Ask the Pharmacist

Q) I have been getting a lot of pressure from my son to buy him a cell phone. He still feels kind of young to be getting one, but I am aware most of his friends already have one and I don’t want him missing out on connecting with them. I understand there are real concerns when it comes to what he may access online as well as the pros and cons of social media, but are there legitimate health concerns as well?

A) This question/decision is one that just every parent has faced over the last 25 years or so and I don’t believe the solution is getting any easier. We know far more about the positives and negatives to owning portable screen devices than we did in the early 2000’s but this has served to only make the decision seemingly more difficult.

I will leave all the mental health concerns and socialization benefits out of this article as that discussion could easily fill a month’s worth of articles and still not leave you any more certain as to which way to go when it comes to what’s best for your own child. But there are now some proven concerns that should be known when it comes to their “physical” health when considering this decision for your children.

There is a mountain of evidence that prolonged screen time is detrimental to the eyes of our youth. Studies have shown that the incidence of nearsightedness (also known as myopia) has nearly doubled since 1971 and the frequency continues to be on an upward trend. This condition occurs when the eye grows too long from front to back resulting in poor distance vision.

One study, published in 2021 found that high levels of small device screen time was associated with a 30% higher risk of myopia in both children and young adults. When combined with excessive computer use, the risk rose to around 80%. The reasons behind this are multiple, but one is the lack of exposure to natural daylight. Researchers believe that that the UV light from the sun (as long as the eyes are protected from intense sunlight) plays an important role in healthy eye development.

Beyond myopia, there is another common eye condition pediatricians see due to excessive screen time. It is called computer vision syndrome (CVS) or digital eye strain. It is believed that looking at a digital screen makes the eyes work harder than when they are performing other tasks and the result is a cascade of symptoms that can include:

· Dry eyes
· Tired eyes
· Fluctuating vision
· Headaches
· Back, shoulder and neck pain

This condition may be helped by the use of blue light glasses (even in children) as well as, of course, reducing the amount of time the eyes are focussed on a screen.

It is increasingly believed that the blue light emitted from cell phones, tablets, computers, and television, can increase the chances of dealing with serious eye conditions later in life such as macular degeneration. At a worse case scenario, this can lead to permanent blindness. Blue light is very close to UV light in wavelength and there is concern that it can damage the eyes over time, much as sunlight can. In a younger eye, the natural lens is smaller and clearer and therefore the blue light is more easily transmitted to the retina where the damage may occur. Blue light is also well known for interrupting our circadian rhythms and therefor throwing off sleep patterns when people of any age are exposed to it close to bedtime.

But it’s not just eyes that are being affected by screen time. The slouched position that kids and students (and adults!!) often use at a computer workstation or lazing on a couch increases the pressure on the spinal muscles, ligaments, nerves and disks. This manifests itself as back pain, neck pain and headaches. “Text neck” is also becoming a thing and these cumulatively are keeping chiropractors, massage therapists and physiotherapists busier than ever.

While eliminating screens is virtually impossible for most of us, we can as parents or individuals enforce taking regular breaks from our screens. Experts suggest following what has become known as the 20-20-20 rule. This states that for every 20 minutes of screen time, give your eyes a 20-second break by trying to look away at something that is roughly 20 feet away. Another positive step is to focus on remembering to blink. Resting your eyes, for even just a few seconds, can help. Artificial tears are safe to use in children and can help relieve the dryness and discomfort the eyes may be feeling from eye strain.

For computers at desks, the top of the screen should be at or only slightly below eye level. The chair should be as close as possible to the keyboard to eliminate reaching and the feet should be flat on the floor or resting on a raised surface. Pillows can accomplish this for children who are using a tablet type device. The purpose of these interventions is to minimize the angle at which the individual is looking down at their screen which puts a strain on their torso.

Screen devices come with lots of benefits and familiarity with them is going to be essential for many of our kids to find jobs in the economy of the future. But they do come with some risks that can be modified with a little discipline, whether it be self-induced or adroitly supplied by an ever-helpful parent. For more information about this or any other health related questions, contact your pharmacist.