If a pediatric patient complains of headaches, primary care providers should inquire about their screen time habits. Spending too much time staring at a screen, such as a phone, tablet or computer, can cause digital eyestrain, a key trigger in pediatric headaches.

The pandemic may exacerbate symptoms

Symptoms of digital eyestrain include headaches, especially around the eyes and temples, dry, itching or burning eyes, and blurry vision. Poor posture while viewing screens also can cause headaches by straining the neck and back.

During the COVID-19 pandemic, many students have attended school online and participated in fewer in-person activities; it follows that many parents report children’s screen-time usage at an all-time high. Between school, socializing and playing games, some teens may be spending more than nine hours per day using digital devices.

Screen time recommendations

The American Academy of Pediatrics recommends no screen time for children under 2 years old, with the exception of video chatting. Kids ages 2 to 5 should have no more than an hour of daily screen time. There are no defined limits for older children, but parents should work with them to set boundaries around daily screen time.

“If the child’s screen-time use sounds excessive, it’s worth guiding the family to make some changes to see if symptoms improve,” said Elizabeth S. Doll, M.D., child neurologist with Norton Children’s Neuroscience Institute, affiliated with the UofL School of Medicine.

Tips to reduce headaches from digital eyestrain

1) Follow the 20-20-20 rule. Every 20 minutes, take a 20-second break and look at an object at least 20 feet away to reduce eye strain.

2) Follow the 1-2-10 rule for distance. Hold phones 1 foot away; sit 2 feet away from computers; sit 10 feet away from the TV. More time-intensive work, such as schoolwork, should be done on a larger screen, like a computer, instead of a smaller phone screen.

3) Adjust display settings. Brightness settings should match the brightness of the room or environment, and text size should be increased on devices, so the eyes don’t have to strain to focus. Squinting in poor light also may lead to eyestrain headaches. Some devices also have a “night mode” or “dark mode” that can reduce screen brightness.

4) Blink more often. Staring at a screen reduces normal blink rates (15 to 20 times per minute) by more than half. Blinking moistens the eyes and can reduce the feeling of dryness.

5) Turn off screens before bedtime. Devices should be put away at least an hour before bedtime. Blue light from screens can suppress production of the sleep-related hormone melatonin and disrupt the circadian rhythm.

8) Emphasize regular checkups for vision screenings. If a pediatrician notices any concerning symptoms during the child’s annual wellness visit, the child may be referred to a pediatric ophthalmologist or child neurologist.

Do blue light glasses work?

According to the American Academy of Ophthalmology, research shows that blue light glasses are not effective at preventing digital eyestrain, as the symptoms are linked to how electronic devices are used, not the blue light coming from them. These glasses — which can cost $15 to $50 for nonprescription lenses — are not harmful to wear, but patients should be encouraged to change habits instead.