I. First, Understand: What is "Screen Sickness" in Children? (Video Display Terminal Syndrome)

Video Display Terminal Syndrome (VDTS) is not exclusive to adults; its prevalence is increasingly high among elementary and middle school students. Outpatient data shows that 80% of children who use electronic devices for more than 4 hours daily exhibit related symptoms. Simply put, it refers to the eye and systemic discomfort caused by prolonged viewing of screens such as phones, computers, and tablets, including symptoms like dry eyes, blurred vision, neck and shoulder pain, insomnia, etc. In severe cases, it can affect attention and growth development.

Last week, I treated Lele, a third-grader. His mother mentioned that the child spends nearly 6 hours daily on screens for online classes and watching short videos after school. Recently, he has been frequently rubbing his eyes, complaining of "sand in the eyes," and feeling dizzy after short periods of homework. His vision test showed a 50-degree decline compared to six months ago. Further examination revealed that Lele does not have simple myopia but a typical case of "screen sickness" — unstable tear film (severe dry eyes) + accommodative fatigue, compounded by long-term poor posture of looking down at the tablet, leading to tense neck and shoulder muscles.

II. Why Are Children Particularly Susceptible to "Screen Sickness"?

Compared to adults, children's eyes and bodies are still developing, making them more vulnerable to screens. There are three main reasons:

1. Immature Eyes: Children's lenses have strong accommodative ability, but prolonged focus on nearby screens causes the ciliary muscles to remain contracted, akin to muscles being constantly tense, leading to eye strain and temporary vision decline. Additionally, children's tear films are thinner, and their blink rate decreases from about 20 times per minute to 6 times when staring at screens, causing the eye's "moisturizing film" to evaporate quickly, resulting in dry eyes and a foreign body sensation.

2. Poor Posture: Does your child lie down to look at their phone or play with a tablet while lying on their stomach? In the clinic, we often see children placing laptops on their laps while doing homework or curling up on the sofa watching videos. Such postures place extra pressure on the cervical spine (three times the normal pressure when the head is tilted down), keeping neck and shoulder muscles tense, which over time leads to soreness, numbness, and even affects spinal development.

1. Poor Self-Control: While adults can remind themselves to take breaks, children, once engrossed in games or short videos, lose track of time and remain sedentary for hours, which their eyes and bodies cannot withstand.

III. Be Alert to These Signs of "Screen Sickness" in Children!

Parents can check if their child exhibits two or more of the following signs, indicating a need for intervention:

• Ocular Signs: Rubbing eyes, frequent blinking, complaints of dry or painful eyes, blurred vision, photophobia (sensitivity to bright light);

• Systemic Signs: Complaints of neck/shoulder pain, back soreness, dizziness, headaches, poor concentration, difficulty sleeping or nightmares at night, decreased appetite;

• Behavioral Signs: Inability to detach from electronic devices, crying or tantrums when devices are taken away, decreased homework efficiency, increased irritability.

A reminder for parents: Do not mistake "screen sickness" symptoms for simple myopia! If your child complains of blurred vision, do not rush to get glasses. First, observe if it improves after rest — vision decline from "screen sickness" is often temporary and can recover with timely habit adjustments. Blindly prescribing glasses may turn pseudomyopia into true myopia.

IV. Pediatrician's "Screen Prevention Guide" for Parents: Simple and Practical

Preventing "screen sickness" hinges on "controlling time, adjusting habits, and optimizing the environment." Here are several highly practical methods shared by parents in the clinic:

1. Set a "Screen Budget": Strictly Control Usage Time

• Lower Grades (1-3): For educational use, limit single sessions to no more than 20 minutes, with a daily total not exceeding 1 hour. For non-educational use (watching videos, playing games), limit single sessions to no more than 10 minutes, with a daily total not exceeding 30 minutes.

• Upper Grades (4-6): For educational use, limit single sessions to no more than 30 minutes, with a daily total not exceeding 2 hours. For non-educational use, limit single sessions to no more than 15 minutes, with a daily total not exceeding 1 hour.

