What We Tell Parents About Digital Eye Strain in Children

Why we talk about screens at every children's exam

Screen time is not going away. We do not lecture parents about reducing it — we focus on making it more sustainable for their child's eyes. At nearly every children's exam at Spadina Optometry, we ask about screen habits, homework routines, and outdoor time because these directly affect what we see during the exam.

Digital eye strain and myopia risk are related but different problems, and the steps that help with one also help with the other.

What actually works at home

Take real breaks — not 20-second glances

The commonly cited 20-20-20 rule (look at something 20 feet away for 20 seconds every 20 minutes) is better than nothing, but it is not enough to fully relax the focusing system during sustained near work.

We recommend: 5 to 10 minutes away from all close-up work every 30 minutes. During the break, your child should look at something far away, go outside, or do something that does not involve a screen or a book. This gives the focusing muscles time to actually reset.

Set up the screen properly

• Distance: arm's length — if your child is leaning in, the text may be too small or they may need an eye exam
• Height: top of the screen at or slightly below eye level, so they look slightly downward
• Lighting: the room should be well-lit; the screen should not be the brightest thing in view
• Glare: angle the screen away from windows and overhead lights
• Chair: feet flat on the floor, screen at a comfortable height without hunching

Prioritise outdoor time

We recommend at least 90 minutes of outdoor time daily. Natural light and distance viewing help regulate healthy eye growth in children. For kids who are already myopic, outdoor time is one of the most effective complementary strategies alongside clinical treatments.

This does not have to be structured sports or activities — walking, playing, or just being outside counts.

Watch for symptoms that need more than habit changes

Adjusting screen habits helps with eye strain. But some symptoms indicate a problem that cannot be fixed with breaks and posture alone:

• Headaches after screen use or homework — may indicate an uncorrected prescription or focusing issue
• Rubbing eyes frequently — may indicate fatigue, dryness, or strain from an undiagnosed issue
• Squinting at screens or the board at school — often a sign of myopia
• Holding devices very close — may indicate uncorrected farsightedness or a focusing problem
• Blurred vision that does not clear after a break — needs clinical assessment

If your child has any of these, book an eye exam rather than adjusting habits and hoping it resolves.

When to book an exam

Annual eye exams are recommended for all children — not just those with symptoms. Many vision problems in children are asymptomatic because kids assume the way they see is normal.

At Spadina Optometry in downtown Toronto, we assess screen-related symptoms, focusing ability, eye alignment, and refractive status as part of every children's exam. If myopia is developing, we can discuss myopia management options to slow progression.

OHIP covers one eye exam per year for children under 20.

Related

• Does screen time cause myopia? — the link between near work and myopia risk
• Is the 20-20-20 rule enough for managing myopia in kids? — why longer breaks matter more
• When should kids have their first eye exam? — recommended schedule from infancy
• Myopia in children: causes and treatment — our myopia management approach