Katherine Korakakis says the English Montreal School Board first started hearing from parents about their children’s deteriorating eyesight during the pandemic.
“Around May of 2021, we were getting calls and emails from parents about the uptick of children’s prescriptions,” said Korakakis, who is chair of the board, which oversees more than 35,000 students in English schools across Montreal.
“What we’ve heard is children didn’t have glasses, then they got glasses, or children that had glasses have gotten progressively worse.”
Many parents attributed the vision changes to the increased time their children were spending on screens due to the shift to online learning.
Experts say emerging data bears these concerns out, which means kids are at increased risk of developing serious eye diseases as they age.
“Across the world, there’s actually been an increase where by the age of like, 18 to 19 … 96 per cent of [some countries’] kids are actually myopic,” said Dr. Stephanie Dotchin, a pediatric and adult ophthalmologist based in Calgary.
“We’re not that high in Canada, but we’re definitely seeing more and more kids become myopic,” she said, referring to the eye condition that causes faraway objects to look blurry. Dotchin says that in her own practice it is no longer unusual to see preschool children — some as young as three — with myopia.
The likely culprit is that kids spend an excessive amount of time indoors looking at something much too close to their eyes, says Dr. Martin Spiro, president of the Canadian Association of Optometrists.
“Over the years, prevalence of the condition has increased and shifted towards developing earlier in life,” he said. “Currently, it is common to see signs of myopia in children as young as seven or eight.”
Studies are still ongoing on whether screens cause myopia, he says. “The evidence relating to whether it is a screen itself, versus anything else, is not yet conclusive. We will know more later.”
What is known is that, more than ever before, children are spending a lot of time looking at screens. Almost all Canadian children have access to a screen — a phone, iPad, TV — by age two. In 2019, just a little more than half of kids aged five to 17 spent less than the recommended two hours a day on a screen.
In the short term, children with myopia could have a harder time seeing their lessons at the front of the class, potentially compromising their academic performance.
In the long term, myopia causes the eye to elongate — like a “squashed beach ball,” says Dotchin — leading the eye tissues to stretch and thin. The condition can cause a myriad of other health problems as an adult.
These can include cataracts, where the eye lens becomes cloudy, or glaucoma, where a group of eye diseases damage the eye nerve.
Myopia can increase the risk of the retina detaching from blood vessels. It can also lead to a severe form of myopia, myopic maculopathy. Both conditions can lead to vision loss.
Any treatment can only slow down further eye damage; there is no cure for myopia.
Lifestyle matters
Worsening eye vision among children was an issue pre-Covid. A 2018 study found the prevalence of myopia in Canadian children aged six to eight was six per cent, but as high as 29 per cent in those aged 11 to 13.
Data suggests this trend has not abated since the pandemic.
Quebec is the only province to provide eye evaluations of preschool children in public schools, through a program called École de la Vue. Since 2019, the program has evaluated 80 per cent of children entering the province’s schools.
Annually, 35 per cent of the children in the program have a detected eye issue and are referred to an optometrist for a full eye exam, said Steeve Lachance, executive director at the Fondation des maladies de l’œil, the eye research organization that participates in the initiative. This number has stayed roughly steady since they began testing, he says.
Many parents worry screen time is causing more eyesight issues in children, says Dotchin. Medical professionals are hesitant to say there is a definite link between the two without more studies. But research does show that any work done near the face, such as going on a phone or reading, can increase the risk of developing myopia.
Parents keen on mitigating the risk of vision problems in their children should pay attention to their lifestyles. The most important factor is getting enough time outdoors, even during the winter, said Spiro.
“One of the top recommendations that we as optometrists give to school-aged children or younger is get outside, ideally, one to two hours every day,” he said.
Many children prefer to stay inside and play online. To decrease the chances of developing an eye issue, any hand-held screen should be held away from the face by a distance of the child’s own finger to their elbow.
Children should also take regular breaks after 30 to 45 minutes, look out a window and focus on something in the distance, said Spiro.
It can be hard for parents to know whether their child has vision problems, because children tend to assume that if they can’t see well, all children can’t see well, says Spiro.
“What we know is that children, especially at a younger age, will tend to normalize things,” he said. The child will think “it’s normal not to see from the back of the class, it’s only normal to see from the front of the class.”
Children rarely complain to their parents about vision issues. This makes early and regular eye examinations essential, says Dotchin.
Parents should also watch for frequent eye rubbing, squinting or head tilting when looking at objects. Frequent headaches and fatigue are also signs of vision problems.
“They may notice a wandering eye, so the eye may look in a different direction. They may be kind of crossed in towards their nose or they might wander out towards their ear,” said Dotchin.
Parents are not the only ones worried about how screen time is affecting kids’ vision. School staff also worry about its effects, says Jim Daskalakis, who is retiring as principal at Montreal’s St. Gabriel Elementary School after 43 years in education.
Finding the right balance between using screens for educational purposes and fun can be difficult, and parents need to lead the way.
“Parents first of all have to realize themselves that they shouldn’t be on these devices as much as they should, because the kids mimic them,” he said.