• Core Principle: Absolutely no electronic device use 1 hour before bedtime (screen blue light suppresses melatonin, affecting sleep, and poor sleep impacts growth hormone secretion). Also, strictly avoid screen use during meals and while walking.

My advice to Lele's mother was to use the phone's "screen time limits" feature, allowing only educational apps during study periods and setting a 15-minute auto-lock for entertainment time. This proved very effective; within a week, Lele stopped constantly asking to watch videos.

2. Remember Two "Little Rules": Protect Eyes and Posture

• Eye Protection "20-20-20 Rule": Every 20 minutes of screen time, look at something 6 meters away (e.g., trees outside the window, distant buildings) for 20 seconds to relax the eye muscles.

• Posture "One Foot, One Fist, One Inch": Keep eyes one foot (about 30 cm) from the screen, chest one fist away from the desk, and fingers one inch from the pen tip. When using a computer, the screen center should be 15 cm below eye level with a 30-degree downward gaze for more comfortable neck posture.

Lele used to hunch over the desk while looking at his tablet. His mother adjusted the desk height according to these standards, placed the tablet on a stand to raise it, and added timed reminders for distance viewing. Within a week, Lele reported that his "eyes felt less dry."

3. Optimize the "Screen Workspace": Create an Eye-Friendly Environment

• Soft Lighting: Do not let children use screens in the dark or with direct sunlight on the screen (causing glare). Use a soft desk lamp placed to the side and behind the screen to avoid strong light stimulation.

• Choose the Right Screen: Prefer larger screens (TV, desktop computer) over phones or small tablets for better eye protection. Adjust screen brightness to match ambient light—neither too bright nor too dark—and enable "eye protection mode" (reduces blue light).

• Maintain Adequate Humidity: Use a humidifier in air-conditioned rooms to keep humidity at 50%-60%, reducing eye moisture evaporation and alleviating dryness.

4. Parents Should Be "Role Models," Not "Overseers"

Many parents tell their children to reduce screen time while scrolling on their phones late into the night—children learn by example! It is recommended to establish fixed daily "screen-free time" for the whole family to read, take walks, or play games together. This not only reduces children's screen dependency but also strengthens parent-child bonds. Lele's mother later took him cycling in the neighborhood for half an hour every evening. As a result, his screen time decreased, and his sleep improved.

V. What to Do If Your Child Already Shows Symptoms?

If your child already complains of eye pain or neck/shoulder soreness, do not panic. Follow these steps:

1. First, "Screen Break": Have the child step away from electronic devices, rest with eyes closed for 10 minutes, or gaze into the distance for 20 minutes, while gently moving the neck and shoulders (slowly turning the head, shrugging to relax).

2. Moisturize the Eyes: If dry eyes are noticeable, use preservative-free artificial tears (e.g., sodium hyaluronate eye drops) under medical guidance, 3-4 times daily, to relieve dryness.

3. Physical Relief: Apply a warm towel (around 40°C) to the eyes for 10 minutes, twice daily, to promote blood circulation. For neck/shoulder soreness, gently massage the back neck muscles with palms or use a warming patch for relief.

1. Seek Medical Attention Promptly: If symptoms persist for over a week (e.g., blurred vision does not improve, neck/shoulder pain worsens, insomnia persists), take your child to the hospital to rule out issues like myopia or cervical spondylosis. Do not delay treatment.

Final Thoughts:

In the digital age, it is unrealistic to completely prevent children from using screens. However, we can employ scientific methods to allow children to enjoy technological conveniences while protecting their health. Remember: A child's eye and spinal development occur only once. Preventing "screen sickness" is more important than treating it. The best "eye protection medicine" is sunlight and exercise. Taking children outdoors to run and look at distant greenery is more effective than any eye care product.

If parents have further questions about children's screen use or vision protection, please feel free to consult — safeguarding children's health is our shared responsibility!