Excessive Screen Time Risks Triggering Squint in Children

Excessive use of gadgets can increase the risk of developing crossed eyes, or strabismus, according to a medical expert. Dr Lely Retno Wulandari, a consultant in paediatric ophthalmology and strabismus, explained that when a child stares at a screen for too long, the eyes are continuously forced to focus at a near distance. This condition makes the accommodation system—the eye’s mechanism for maintaining focus—work non-stop. Such strain can worsen refractive errors, including near-sightedness and far-sightedness. Uncorrected or progressively severe refractive errors then risk triggering a squint in children. “Gadgets will trigger a squint in children who have a tendency towards minus eyes or myopia. Excessive screen exposure can worsen myopia. Why? Because the child only focuses on seeing things close up continuously, so the eyeball can become elongated. A squint is the complication,” Dr Lely said during an interview following the launch of the Strabismus Surgery Centre at JEC in Jakarta. According to Dr Lely, in children with hypermetropia, where the eyeball is shorter than normal, excessive accommodation effort can trigger an inward squint or esotropia. Meanwhile, in children with myopia, especially if the minus prescription increases excessively, it can trigger an outward squint or exotropia. “I urge parents to pay attention and limit children’s screen time to help prevent the occurrence of crossed eyes,” Dr Lely said. To reduce the risk of squinting, Dr Lely advised parents to implement the 20-20 rule. This means that for every 20 minutes of gadget use, children should rest for 20 seconds. “During this break, children should look at distant objects, about 20 feet away, or look towards the sky,” she said. In addition to providing breaks during screen use, parents must also monitor the total daily duration of gadget use. Children under two years of age are not recommended to be exposed to gadgets, except for brief video calls with family. For children aged two years and above, gadget use should be limited to about one to two hours a day. As the child grows older, this duration can be adjusted and may reach around three hours. “Parents should not be careless when setting rules. For example, many parents nowadays forbid children from using gadgets on weekdays but allow them to use gadgets continuously on weekends. That should not be the case, because usage needs to be limited according to the child’s age,” she said. Besides gadget use, other factors also increase the risk of strabismus in children. The first factor is genetics; a child may have a higher risk of developing a squint if there is a family history of the condition, whether in the parents or grandparents.