Incidence of myopia with the use & abuse of smartphone
EARLIER in Pakistani children, Myopia (short-sightedness) was noticed in 1950, when Smartphone did not exist.
Currently, the use of Smartphone is a relatively new behaviour observed in people from every walk of life, the young and old, irrespective of their financial position.
The use of Smartphone with its multiple features has completely changed the social pattern and our life-style.
Its (ab-)use has resulted in increased traffic accidents, sedentary life in youths, sense of irresponsibility in essential fields of life, house maids, servants, young drivers, school and university students.
In fact, it has become a part of our dress completely merged with our personality.
At times, driving in the city roads has become dangerous and increasingly difficult as we will find the drivers with one hand on the steering and the other close to the ear with Smartphone resulting in complete lack of attention to follow traffic rules.
Apart from all these changes in life-style, we are more concerned about our growing generation, who suffer from Myopia (short-sightedness) in children who can see clearly at a closer distance but face difficulty in seeing distant objects, caused by disproportionate elongation of eye growth during childhood and adolescence from abuse of Smartphone.
Unfortunately, it is a rising malady all over the world, ranging over 50% in the young adults of European countries and around 80% in urban areas of Asian countries.
Current studies have shown that increase of screen-time (watching TV, excessive use of Smartphone and close reading behaviour) by one hour/day may result in the rise of –0.28 Dioptric power of myopia in a short time, especially in curtailing the outdoor activity and lack of sleep, observed in children from 6 to 14 years of age.
The environmental factors also explain why children growing up in urban areas are more often myopic than those growing up in rural areas.
In a current study, Smartphone is commonly used around 4 hours/day in school children and university students in the United States and other developed countries.
Similarly its use in Chinese students is also on the rise. A longitudinal study among 5-15-year-old children from India showed that the use of screen time (including smart phone) more than 7 hours/day is associated with myopic progression, as compared earlier use with 4 hours/day.
Exposure to increased screen time amongst 26,433 pre-school children in China, Japan, Taiwan, Singapore is ranging around 80%.
The school going students from 12 to 16 years of age in Ireland spend more than 3 hours/day often suffer from myopic changes to minus -3.70 Diopters.
Similarly, Dutch teenagers from 12–16 years from the first, second, and third grades spend almost 4 hours per day on their Smartphone, and were associated with myopic errors, particularly in those with low outdoor exposure.
Face-to-screen distance was also measured using the front camera of the android device of Smartphone, and calibrated by holding their Smartphone exactly 29.7 cm in front of their eyes on a A-4 size of the paper, counted on 592 measurements.
Meanwhile, outdoor exposure per day (in hours) was calculated for school days and non–school days separately in association with Smartphone continuous use (minimum for 20 minutes) in 54% of the girls from 13.7 ± 0.85 years of age; They spent on average 3.71 ± 1.70 hours/day on their Smartphone on school days and 3.82 ± 2.09 hours/day on non–school days, with an average face-to-screen distance being 29.1 ± 6.25 cm.
In Summary, the rise in myopic prevalence in the last decade is caused by many lifestyle and behavioural changes.
For instance, spending less time in outdoors activities is an established risk factor as many researchers concluded this observation.
This study suggested a frequent breaks from Smartphone use in teenagers, may lead to visual impairment and even blindness resulting from retinal complications later in life.
In fact, abuse of Smartphone has become a recognized important risk factor; suggesting that regular breaks during near work with Smartphone use will help to prevent myopia in teenagers.
From the current study, a Smartphone application (Innovattic), has been developed that registers time on Smartphone use and face-to-screen distance electronically for objective measurements as measured by the Myopic Application.
Now, it is hypothesised that the increased smartphone use with repeated breaks added with outdoor exposure in myopic children.
Myopia can be modified as observed from secondary schools in semi-urban areas of Holland.
—The author is a retired Professor and Eye Surgeon from Rawalpindi Medical University.
He is also a hon Professor of a Tianjin University of China.