As kids spend more and more time tethered to gadgets—watching YouTube videos on a tablet or blasting tunes through their headphones—experts are worried about the potential harms these devices might be having on their vision and hearing.
Vision experts are seeing a marked increase in conditions such as dry eye and nearsightedness in children, which they believe is at least partially due to too much screen time. New research also suggests that blue light—emitted by smartphones, tablets, computers, and TVs—might, over time, damage the retina, the thin layer at the back of the eye that contains light-sensitive cells. And audiologists are concerned that habitual use of headphones at unsafe levels may lead to an increase in hearing problems in kids and teens.
Here, what we know about kids and technology, and what parents can do to keep children's eyes and ears safe.
Whether it's technology-based or not, so-called near-work, such as reading a textbook or looking at a computer or TV screen up close, can cause the lens of the eye to shift its focus, says K. David Epley, M.D., a clinical spokesman for the American Academy of Ophthalmology. Over time, this can cause the eyeball itself to lengthen, which can lead to—or worsen—nearsightedness.
For instance, a study of nearly 2,000 school-age children in Taiwan, published in June in the journal Ophthalmology, found that those who reported two or more hours of “cram school” (after-school or weekend prep courses typically involving close reading and studying) were more likely to be nearsighted than those who didn't do the extra academic work.
The Taiwan research findings can’t directly be applied to American children, Epley says, but other studies have found similar rises in nearsightedness here: “Even in this country, it's approaching 45 percent. A few decades ago it was down in the 20s,” he says.
While we don't know how much of the upswing in nearsightedness may be attributable to technology, he says, “it’s becoming more clear that increased use of devices, as well as just increased reading, potentially at close proximity, without some regular break intervals, could lead to that increase.”
Additionally, staring at screens from any distance causes kids (and adults) to blink less often, which could lead to dry eye. Over time, the American Optometric Association says, chronically dry eyes could damage the surface of the eye and impair vision.
What’s less clear at the moment is how harmful blue light from screens may be. After a July study in the journal Scientific Reports suggested that it might damage the retina in ways that could lead to macular degeneration—an eye disease that causes vision loss—we saw a spate of frightening headlines: “Smartphones speed up blindness” and “Screens are killing your eyeballs.”
While the study raises important questions, it was performed on cells in a lab, so we can’t say how or if the findings apply to people, Epley says. “It’s a huge stretch to say your screen is going to make you blind.”
What we do know is that blue-light exposure, typically just before bedtime, can affect the body’s natural circadian rhythm by suppressing the hormone melatonin, making it harder to fall asleep.
Listening to music or other sounds that are too loud for too long has the potential to harm kids’ hearing permanently, say experts. And, “Noise exposure is increasingly common because of all the portable technology, whether it be your phone or your dedicated music listening device or even your computer,” says Paul K. Farrell, Au.D., an associate director of ASHA Audiology practices at the American Speech-Language-Hearing Association.
But the extent of noise-related hearing loss in this group hasn’t been established.
A 2015 report from the World Health Organization estimated that about 1.1 billion teens and young adults were at risk of hearing loss, at least partially due to high sound levels from personal audio devices such as smartphones and iPods, and from noisy rock concerts, sports venues, and nightclubs.
A study published in 2017 in the journal Pediatrics, however, found that hearing-loss rates in adolescents aren't increasing drastically. In fact, they appear to be hovering around the same level they did in the 1990s.
More studies might be needed to get a better handle on how noise may be harming young ears. “Unfortunately there hasn’t been a lot of research reported on the risk of hearing loss from noise exposure," Farrell says. "But we can say there’s definitely an increase in concern.”
Experts agree that children’s eyes and ears need regular breaks from tech activities. Here, some helpful strategies.
Limit technology (and close work time). When kids are looking at a screen, follow the 20-20-20 rule: Set a timer for 20 minutes, suggests the AAO, to remind them to look out a window or at an object that's at least 20 feet away for 20 seconds.
If a youngster is reading an e-book, use the bookmark function to help him or her remember to take regular visual breaks. In a physical book, you can place paper clips at the beginning of every other chapter. During video game play, kids should rest their eyes after each level. When listening to music, on headphones or through speakers, tell them to take breaks every hour.
Some newer technologies, such as routers that pause WiFi access during dinner and bedtime, can help too.
Use screens properly. Encourage children to adopt good posture when using technology and to keep anything with a screen about 18 to 24 inches away from their eyes. Remind them to blink when looking at a screen and don't allow them to use computers in brightly lit areas—to help protect against eye strain.
If you want to reduce blue light exposure, note that some devices, such as smartphones and computers, have nighttime settings, which filter out the blue tones from the screen. "It doesn’t completely eliminate blue light exposure," says Epley, "but it does reduce how much is presented to your brain." No research has determined how effective these settings are at helping you sleep, says Epley, but there's no harm in trying them.
Give them outdoor time. Some research indicates that children who spend time outside each day have a lower risk of developing myopia, Epley says. Researchers aren’t sure why, but there’s no harm in more outdoor play time—especially since it can offer other benefits, such as exercise.
Turn down the sound. One of the leading causes of hearing loss is exposure to noise. Even a single burst of loud sound, such as a firecracker, can damage the tiny hair cells that line the inner ear, often irreversibly.
If your child can’t hear you when listening to music on headphones or through speakers, reduce the volume. Do the same if they're wearing headphones and you can hear the music.
Choose the right headphones. Consider noise-canceling headphones for use when kids are listening in noisy environments, such as in a car or on the bus. This may encourage them to use lower volumes since they won’t need to crank it up to drown out outside noise. (In very noisy situations, such as at a rock concert, on an airplane, or near a chainsaw or firearm, make sure they use hearing protection such as earplugs.)
You might come across some “kid-friendly” headphones on the market that claim to limit the volume at which sound can be played. These can be a good option, says Farrell, but keep in mind that there’s no agreed-upon safe level of sound for headphones, and manufacturers of such devices are not held to strict standards.
And some headphones have been found to play sounds at levels higher than those stated on their packaging. As with any consumer product, says Farrell, “you can never be guaranteed it’s doing exactly what it says.”
Model good behavior. One of the most important steps, say experts, is adopting safe technology habits yourself. If you do so, youngsters are more likely to treat their own eyes and ears with care.
Know when to get help. Watch for symptoms of eye or ear strain in your kids. Eye strain might cause behavioral changes, such as irritability, aggressiveness, or anger. Kids may also start rubbing their eyes (which may look pinkish), blink a lot, or complain of discomfort, Epley says. Putting stricter limits on their screen time may help. But if problems persist, take them to their doctor.
Signs of a hearing problem, Farrell says, could be “any pain, ringing, or buzzing in ears, or if sounds are muffled after exposure to a loud sound.” Being less responsive when called, missing parts of a conversation, or declining school performance might also signal that it's time for a hearing checkup.