The balancing act between eye health and increasing technology in the classroom – Tips & Results

The increasing use of technology in the classroom has forced ophthalmologists, optometrists and educators to consider the perfect balance in child development.

The COVID-19 pandemic is affecting many areas of daily life, including the increased use of virtual learning for children in schools. With up to 94% of children’s screen time in virtual classes,1 It is more important than ever for educators and ophthalmologists to strike a balance to avoid long-term effects on children’s development.

Long-term effects begin at a young age

The use of computers and smart devices in schools from a young age can have significant long-term adverse effects on children. A systematic review published in The lancet found that screen time on smart devices and computers was significantly associated with myopia,2 and a study published in Ophthalmic Epidemiology found that more than 75% of students surveyed in Nanjing, China had symptoms of computer vision syndrome, including dry eyes and itching.3

“Prescriptions related to myopia, [are] happens at a higher frequency than [they] used to, and the level of prescriptions is greater than ever,” said Noah Tannen, OD, FAAO, FCOVD, Optometrist at EyeCare Professionals in New Jersey. “And researchers have linked that to virtual learning and also just more time being spent indoors during the pandemic.”

Tannen explained that having higher prescriptions now means those children will struggle with the side effects of the high prescriptions later in life, which can include retinal tears or detachments.

“The risk of retinal detachment increases significantly with each prescribed diopter, and especially levels above -6 or -7 are considered pathological and the risk factors are quite high when you get to that range,” he said.

Early onset is the biggest predictor of how high the prescription will end up, making prevention all the more important in young children. “Fortunately, there are things we can do now to mitigate or counteract the impact that a lot of screen time or the pandemic has had on vision,” he said.

Technology in the Classroom: A Constant Change

When children were unable to attend classes in person in March 2020, there was a shift to online learning across the country and state.

Sabina Ellis, data manager for the South Orange/Maplewood, NJ, school district and chair of the New Jersey Education Association (NJEA) Technology Committee, said, “Since the pandemic, screen time has increased, I can say that for sure. Especially in the last 3 years of screen time [increased] When it came to Chromebooks, students were using their own laptops, iPhones, Androids, and tablets.”

Gabriel Tanglao, deputy director of the NJEA’s Division of Human and Civil Rights, Justice and Governance, said the increase in screen time was also due to the need to ensure children are still learning during the pandemic. “Obviously the use of technology is increasing dramatically… We had to make sure that students had access to technology in order to have access to learning. There have been districts investing to ensure more technology is available,” he said.

Ellis added, “And parents love the options, ‘Oh my kid is sick, we can still go to school. We don’t miss a lot of class time.’”

Both said that technology also comes with the need for a sense of balance. Ellis noted that the use of technology has impacted children’s social and mental health, as many children are returning to school in person and are struggling to disengage from the virtual world and interact with others in healthy ways. Tanglao said to keep an eye on children’s brain chemistry as technology can be addictive.

The balancing act: avoiding constant screen time

As Tannen explained, constant screen time can have long-term effects on the retinal health of children with heavy prescriptions early in life, so avoiding constant screen time is paramount to developing eye health.

Both Tannen and Tanglao spoke about the need for breaks in the day from screen time. “You should get into the habit of looking away from a screen every 20 minutes and focusing on an object 20 feet away for at least 20 seconds,” Tanglao said.

Tannen added that 20-minute screen breaks can be beneficial for kids in classrooms.

Ellis noted that teachers in her school district have begun to emphasize writing in the classroom as children have almost forgotten how to write after 2 years of just typing.

“Since January, teachers began to back away from Chromebooks. They started doing more handouts and writing… So just practice the penmanship, turn off the light, back[ing] away from the computer,” she explained. “So there they are trying to break away from technology. It’s good in one aspect, but when we learn that, we lose our life skills.”

“We can’t think of it in binary terms: technology is good/technology is bad, screen time is good/screen time is bad. There is no going back to non-screen based learning,” said Steve Baker, NJEA communications director. “So it’s really about how you integrate it and how you avoid the risks that come with overuse of technology.”

Going Forward: Future Plans for Schools

Collaboration between educators and ophthalmologists to give proper consideration to children’s eye health is key to the ongoing conversation about school children’s eye health.

“I’d love to go into schools and talk to teachers and administrators, educate them and raise awareness,” Tannen said. “It’s a delicate balance because kids now have to be tech-savvy.”

He added that incorporating outdoor activities into the school day, such as breaks or the gym, and teaching outside when the weather permits can go a long way in preventing vision deterioration.

Ellis said children in New Jersey, starting in Pre-K, will have a mandatory school term in September dedicated to learning about technology, such as learning how to use a computer, and it’s important to teach doctors at the listening to introduction.

“There has to be a balance. It’s not good to be on a screen like our parents would tell us,” she said. “This is generally true when working with students, we just have to take a step back. It’s okay to step back and take that walk outside; It’s okay to play outside.”

Tanglao said that well-being should always come first in future decisions about technology in the classroom. “I appreciate the framework of keeping wellness at the heart of this conversation about tech literacy and its development, so just make sure that’s central as we think about the development of young people and our educators,” he said.

Collaboration between educators and physicians to assess and address the impact technology has on vision and eye health in the classroom will be critical to achieving the right balance between teaching children about technology and maintaining their health.


  1. Kaur K, Kannusamy V, Gurnani B, Mouttapa F, Balakrishnan L. Knowledge, attitudes, and practice patterns related to digital eye strain among parents of children enrolled in online courses in the COVID-19 era: a cross-sectional study. J Pediatr Ophthalmol Strabismus. Published online December 20, 2021. doi:10.3928/01913913-20211019-01
  2. Foreman J, Salim AT, Praveen A, et al. Association between digital use of smart devices and myopia: a systematic review and meta-analysis. Lancet Digit Health. 2021;3(12):E806-E818. doi:10.1016/S2589-7500(21)00135-7
  3. Li R, Ying B, Qian Y, et al. Prevalence of self-reported computer vision syndrome symptoms and associated risk factors among high school students in China during the COVID-19 pandemic. Ophthalmic Epidemiol. Published online August 25, 2021. doi:10.1080/09286586.2021.1963786

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