“Don’t read in the dark”
“Don’t sit so close to the TV”
“Take a break from the iPhone”
With each generation, we add more things that children can focus on in the “near distance” category. And with every generation comes an increase in kids that suffer from myopia, aka. Near-sightedness.
But at the same time, we get data that says being too close to something is not directly correlated to worsening eyesight over time. There are several potential pathways of causality:
Long periods of near work without a visual break > Eye Strain > Increased Myopia
Long periods of near work without a visual break > Eye Strain
Long periods of near work without a visual > Increased Myopia
Available studies deliver unclear and sometimes conflicting results as to which causality is the ‘truth’, but trend towards supporting a causality between already present risk factors of myopia being exacerbated by eye strain resulting in an increase of myopic severity.
So it is not the act of reading in the dark, or sitting to close to a device that is inherently troublesome, but the increased eye strain that those behaviors tend to cause in most individuals. And this is not a new phenomenon. An 1884 article wrote,
“Within the past ten or twelve years, numerous examinations of the eyes of school children (between six and sixteen years) were made in every country of the civilized world; and whether the reports come from Germany or France, from England or Russia, from Switzerland or our own country, all the statistics prove that there is more or less near sightedness in every nation, and that the percentage of near sighted pupils increases in all countries (in some countries at a frightful rate), from the lower to the higher grades in each school, and from the common schools to the high schools and colleges. On the other hand, it is a fact that near-sighted eyes are not found among the uncivilized races… Myopia, therefore, is in a certain sense the logical result, the inevitable evil, of our civilization, and will exist as long as this lasts.” (1)
1880’s racism aside, it’s the same trend we see in modern studies around digital eye strain (DES). According to the AOA, DES can occur after just two hours of continuous digital device usage. And a 2022 comprehensive literature review wrote,
“With the lockdown restrictions during the COVID-19 pandemic, outdoor activities were restricted for all age groups, and digital learning became the norm for almost 2 years. Hence, digital device usage increased throughout the world, exacerbating DES symptoms. DES prevalence amongst children alone rose to 50–60% in the COVID-19 era… One of the most significant ocular health complications of the COVID-19 pandemic has been new-onset myopia and the increased progression of existing myopia due to excessive near work. The prevalence of myopia has been nearly 50% in the COVID era, with accelerated progression from 0.3D in pre-COVID to 1D in the COVID era. This influence on myopic progression has been maximum in the age group of 6–8 years”. (2)
So, here we are, 120 years after it was written that “All these eyes could be saved by a little care and attention. We should see that our children do not read too long; we should see that they do not read by insufficient light, and we should see that they do not approximate the book too much… Children have a natural tendency to hold small objects unnecessarily near their eyes. This tendency is the principal source of danger for eyes disposed to become near-sighted, and parents and teachers cannot be too careful lest this tendency to approximate the book grows into a bad and dangerous habit.” And the answer is still the same!
Keep your devices at a distance, take frequent breaks, get outside when you can, and generally follow any and all advice given by your trusted medical professionals to reduce eye strain whenever possible.
Even Apple is getting on board with helping in the effort! With the latest updates, there’s a new feature called “Screen Distance”. Everybody should turn this on, but especially if the device is going to be frequently used by anyone under 18. Below is a summary of how to enable this feature on an iPhone.
1. Navigate to Settings
2. Navigate to Screen Time
3. Navigate to Screen Distance
4. Toggle On
Video of enabling the feature:
At the end of the day, while the causation between increased near work and increased eye strain and increased myopia has yet to be documented in a study, there are enough correlation studies that can verifiably conclude that near work is associated with an increased risk of high myopia that doing your part to decrease eye strain in everyday life can not only save you from the symptoms of eye strain, but decrease your risk of developing worsening eyesight.
Also, a general reminder that if your current contact lens feels as if it is increasing eye strain, talk to your eye doctor about switching brands. Different brands work differently for different people, that’s why they’re there! Don’t be afraid to try them all and see what works best for you.
If you have daily lenses you can always come grab one of our handy DailyLens organizers to keep track of your lenses and live a simpler, healthy life.
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