New Delhi: A warning by the World Health Organisation (WHO) that children’s screen time should be limited to one hour/day comes just as Indian doctors have been flagging a new health crisis: Children younger than six years old are increasingly reporting headaches and the primarily-adult condition of short-sightedness.
The culprit is easy to identify: Unbridled screen time, with parents of young children giving them easy access to devices such as smartphones and tablets for not just games, but things like nursery rhymes and bedtime stories that earlier generations learnt through books and audio tapes.
“Out of 100 children, at least six children — as young as three years old and up to six years — complain about having a headache,” said Dr Ashok Kumar Roy, an ophthalmologist at Fortis Hospital, Kolkata.
According to doctors, these headaches are later diagnosed as a sign of the vision condition ‘myopia’, or ‘short-sightedness’, which has been known to be common among adults but not young children.
Myopia is a refractive error, where light rays focus in front of the retina, but not on it, causing one’s vision to blur.
According to the website All About Vision, myopia occurs “when the eyeball is too long, relative to the focusing power of the cornea and lens of the eye… or the cornea and/or lens [are] too curved for the length of the eyeball”, or both.
Dr Aditi Dusaj, an eye specialist at Sri Balaji Action Medical Institute, Delhi, said she had been diagnosing myopia in two to three children every month.
“Headache is its first symptom. This particular condition is known as ‘accommodative myopia’, which develops due to the frequent accommodation of lens while the child is busy looking at a screen,” she added.
“The frequent accommodation — due to the movement of images on the mobile phone — causes the lens to become more convex and rays of light focus in front of the retina, causing myopia,” she said.
The trend is against the usual eye development pattern among younger children.
“Kids are generally diagnosed with hypermetropia — farsightedness — because their eyeballs are small. As the size of eyeball increases with time, their vision improves naturally,” said Dusaj.
Dr Vanuli Bajpai, an ophthalmologist at Manipal Hospitals in Dwarka, Delhi, echoed the concern, saying the prescription of eye medicines such as paediatric tear gels for dry eyes, irritation and red-eyes was becoming routine.
“I have gathered that parents hand over the mobile phone to their children as early as two years of age for entertainment purposes,” she said, before adding, “Medicines won’t work unless parents help children cut down their screen time.”
Teenagers at risk too
The proliferation of digital devices — for work and for entertainment — has spawned a condition called the computer vision syndrome (CVS), also referred to as ‘Digital Eye Strain’.
According to the American Optometric Association, a US-based organisation that represents thousands of optometrists, CVS includes a group of eye and vision-related problems that result from the prolonged use of computers, tablets, e-readers, and cell phones.
The association says the disorder is prevalent among working individuals in the US, where workers are estimated to spend, on average, seven hours a day on computers.
However, Indian doctors say that, apart from the working classes, they are increasingly diagnosing teenagers with CVS.
Dr Dusaj told ThePrint that she diagnosed at least one case every day where the age of the patient was between 13 and 19 years. Dr Bajpai said one out of every 10 consultations involving teens turned out to be a case of CVS.
Doctors at National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India’s premier centre for studying mental health and neurological conditions, said a similar trend was observed at its technology de-addiction clinic SHUT, or the Service for Healthy Use of Technology.
Dr Manoj Sharma, professor of clinical psychology at SHUT, said he consulted 8-10 teenagers per week against one-two till 2015.
“The age of these patients is anywhere between 11 and 20 years, and they watch screens for over seven to eight hours in a day,” he said.
“These children come to us from different parts of the country, especially Kolkata, Sikkim, Delhi and Rajasthan,” Sharma added.
However, Sharma said he usually dealt with teenagers, and not younger children. Explaining why, he added, “In early stages, parents don’t realise that their offer to give mobile phones or laptops to young children will turn into an addiction one day.
“When some symptoms occur at a younger age, they visit paediatricians and ophthalmologists. They come to us when the child is completely out of their control and suffering from more serious complications, including depression, poor academic performance, confidence issues, loss of appetite and disturbed sleep,” he told ThePrint.
WHO guidelines panic Indian parents
The WHO guidelines on screen time, released last week, sought to reinforce the years-old emphasis on physical activity for healthy growth among children.
“For those aged two years, sedentary screen time should be no more than one hour, less is better,” the United Nations health agency said in the release, also stating that the same rule would apply to children aged up to five years.
Screen time was not recommended at all for children aged one or younger, the WHO added.
According to the WHO, “the failure to meet current physical activity recommendations is responsible for more than 5 million deaths globally each year across all age groups”.
“Currently, over 23 per cent of adults and 80 per cent of adolescents are not sufficiently physically active,” it added.
After the release of the advisory, the Gurugram-based online mental health consultation platform, ePsyClinic, said several parents had approached them for help.
“We received 140 queries Wednesday from mothers of kids aged less than 18 months. The majority of mothers discussed how their kids were dependent on phone screens for even eating food,” said ePsyClinic CEO Shipra Dawar.
The portal also claimed to have received another 80 queries from parents of children aged between 18 months and five years who were concerned that “their children spend between 4-5 hours on the phone every day”.
In light of these queries, the portal has launched a half-hour session on “de-addiction strategies of screen time for kids” where doctors will counsel parents on helping their children grow physically and mentally fit.
More than a vision problem
Apart from mental and physical development, the dependence on sedentary forms of entertainment is also costing children progress on other benchmarks, say doctors.
“We measure the development of the child on the basis of four parameters — physical growth, mental growth, social personal behavioural development, and language skills,” said Dr Vikas Taneja, head of the paediatrics department at Manipal Hospitals, Dwarka, Delhi.
“Children these days are missing out on all four parameters,” he added.
According to Dr Satish Koul, head of the department and director, internal medicine, at Narayana Superspeciality Hospital, Gurugram, digital addiction is as bad as drug addiction.
“A study has found that screen-time addiction is similar to opium addiction,” he told ThePrint.
“It’s time for parents to send their children back to experience nature, traffic lights, birds and colours if we want our next generation to be fit and sound,” he added.
With increasing diagnoses of wrong standing and sitting postures, not-so-fine motor skills, poor communication skills and early onset of depression among children, doctors are advising parents to take their children back into the playgrounds.
Dr Sumita Saha, consultant paediatrician at Fortis Hospital in Anandapur, Kolkata, advises parents to play traditional games with their children, like marbles, cricket and football.
“It will help them develop physical balance, hand-eye coordination and keep them fit,” she said.
“Children’s motor skill development is getting compromised due to the decreased physical activity,” Saha added.