifting their education systems online to social-distance and the enforcement of lockdowns affecting their playtime, the effects of the pandemic on children’s eyesight, although subtle at the start, have now laid deeper influences on their eye health. That is why, it is important to examine the situation of pediatric eye health after a pandemic, by understanding the different ways in which it has affected children from seeing the world clearly.¹

India is the second most populated country in the world, with around 41% of its population (492 million) being less than 18-years of age. The young generation is an important asset for the nation’s development, and their problems need to be addressed in time. One important clinical condition which has created an uproar in the rest of the world is myopia, also known as nearsightedness.² According to a study, the prevalence of myopia increased from 1.4 to 3 times in 2020 (the year of the COVID-19 pandemic) as compared to the previous 5 years.³ The effect of pandemic on children’s eyesight could be attributed to several factors:

Screen-time overload

With the human population largely confined indoors to maintain social distance, digital gadgets had become an indispensable part of daily lives. Few studies have suggested up to a 100% increase in screen time for children who attend classes online.⁴ This occurred due to schools transitioning to remote learning and social interactions moving online. Children found themselves immersed in digital devices for hours on end, engaging in online classes, entertainment, gaming, and video chatting with friends and family. Notably, online entertainment services have reported 82% increase in screen time spent daily.⁴

According to the Indian Academy of Pediatrics, screen time for children between the age of 5 and 10 years should not exceed 2 hours, inclusive of recreational screen time and time spent to complete educational and extra-curricular assignments.⁵ However, the pandemic pushed these limits to the extreme, by surpassing these guidelines due to increased usage for online learning, entertainment, and socializing.⁶

It should be noted that the negative impact of children’s vision can result from the extended use of screens that strain the eyes, causing various issues like discomfort, tearing, tiredness, burning sensation, headaches, blurred vision, redness, squinting, double vision, dryness, or foreign body sensation.⁴

Not enough fun in the sun

Remember the joy of your child's laughter echoing in the park or the shared giggles during playdates before the Covid-19 Pandemic? Lockdowns and social distancing had turned those joyous moments into distant memories. However, outdoor play isn't just about fun; it has been a vital ingredient for healthy eyes. This is because daily 120 minutes of outdoor sunlight exposure can help slow down the progression of myopia significantly.⁷

Although the pandemic did not cause vision-related issues like myopia directly, the associated home quarantine and online schooling notably affected myopia progression. With parks closed, and outdoor spaces restricted, children were denied this crucial element for their visual health- outdoor time. The consequence? Increased myopia risk among children, a trend associated with the negative effect of children’s vision, especially when they step into adulthood.

Moreover, some were increasingly experiencing what is called 'Quarantine myopia', developed during the COVID-19 home quarantine. Reduced time spent outdoors, increased near work and increased time spent on electronic gadgets and online learning are some of the contributing factors that indicate negative impact on children’s vision.⁸

Delayed doctor visits and its consequences

Another concerning aspect of the impact of pandemic on children's eyes is the delayed detection of eye-related issues. Routine eye check-ups became a casualty of the lockdowns, with many parents postponing non-essential medical visits to reduce the risk of exposure to the virus. While hospitals and clinics largely shifted online through teleconsultation the realm of eye care did not see this shift due to a lack of facilities and infrastructure to conduct online eye exams for children. This delay in seeking eye care may have resulted in vision problems going unaddressed, potentially leading to more severe issues down the line.

The Way Forward

As we navigate this post-pandemic landscape, it is important to prioritize and address the negative impact of the pandemic on children's vision and overall eye health. Parents and educators must work collaboratively to strike a balance between the benefits of technology and the need for outdoor activities.

