Interview: Eye care tips from Dr Lee Sao Bing

It is a constant battle at home, this battle with technology like the TV, iPhone and iPad. It is easy to give in and let these gadgets take over as the 'babysitters' to keep the kids occupied. While the position of 'no TV, iPhone or iPad' have been kept to as much as possible these few years, things do relax a little around the house when the hubby or parents-in-law are watching their favourite movies or Korean dramas. I mean, in today's world, how can you possibly keep these technology away from the kids. We are all bombarded by it everywhere! 

The trick then is to manage the kids' exposure to these gadgets, so that they get the chance to be exposed to the world around them, rather than sit in silos, facing a screen.

And who better to get such tips from than an eye doctor? I am very happy to introduce Dr Lee Sao Bing, Medical Director of Shinagawa LASIK & Eye Centre. A father of two sons, Dr Lee shares eye care tips for children six years and below. 

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Could you please share eye care tips for young children aged 6 yrs and below? What should parents know when exposing their children to TV and electronic gadgets like the iPad and XBox?

(1) No watching of TV (eg LCD screen or tablet) or reading while in the car 

(2) No using of tablet while having meals, basically cut down on the use of hand held devices, children tend to hold these devices very close to the eyes, they hold smart phones even nearer.

(3) If educational games are really needed, then Xbox or Wii better than desktop computer, desktop better than laptop, laptop better than tablet, tablet better than smart phone. (Reason: the further away the better)

(4) After every half hour of using these devices, must take a break (eg go get a drink) 

(5) Read under good light

(6) Do not lie down while reading or using hand-held devices

(7) Reading material – the larger the print the better (reason: can view from further away)

(8) Outdoor games better than indoor games (eg, go to the pool, the playground)

(9) Wear sunglasses with proper UV protection if out in the sun for long duration. Eg long drives, a day at the zoo, boating etc

Is it harmful for kids to be exposed to TV and electronic gadgets when they are too young, like a year old? What are the potential harms? Why are they harmful?

The only harm is with regards to increase in myopia (short-sightedness). Research has shown that increase in myopia is associated with more hours spent doing near work. Near work includes use of hand-held devices or computers, reading, writing…etc.

When looking at a near object, the eye muscle (ciliary muscle) has to contract to allow the natural lens of the eyeball to become more spherical in shape in other to allow objects to come into focus. This action is called Accommodation. It has been shown that greater accommodation (seeing nearer objects for long duration) is linked to increase in myopia. Myopia increases when the eyeball grows longer. By having a longer eyeball, the ciliary muscle does not have to work so hard to focus at near objects. 

Is there an ideal age to start exposing young children to these electronic gadgets? Is it true that they should only be exposed once they reach 2 years of age?

From my personal opinion, the later the better in terms of helping to prevent the onset of myopia.  But of course this has to be balanced with the need for education. So, I guess the best is to revert to the style of education from years ago when there were hardly any hand-held devices. 

Children get very attached to these devices. The younger they are exposed to them, the longer time they will spend holding these devices up close. Secondly, when they are very young, they are unlikely to sit at a desk to view these gadgets at a distance. They are more likely to hold the device very close to view the images.

As a parent in a highly technological world, what do you do to help your children take care of their eyes? Do you set rules to limit your children's use of technology? Can you share your personal experience?

I adhere closely to the nine tips that I shared earlier. My two boys do not play games on smart phones. They play once a while (once or twice a week) on the tablet and about 30 minutes on the computer once a day or once in two days. 

Both my boys have homework to do and I feel that’s already enough of near work that they do each day. I make it a point to bring them out for activities – eg, swimming, playing tennis, jogging, roller blading, scootering etc.

As an eye doctor, do you come under pressure to make sure your children have good eye health & care, to set an example for others?

I don’t feel any pressure because I thoroughly believe that these habits are good for them. I practice it myself too. 

Any other advice for parents?

Parents have to believe in this advice first and practice it themselves in order for their kids to believe in it and follow the advice. 

Good eye care habits for everyone (yes, even adults can have an increase in myopia if they do not have good eye care habits, not just young children):

(1) Sit 50 cm from the computer

(2) Sit 30 to 40 cm from the paper while writing

(3) Sit about 2.5 m away from the TV

(4) Read under good light

(5) Do not lie down to read

(6) After every 30 minutes of near work, take a break, eg look outside the window for a while

(7) Change all hand-held games to outdoor games (afraid of the sun? there is indoor tennis, badminton, table-tennis, gym, jog early morning or in the evenings… by the way, no reading or using the tablet while on the tread-mill or cycling machine in the gym)

(8) Taking the MRT or bus and feeling bored? Don’t watch videos or play games on your phone, listen to music instead. 

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Thank you Dr Lee.