The Myopia Pandemic Accelerating in the COVID-19 Era

Many more children are now showing myopia that progressed over just a few months (that is, their vision got worse in a short time).

“The effects of increased digital device use on children’s eyes during the coronavirus pandemic”

Papers on this topic keep being published from all over the world.

The Myopia Pandemic Accelerating in the COVID-19 Era

Digital Screen Time During COVID-19 Pandemic: Risk for a Further Myopia Boom?
Digital Screen Time During the COVID-19 Pandemic: Risk for a Further “Myopia Boom”?¹
American Journal of Ophthalmology 2020

Mitigate the effects of home confinement on children during the COVID-19 outbreak
Mitigating the Various Adverse Effects of Increased Time at Home on Children During the COVID-19 Outbreak²
The Lancet 2020

COVID‐19, sweat, tears… and myopia?
COVID-19, Sweat and Tears… and Myopia?³
Clinical and Experimental Optometry 2020

The direct effects of the virus on the eyes (conjunctivitis, anterior uveitis, retinitis, optic neuritis) also matter.

More serious than that, however, is that during lockdowns and stay-at-home periods, the use of digital devices has grown longer,
and their effect on eye health is becoming the greater concern.

Footprints the World Has Never Seen for Children’s Eye Health: COVID-19

I am introducing the following.

An Unprecedented Footprint of COVID-19 on Eye Health⁴
SSRN 2020

I also want to restate what you can do right now for your child’s eye health.

“The Indian Express”

During the COVID-19 crisis,
children’s screen time is rising with online classes, homework, games, television, and more.
With little chance to play outdoors, screen time keeps increasing.

It is estimated that by 2050, 50% of the world’s population will be myopic.

It is also known that myopia increases with more than 2 hours of digital device use or television viewing.

Becoming absorbed in digital devices
• speech problems
• attention deficits
• depression
• communication difficulties, and more

is a recognized concern.

“The Nutrition Insights”

Screen time is increasing because of home confinement due to COVID-19.
Lockdowns and home isolation to prevent infection: as screen time rises, damage to the eyes keeps growing.

Education, work, and entertainment in virtual spaces have reached levels never seen before.

“The Conversation”

The increase in screen time caused by the coronavirus pandemic is a serious matter for children’s eyes.
With lessons moved online at home, children spend more time in front of computer screens.
During the infectious disease crisis, time spent playing outdoors has decreased.
Both the rise in screen time and the drop in outdoor play put children’s eyes at risk of myopia progression.

As myopia progresses, it can lead to serious eye disease in the future. Sometimes it can lead to blindness.

The number of people with myopia is increasing worldwide.
Among children aged 6 to 10, about 40% in Western countries and even more in Asia are already myopic.

“The World Health Organisation”

During this pandemic, children’s eyes need good care.
Digital device use: we recommend no more than 1 hour for children 5 and under, and none at all for those 1 and under.

“The Children Eye Foundation”

1. Vision should be checked regularly throughout childhood.
   
2. By 4 months of age, it is desirable for both eyes to be aligned straight ahead (no strabismus or phoria).
   
3. On sunny days, wear a hat and sunglasses (ones that block UVA and UVB).
   
4. Children should not play with laser pointers.
   
5. Children 5 and under in particular should spend as little time as possible on digital screens.
   
6. Detecting a decline in a child’s vision early affects the child’s whole life.
   Eye damage that cannot be reversed is important to prevent.
   
7. To prevent myopia (difficulty seeing in the distance), children should play outdoors every day whenever possible.
   
8. If there is an eye infection (such as infectious conjunctivitis), the child must stay home from school until the discharge has stopped.
   
9. If your eyes feel itchy, it may be allergic conjunctivitis.
   
10. Your eyes and your vision are worth protecting.
    For play and activities that could injure the eyes, wear protective eyewear to protect them.

• Under 2 years = no screen time (no digital devices)
• Ages 2 to 5 = 1 to 2 hours a day (with plenty of free play)
• Ages 5 and over = guide screen time and build in frequent breaks

are recommended.

What the World’s Leading Experts Say

1. Vision screening should be done at regular intervals throughout childhood.
2. By 4 months of age, babies should have straight eyes.
3. Children should wear a hat and sunglasses (with UVA and UVB protection) when it is sunny.
4. Children should not play with laser pointers.
5. Time spent on screens should be minimized as much as possible, especially in children under age 5.
   • Under the age of 2 = no screen time
   • 2-5 years old = 1–2 hr/day (more unstructured play)
   • Over the age of 5, screen time should be guided and include frequent breaks
6. Early detection of vision problems in children is important to potentially prevent irreversible visual issues that can affect the child for his/her entire life.
7. To help avoid becoming nearsighted (trouble seeing far away), children should play outdoors every day when possible.
8. If an eye is infected, the child should stay out of school until there is no longer discharge.
9. If an eye feels itchy, an allergy may be present.
10. Your eyes, your vision, are a gift. Protect them by wearing safety glasses at play and activities that have an increased incidence of eye injury.

“The American Academy of Ophthalmology”

For parents and teachers of children, we recommend the following:
• After looking at something up close for about 20 minutes, take a 20-second break
• Use a timer to take breaks effectively
• Keep digital devices 18 to 24 inches (45 to 60 cm) away

The “20-20-20 rule” and other things you can do for children’s eye health

The 20-20-20 rule

After looking at something up close for about 20 minutes, look at something far away (20 feet, about 5 to 6 meters) for 20 seconds.

Setting up Screen Time

Use Screen Time on your iPhone, iPad, and iPod touch (Apple)

With Screen Time, you can see real-time reports of how you spend your time on your iPhone, iPad, and iPod touch, and set limits on the things you want to manage.

Play that can reduce digital device use

Table tennis, badminton, board games, chess, shogi, and more

These can be expected to improve mental and physical health⁴。

References

1. WONG, C., TSAI, A., Jonas, J., Ohno-Matsui, K., CHEN, J., ANG, M., TING, D. (2020). Digital Screen Time During COVID-19 Pandemic: Risk for a Further Myopia Boom? American Journal of Ophthalmology https://dx.doi.org/10.1016/j.ajo.2020.07.034

2. Wang, G., Zhang, Y., Zhao, J., Zhang, J., Jiang, F. (2020). Mitigate the effects of home confinement on children during the COVID-19 outbreak The Lancet 395(10228), 945-947. https://dx.doi.org/10.1016/s0140-6736(20)30547-x

3. Navel, V., Beze, S., Dutheil, F. (2020). COVID‐19, sweat, tears… and myopia? Clinical and Experimental Optometry 103(4), 555-555. https://dx.doi.org/10.1111/cxo.13086

4. Goswami, S. (2020). An Unprecedented Footprint of COVID-19 on Eye Health SSRN Electronic Journal https://dx.doi.org/10.2139/ssrn.3635322