In the year I turned sweet 16, I became a four-eyed teen. Fast forward to this day, my teen son started needing glasses at age 11. I\u2019ve noticed more kids are wearing glasses at a younger age today.\u00a0 I think our modern lifestyles of exposing our children to lots of screen time these days is largely to blame.\u00a0I\u2019m one of those mothers who\u2019s guilty of allowing my kids to have screen time as a way to keep them occupied while I tend to something. Or when I\u2019m simply trying to have an uninterrupted meal! I Started To Get Concerned When\u2026 During the MCO period, my kids were on the computer and smartphone a lot more than usual, due to all the online classes. I noticed my younger one rubbed his eyes more often and at one point had more eye boogers than usual. This worried me, as he\u2019s just eight. A very young age to start developing vision problems! I need some expert advice on how to prevent myopia in children. So, I decided to get sound eye health advice from a professional in her field, Dr Malisa Ami. She\u2019s an ophthalmologist at Sunway Specialist Centre Damansara. Image credit: Dr Malisa Ami Dr Malisa is an eye Doctor and Surgeon with special interests in Cataract, Children's Eye Health and Squint. She\u2019s passionate in increasing awareness on eye health and improving vision for all. Read our Q&A, and be properly guided to take better care of our children\u2019s eye health to safeguard them from vision and other related health issues. I have benefited from her detailed sharing. How Excessive Screen Time Affects Children's Eye Health Q1: Dr Malisa, how does screen time affect vision and health in general? Excessive and prolonged near work has been shown to be linked with the development of childhood short-sightedness, which is termed as myopia.\u00a0Examples of near work include reading, intensive studying and screen time. I often tell the children in my clinic that if they spend too much time on their mobile phone or digital pad, then they will spend less time playing outdoors. Studies have shown that sun exposure and playing outdoors have a protective effect on myopia and its progression.\u00a0 Children who spend more time indoors have a higher risk of developing myopia. If one or both parents are myopic, this risk is even higher. Besides needing glasses to see clearly, being inactive will also weaken their body muscles. In addition, exposure to screen time before bedtime can disrupt the sleep pattern and cause poorer sleep quality. Other harmful effects of excessive screen time are strabismus and accommodative spasm. Strabismus, or what some may term as a squint, is an abnormal alignment of the eyes. The eyes are not straight where one eye can be turned inwards towards the nose or outwards. Accommodative spasm, on the other hand, occurs when the eyes\u2019 focusing muscles are unable to relax after a prolonged period of near work or screen time. This causes \u201cpseudomyopia\u201d. It is a condition where the eyes cannot relax to see far objects and will need cycloplegic eye drops to relieve the spasm. Q2: Once they are myopic, do their conditions get worse as they grow? Image credit: Ketut Subiyanto from Pexels Yes, the younger a child is diagnosed with myopia, and the higher the initial power, the more likely that the child will become highly myopic by the time they reach their teens.\u00a0 \u00a0 Myopia increases as the eyeball length increase with the child\u2019s growth. This usually stabilises when the eyeball stops growing at around 18-20 years of age. It is important to slow down the progression of myopia and prevent it from reaching over\u00a0-6.00D power to prevent the complications of high myopia. If one has high myopia, it can cause eye problems when they become adults. For example, the retina, which is the nerve lining inside the eye, can tear and become detached. This requires urgent eye surgery to preserve the eyesight.\u00a0 Another concern is myopic maculopathy, where the most sensitive part of the retina, termed as the macula, becomes thinned out and causes extremely poor vision.\u00a0 Unfortunately, myopic maculopathy cannot be reversed or cured. These conditions can rob them of their good eyesight and may affect their ability to drive or work in the future.\u00a0 The good thing is that there are now treatments and preventive measures that can slow down myopia. These include special eyedrops, outdoor play, reducing screen time and taking eye breaks during near work. Measures To Prevent Myopia In Children Image credit: Lisa Fotios from Pexels Q3: Speaking of reducing screen time, how much screen time is acceptable? Based on the World Health Organisation guidelines, children under two years old should not be given any screen time at all. Those aged two to four years old should be restricted to no more than one hour of screen time, and less is certainly better.\u00a0 This aims to not only preserve eye health but also improve physical and mental health as well as prevent obesity and related diseases later in life. For children aged five years and above, I would advice no more than 1.5 hours (but less is better) of screen time a day. This should be lessened if the child exhibits irritability, addictive behaviour or has a negative impact on the child\u2019s educational and sleep requirements. Q4: You mentioned taking eye breaks during near work. Can you tell me more about it? Certainly! Parents, caregivers and teachers can take these simple steps to minimise or reduce the risk of myopia and eye strain in children (they are useful tips for adults too!): \tTake frequent eye breaks. Follow the 20-20-20 rule \u2013 for every 20 minutes of screen time, take a break for 20 seconds by looking at something far, i.e. 20 feet away. Set a timer to 20-minute intervals to remind them to take breaks. \tMaintain adequate viewing distance from the screen. This is 50 cm for laptops and computers, 40 cm for mobile phones and 30 cm when reading a book. \tKeep a good posture \u2013 Children should be sitting up straight when viewing the screen. Avoid head tilting, slouching over the computer or resting their head on their hands whilst watching. \tKeep the brightness of the screen adequate enough for viewing but not too bright. Avoid reflections on the screen as this causes glare and tires the eyes. \tEnlarge the screen to make viewing easier and to avoid eye strain. \tRemind them to blink whilst watching. This redistributes the tear film over the eye surface, prevents dry eyes and lessens eye strain. More Qualified Advice On Myopia From Dr Malisa The above Q&A session that I had with Dr Malisa has been insightful and full of useful tips that we can apply right away. She has more insightful tips and information to share, but we will keep that coming in Part Two. In the meantime, you may want to read more about this topic in a previous story. For now, let\u2019s digest and put her advice to good use with our children. To learn more on how to prevent myopia in children, stay tuned for the next instalment of more eye health advice from the good doctor.