Secondary Logo

Journal Logo

Letters to Editor

Tech-imprisonment in post-millennials

A boon or bane in the COVID-19 era?

Coutinho, Karobi Lahiri; Shirodkar, Sailie; Rathod, Anisha

Author Information
doi: 10.4103/ijo.IJO_2383_20
  • Free

Dear Editor,

Digital screen usage has become an integral part of our day-to-day activities, so much so that even children have not been spared. It has had a significant impact among on post-millennial generation, that is, Gen Z, which includes individuals born between the years 1995 and 2015, who are currently between 5 and 25 years old.[1] This is largely because the impetus on learning or information dissemination in COVID times through the seven lockdowns has been through digital means, using apps and many other portals for online classes. Blue light emission from these screens coupled with computer radiation has been widely believed to play a causative role in several eye-related disorders.

2.1 What is blue light?[23456]

Blue light is one of the colors of the visible spectrum with a short wavelength (between 415 and 455 nm) and higher amount of energy. Blue light exposure from these screens is much less than the amount of exposure from the sun. An exception to this is the Kindle Paperwhite, which is an array of four edge-mounted LED's that direct the light towards the surface of the electronic ink display rather than a backlight which shines into one's face.

Blue light has therefore been widely believed to be play a causative role in ocular disorders such as dry eye, cataract, age-related macular degeneration etc. Moreover, through its effects on the secretion of melatonin from the pineal gland, it is also thought to affect the human circadian cycle and induce sleep cycle disturbances.

2.2 Effects of excessive screen time on children's eyes[7]

On an average, a child between 8 and 18 years of age, indulges in screen time of greater than 10 h per day between school, online studies, projects and smart devices. This has been linked to social stunting and health-related issues due to lack of outdoor activities. Common among these are acute onset esotropia and computer vision syndrome, which is characterized by headache, eye strain, fatigue, blurring of vision for distance and severe dry eye. A study has demonstrated that preschoolers with more than 1–2 h of screen time have an eightfold increase in ADHD (Attention deficit hyperactivity disorder).

2.3 Recommendations for mindful use of digital screens[891011]

Although they have not established any fixed guidelines for the proper usage of digital screens, the American Academy of Ophthalmology has enlisted several suggestions for the same.

  1. For an ideal posture, the display should be approximately 25 inches away or at an arm's length, and held in a manner that one's gaze is directed downwards. Brightness and contrast should be adjusted to a comfortable level
  2. Matte screen filters can be used to reduce the glare from glass screens
  3. The 20/20/20 rule: The child should be advised to look up from screen every 20 min to look at an object 20 feet away for 20 s
  4. Dryness should be prevented by frequent use of artificial tears and humidity-controlled environments.
  5. Children should be reminded to blink frequently
  6. Glasses can be preferred over contact lenses to prevent dry eye
  7. Use of electronic devices before bed should be eliminated or minimized at least 1-2 hours before bedtime. Alternatively, night-time settings may be used to limit the exposure to blue light causing sleep disturbances
  8. The use of special eyewear for operating computers is not promoted by the Academy, as there is presently no evidence that radiation from digital screens can damage the child's eyes or developing visual system. Moreover, a recent study has also stated that blue-blocking glasses are no more effective than neutral filters in limiting the transmission of blue light.[12]

The following guidelines[131415] may be followed with respect to maximum screen time for children, with directives from the American Academy of Ophthalmology and World Health Organization.

  1. Under 18 months: No screen time
  2. 18-24 months: Minimal viewing and limited solo use
  3. Pre-schooler (3–5 years): Less than 1 hour per day
  4. Elementary school (6–10 years): 1–1.5 hour per day
  5. Middle school (11–13 years): Upto 2 hour per day.

Besides refractive correction and routine ophthalmic evaluation, certain eye exercises may also be prescribed. These include up-and-down, side-to-side, nose-to-thumb, eye shifting, eye tracking, eye writing, imaginary clock, flashlight following etc. Outdoor activities promote natural movements of the eye, hand-eye coordination, depth perception and eye tracking, thereby promoting the overall development of the visual system.

2.4 Role of blue light and electromagnetic radiation in eye strain[16]

A study by the National Library of Medicine found no measurable UVA or UVB radiation from computer monitors. Furthermore, the Radiation Protection Programme from the Massachusetts Institute of Technology summarizes the current research for computer monitoring saying, “There is no data to suggest a health risk from the exposure to electromagnetic fields associated with the use of monitors.”

Recommendations for parents on monitoring digital screen usage during the lockdown.

Parents can help in setting up a Family Media Plan, as recommended by the American Academy of Pediatrics.[171819] This can help in

  1. Customizing guidelines on screen time by creating a visual breakdown of the time spent on screens
  2. Ensuring that media use is in line with the family's values (e.g., Avoiding fast paced programs with distracting or violent content; encouraging educational or creative pursuits on screens)
  3. Determining screen-free zones and times (e.g., No screens during meals; switching off devices 2 hours before bedtime; outdoor use can be limited by packing a bag with small toys, crayons and paper to distract the child)
  4. Maintaining balance and ensuring that children get enough sleep and exercise.

