Evidence from this study suggests that screen exposure may have a negative effect on ocular surface health. Photo: Getty Images.

While screen time leaves many parents worried about the eye health of their children, a recent study notes that they may need to be even more vigilant. Researchers in Turkey have determined that symptomatic ocular surface disorder may develop in healthy children even if there are no signs of dry eye due to this type of exposure.

The study evaluated the duration of screen exposure and its effect on ocular surface signs and symptoms in 200 randomly selected 10- to 18-year-old healthy children. Children with amblyopia, ocular motility disorder, anisometropia and refractive errors greater than ±0.50D were excluded from the study. Other exclusion criteria included use or history of contact lenses, use of artificial tear drops, any ocular surface or systemic disease, use of a drug that would disrupt the ocular surface, history of excimer laser surgery and tobacco usage.

The effect of screen exposure on the ocular surface was evaluated using tear breakup time, kerato-epitheliopathy (Oxford) score and Schirmer test. The Ocular Surface Disease Index (OSDI) was used to assess subjective dry eye symptoms. The researchers compared findings for children with a daily screen exposure time of fewer than two hours with those reporting more than two hours.

While 88.5% (n=177) of the participants stated that they use mobile phones or computers every day, 11.5% (n=23) stated that their use of mobile phones and computers is limited to one to three days a week. There was a positive correlation between age and mean daily screen exposure. Over three-quarters of the participants younger than 12 owned cell phones, and this rate increased to over 90% for subjects over 15 years old. The mean tear breakup time was 10.3 seconds, and the mean Schirmer test was 15.6mm. The Oxford score was 0.4, and no corneal staining was detected in 83.5% of the subjects. The mean OSDI score was 23.5, and 67.5% of subjects had mild-to-severe ocular surface disease.

“In our study, which represented a large sample of Turkish children between the ages of 10 and 18 years, despite how conventional tear parameters were determined to be normal, current ocular surface symptoms, as indicated by high OSDI scores, were similar to those of adults,” the researchers noted.

The study concluded that the high OSDI scores could be a precursor of more serious ocular surface problems from excessive screen contact in these children on their way to becoming adults. “Children and their families should be informed about ophthalmological problems caused by screen contact,” the researchers said.