Letter to Editor
Impact of COVID-19 on Children - A Pediatric Ophthalmologists Perspective
Kirandeep Kaur,1 Bharat Gurnani2
1Department of Pediatric Ophthalmology and Strabismus, Aravind Eye Hospital, Pondicherry, India
2Department of Cornea and Refractive Services, Aravind Eye Hospital, Pondicherry, India

Corresponding Author
Bharat Gurnani
Cataract, Cornea and Refractive Services, Aravind Eye Hospital, Pondicherry, India
Email: drgurnanibharat25@gmail.com


Dear Editor,

The COVID-19 has emerged as a rapidly spreading pandemic. In India there are approximately 321 million children under lockdown.1 Though this time has come with an opportunity for self growth, discipline and family cohesion, it is not free of disadvantages.2 

There are lots of concerns for the young population. Digital devices are winning the quest as children are additionally glued to screens for education, apart from entertainment. There is a strong evidence that prolonged use of digital devices makes children susceptible to problems like Computer Vision Syndrome. Excessive screen time is associated with tiredness, eye strain, sedentary lifestyle, anxiety, disobedience and reduced interest.3 Furthermore, there is a highly anticipated myopia pandemic amidst the COVID-19 pandemic. There is also evidence that attention deficits and communication issues are more common with children addicted to gadgets.

In the present scenario, leisure activities like playing outdoors and meeting friends are restricted. Contact with peers is limited through online video calls or chat applications. Pietrobelli et al4 reported decrease in sports activities by 2.30 hours/week, an increase in sleep time by 0.65 hours/day and screen time by 4.85 hours/day among children during COVID-19 lockdown. These can have a strong negative impact on the mental health. 

Thus, it is important to engage children in physical activities, and restrict screen usage for educational activities only. Not to give digital devices any space on the dining tables. Junk foods, carbonated drinks and sweets should be avoided. Any sign of anxiety or depression must be given cognizance.5 Here are the few preventive measures to follow:
  • A - Adjust the monitor screen position and brightness
  • B - Blink frequently
  • C - Change habits and follow the 20-20-20 rule i.e. while using digital devices after every 20 minutes, take a 20 seconds break and relax your eyes by looking at something 20 feet away 
  • D - Drink adequate fluids
  • E - Exercise (Outdoor/Terrace games)
  • F - Fruits and fresh vegetables
  • G - Glasses should be worn regularly
Be optimistic and let children know that they are the strong warriors of this tough time.

  1. Nagata JM, Abdel Magid HS, Gabriel KP. Screen time for children and adolescents during the COVID-19 pandemic. Obesity (Silver Spring). 2020;10.1002/oby.22917. 
  2. Gurnani B, Kaur K. Impact of the COVID-19 pandemic on clinical ophthalmology. Indian J Med Res. 2021 Jan & Feb;153(1 & 2):199-200. doi: 10.4103/ijmr.IJMR_3883_20. PMID: 33473015.
  3. Yang GY, Huang LH, Schmid KL, Li CG, Chen JY, He GH, Liu L, Ruan ZL et al. Associations Between Screen Exposure in Early Life and Myopia amongst Chinese Preschoolers. Int J Environ Res Public Health. 2020;17(3):1056. 
  4. Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M., Faith M., Zoller T. et al. Effects of COVID-19 Lockdown on Lifestyle Behaviors in Children with Obesity Living in Verona, Italy: A Longitudinal Study. Obesity (Silver Spring). 2020;10.1002/oby.22861.
  5. Kaur K, Kannusamy V, Gurnani B. Incremental innovations in pediatric ophthalmology department during the COVID-19 pandemic: An experience from a tertiary eye care hospital. Indian J Ophthalmol. 2021 Apr;69(4):1000-1001. doi: 10.4103/ijo.IJO_118_21. PMID: 33727481; PMCID: PMC8012946.