The AAP also recommends discussing safe and respectful behavior online and offline with children. This includes cyberbullying, online predators, personal privacy and safety.

It is safe to conclude that digital screens have crept into our lives as an integral necessity, especially in lockdown times. It is keeping the cogwheels of the educational machinery active and well-oiled for online classes, continued medical education (CME) programs, meetings, media communication and work-from-home settings. This is the thread of communication, which links several events, and which keeps us abreast with information worldwide. Therefore, since it is an unavoidable commodity, one needs to set limits for usage and practice safety measures for a more comfortable, healthy existence and long-term associations with digital screens.

2.5 Financial support and sponsorship

Taparia Institute of Ophthalmology, Bombay Hospital Institute of Medical Sciences, Mumbai for all general and departmental help.

2.6 Conflicts of interest

There are no conflicts of interest.


Taparia Institute of Ophthalmology, Bombay Hospital Institute of Medical Sciences, Mumbai for all general and departmental help.


Boomers, Gen X, Gen Y, Gen Z Explained [Internet]. Kasasa. 2020 June 18. Available from: https://wwwkasasacom/articles/generations/gen-x-gen-y-gen-zLast cited on 2020 Jul 13
Zhao ZC, Zhou Y, Tan G, Li J. Research progress about the effect and prevention of blue light on eyes Int J Ophthalmol. 2018;11:1999–2003
Renard G, Leid J. The dangers of blue light: True story! J Fr Ophthalmol. 2016;39:483–8
Benedetto S, Drai-Zerbib V, Pedrotti M, Tissier G, Baccino T. E-readers and visual fatigue PLoS One. 2013;8:e83676
O'Connell F. Light Reading: How the Kindle Paperwhite Works [Internet] The New York Times. 2012Last accessed on 2020 July 13 Available from: https://archivenytimescom/wwwnytimescom/interactive/2012/12/26/technology/light-readinghtml
Boettner EA, Wolter JR. Transmission of the ocular media Invest Ophthalmol. 1962;1:776–83
Bhola R. The Effects of Too Much Screen Time on Children's Vision [Internet] CHOC Children's Blog. 2017 Available from: https://blogchocchildrensorg/effects-of-screen-time-on-childrens-vision/Last cited on 2020 Jul 13
Porter D. Blue Light and Digital Eye Strain [Internet] American Academy of Ophthalmology. 2020 Available from: https://wwwaaoorg/eye-health/tips-prevention/blue-light-digital-eye-strainLast cited on 2020 Jul 13
Gudgel D. Screen Use for Kids [Internet] American Academy of Ophthalmology. 2020 Available from: https://wwwaaoorg/eye-health/tips-prevention/screen-use-kidsLast cited on 2020 Jul 13
AAO News Releases. Protect Your Eyes From Too Much Screen Time [Internet] American Academy of Ophthalmology. 2019 Available from: https://wwwaaoorg/newsroom/news-releases/detail/protect-your-eyes-from-too-much-screen-timeLast cited on 2020 Jul 13
Tosini G, Ferguson I, Tsubota K. Effects of blue light on the circadian system and eye physiology Mol Vis. 2016;22:61–72
Palavets, Tatsiana BA, Rosenfield, Mark MC. Blue-blocking filters and digital eyestrain Optom Vis Sci. 2019;96:48–54
AAP News Room. Children and Media Tips from the American Academy of Pediatrics [Internet] American Academy of Pediatrics. 2018 Available from: https://wwwaaporg/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/Pages/Children-and-Media-TipsaspxLast cited on 2020 Jul 13
WHO News Room. To grow up healthy, children need to sit less and play more [Internet] World Health Organization 2019 April 24. Available from: https://wwwwhoint/news-room/detail/24-04-2019-to-grow-up-healthy-children-need-to-sit-less-and-play-moreLast cited on 2020 Jul 13
Marcoux H No more guessing: Screen time guidelines from toddlers to teenagers [Internet] Motherly. Available from: https://wwwmotherly/child/no-more-guessing-screen-time-guidelines-for-toddlers-to-teenagersLast cited on 2020 Jul 13
Vimont C Are Computer Glasses Worth It [Internet] American Academy of Ophthalmology 2017 April 27. Available from: https://wwwaaoorg/eye-health/tips-prevention/are-computer-glasses-worth-itLast cited on 2020 Jul 13
Korioth T. Family Media Plan helps parents set boundaries for kids [Internet] American Academy of Pediatrics 2016 October 21 Available from: https://wwwaappublicationsorg/news/2016/10/21/MediaParents102116Last cited on 2020 Jul 13
WHO News Room. To grow up healthy, children need to sit less and play more [Internet] World Health Organization 2019 April 24. Available from: https://wwwwhoint/news-room/detail/24-04-2019-to-grow-up-healthy-children-need-to-sit-less-and-play-moreLast cited on 2020 Jul 13
Radesky J, Christakis D. Media and young minds Pediatrics. 2016;138:e20162591
© 2020 Indian Journal of Ophthalmology | Published by Wolters Kluwer – Medknow