Balancing screen time with breaks, encouraging outdoor play even in limited spaces, and scheduling those overdue eye exams are steps towards nurturing their vision. Following the 20-20-20 rule i.e., after every 20 minutes of screen time, taking a twenty second break and focussing eyes on something 20 feet away will not only reduce stress on the eyes but will also help keep individual active.4

Though the current generation is fortunate enough to have connecting devices and technologies at hand, one should also be smart enough to use them judiciously and not just be tech-slaves. It is for the parents to give clear instructions regarding duration of screen time and abide by them, use parental controls and utilize the lessons learnt during lockdown to encourage communication and build a healthy relationship between them and their children.4

While we may have left the pandemic times in the past, its effects could still linger in the clear and bright future of our children. With a bit of attention and some simple changes, we can ensure that they go on to live freely in a world they see in the highest definition!

References:

1.Ye J. Pediatric mental and behavioral health in the period of quarantine and social distancing with COVID-19. JMIR pediatrics and parenting. 2020 Jul 28;3(2):e19867.

2.Pujari A, Modaboyina S, Agarwal D, Saluja G, Thangavel R, Rakheja V, Saxena R, Sharma N, Titiyal JS, Kumar A. Myopia in India. Clinical Ophthalmology. 2022 Jan 20:163-76.

3.Wang J, Li Y, Musch DC, et al. Progression of Myopia in School-Aged Children After COVID-19 Home Confinement. JAMA Ophthalmol. 2021;139(3):293–300.

4.Agarwal S, Bhartiya S, Mithal K, Shukla P, Dabas G. Increase in ocular problems during COVID-19 pandemic in school going children-a survey based study. Indian journal of ophthalmology. 2021 Mar;69(3):777.

5.Gupta P, et al. IAP Guideline Committee On Digital Wellness And Screen Time In Infants, Children, And Adolescents. Indian Academy of Pediatrics Guidelines on Screen Time and Digital Wellness in Infants, Children and Adolescents. Indian Pediatr. 2022 Mar 15;59(3):235-244.

6.Pasi R, Babu TA, Jamir L, Ravi KS. Screen-Based Media Use Among Children During the COVID-19 Pandemic. Indian Pediatr. 2022 Sep 15;59(9):718-719.

7.Ho CL, Wu WF, Liou YM. Dose–response relationship of outdoor exposure and myopia indicators: a systematic review and meta-analysis of various research methods. International journal of environmental research and public health. 2019 Jul;16(14):2595.

8.Kurupp AR, Raju A, Luthra G, Shahbaz M, Almatooq H, Foucambert P, Esbrand FD, Zafar S, Panthangi V, Khan S. The impact of the COVID-19 pandemic on myopia progression in children: a systematic review. Cureus. 2022 Aug 26;14(8).

FAQs:

Q) What are the problems with children during the pandemic?

Ans: As the world grappled with the problems that arose with COVID-19, children were more vulnerable to its effects. This public health emergency may have caused some children to show inhibited behavioural problems such as feeling lost or dazed, doing less in their daily activities, avoiding communication with others, and being lazy in their personal life. Most importantly, the routines of our youngest generation were upended, a perfect storm of factors responsible for negative impact on children’s vision.

Q) How does the pandemic affect children in India?

Ans: India is the second most populated country in the world, with around 41% of its population (492 million) being less than 18-years of age. The young generation is an important asset for the nation’s development, and their problems need to be addressed in time. One important clinical condition which has created an uproar in the rest of the world is myopia.

Q) In what ways are children affected by the Covid 19 pandemic?

Ans: As the world grappled with the problems that arose with COVID-19, children were more vulnerable to its effects. This public health emergency may have caused some children to show inhibited behavioural problems such as feeling lost or dazed, doing less in their daily activities, avoiding communication with others, and being lazy in their personal life. Most importantly, the routines of our youngest generation were upended, a perfect storm of factors responsible for negative impact on children’s vision.

Q) How COVID lockdown affect children?

Ans: As the world grappled with the problems that arose with COVID-19, children were more vulnerable to its effects. This public health emergency may have caused some children to show inhibited behavioural problems such as feeling lost or dazed, doing less in their daily activities, avoiding communication with others, and being lazy in their personal life. Most importantly, the routines of our youngest generation were upended, a perfect storm of factors responsible for negative impact on children’s vision.