For families with children of all ages, the last several months have been a time of transition and adapting
to social distancing and virtual schooling, leading to an increase in the use of electronic devices such as
tablets and computers.
Dr. Luxme Hariharan, pediatric ophthalmologist at Nicklaus Children’s Hospital, has noticed an increase
in patients with eye strain, irritation and dryness. Dr. Hariharan attributes this to increased screen time.
The doctor recommends five simple steps, BLINK 20-20-20, to address the underlying causes of ocular
surface irritation and eye strain associated with electronic devices.
Remember to BLINK 20-20-20:
B – BLINK with more frequency. Blinking moisturizes the eyes naturally. Prolonged use of electronics
reduces the rate we blink significantly. Look at an object 20 feet away for at least 20 seconds, while
blinking and relaxing the shoulders and neck muscles. This will force the eyes to reset, refocus and relax,
while helping to increase your blink rate.
L – LUBRICATE your child's eyes by applying artificial tears throughout the day. You may use over the
counter products that indicate they are preservative free, as these are less likely to irritate the eyes.
Applying artificial tear ointment at night when the eyes are at rest can also help. Wear glasses instead
of contact lenses, when possible, especially when using electronic devices to reduce dryness. Also,
consider using a humidifier to increase moisture in the air at home.
I – INCHES AWAY from the computer. An appropriate distance for healthy vision is at least 25 inches
away or at arm's length. Angle the computer screen down about 15 degrees to help prevent tears from evaporating. Adjusting the screen's contrast, lighting, glare, display and quality also helps optimize the
screen for the child.
N – NEAR DEVICE BREAKS from electronics such as tablets, phones and computers. It is equally
important to ensure the break does not involve other screens such as televisions or video games.
Instead, consider non-screen options such as going outdoors, reading a book or playing with a toy. Going
outdoors for at least 20 minutes exposes the eyes to natural light.
K-- KNOW YOUR SOURCES and choose those with evidence-based guidelines and strategies. These
include your child's pediatrician, pediatric ophthalmologist, the American Academy of Ophthalmology
and the American Association of Pediatric Ophthalmology and Strabismus. These sources help defy
myths, such as whether the use of blue light glasses decreases the effects of a screen. Currently, there is
not enough evidence to support whether blue light glasses or filters reduce the effects of strain on the
In addition to following the BLINK 20-20-20 strategy, remember that vision screenings are an important
part of a child’s annual physical exam. This is critical since a child’s visual pathway continues to develop
until approximately ten years of age and certain visual disorders may be corrected through early
detection and treatment. Therefore, if a child fails a routine vision exam at the pediatrician’s office or
school screening, it is important to follow up with a pediatric ophthalmologist or pediatric optometrist.
Remember, a healthy set of eyes are important for success in school and life!
Let's make it a goal to achieve healthier vision this 2020!
For more information about the Division of Pediatric Ophthalmology at Nicklaus Children's Hospital, visit