“Confined we use more screens and this can cause an increase of myopia”

On April 6th, Dr. Ignasi Jürgens was interviewed by Laura Rosel in a catalan program called Catalunya Nit de Catalunya Ràdio:

Dr. Jürgens, ICR medical director and head of the Department of Retina and Vitreous, explained the impact of the increased use of screens on vision in these times of confinement at home and offered some tips for taking care of visual health. He also talked about the relationship between conjunctivitis and coronavirus.

We give you the transcript of the interview:

Interviewer: So many hours of confinement at home and exposure to screens are affecting our eyes. That is why we want to talk to the Medical Director of the Insitut Català de Retina, Dr. Ignasi Jürgens.

Good evening, Doctor. The confinement situation is making us work very little on distance vision because we practically don’t go outdoors and we also cause damage to our eyes with the screens. Now we have registered the data barometer of Catalunya Ràdio and TV3 and we have noticed that we are daily up to nine hours on average in front of a screen. So, are we going to get out of this confinement more myopic than how we got in?

Dr. Jürgens: Indeed, one way of handling this state of exception is to be able to work remotely using screens, but also to be able to escape the situation a little by watching series or using all the tools available to us thanks to technology and the Internet.

When we are with these devices, what we do is to use mostly the close vision and, watching close, four phenomena occur: the eye has to make a greater effort to focus close, that is, the muscle we have inside the eye makes the lens we have to focus close and we converge the eyes since both eyes have to look at the same time. In addition, when we look closely, both eyes come closer together, we are at higher risk that the eye surface that is covered with tears will tend to dry out more because we blink less and work in less light. All of these factors cause us to suffer from visual fatigue.

This is not a new phenomenon now, but we have already observed during the last few years that there is an increasing tendency to use close vision and there are already studies that show that myopia is increasing considerably. In Asian countries up to 80% and in our country myopia is already around 60% between 15 and 25 years old. This happens because the mentioned phenomena that the eye does to see well at close range is shown to cause irreversible changes in the eye and this has been proved by population studies of more than 5,000 people.

Interviewer: And in this way it may be affecting children now? The youngest ones are spending more hours than usually in front of the screen and obviously they are not going out to the parks, running or jumping in the streets or squares. Can it affect them even more?

Dr. Jürgens: The child’s eye is a developmental eye and this phenomenon of “myopization”, of increasing myopia, we see it especially when the eye is growing which is approximately up to 18 years, although it can be variable. In children, the harmful effect is twice as much since on the one hand there is this increase in myopia and on the other hand, there is the acquisition of unhealthy habits. It has been confirmed that children under 5 years old who spend a lot of time in front of the screens move less, do less exercise and this has other consequences not specifically related to vision but to health in general.

Interviewer: There is another question, Doctor, that has struck us, and that is that medical studies are beginning to be published according to which conjunctivitis could be a symptom of the coronavirus. In fact, you have warned about this possibility. Since the declaration of the pandemic, have you detected more cases of conjunctivitis?

Dr. Jürgens: In general, viruses that cause colds mainly affect the mucous membranes and can cause conjunctivitis, and this is one of them. Not only this one, but also other viruses. In this case, the conjunctivitis associated with coronavirus is not usually very serious. We see conjunctivitis associated with small epidemics in swimming pools that are caused by a virus called “adenovirus” and that cause conjunctivitis much more severe than coronavirus.

In our center we have 24-hour ophthalmological emergencies and in this situation of exceptionality we must say that we have not seen a significant outbreak of conjunctivitis. In this aspect, we consider that it is a virus that can provoke conjunctivitis, but it is not one of the viruses that provoke it the most.

Interviewer: Therefore, it is another symptom that, although it is a minority, we should keep in mind. Finally, Doctor, what can we do to try to get our eyes to the end of the confinement as healthy as possible?

Dr. Jürgens: When we are working with screens, it is recommended that every twenty minutes or half an hour we raise our eyes for about 20 seconds. In fact, there is the 20-20-20 rule that proposes to look up every 20 minutes for 20 seconds and to stare at a minimum distance of about 20 feet which is equivalent to about 6 meters. That is, to look from a distance, to make these pauses and to work with good illumination because when we do it with few the pupil dilates, the capacity of focus is smaller and we have to make more accommodating effort. Above all, what we have to avoid is that this greater use of screens, video games, etc., become habits once the confinement is lifted. When the pandemic passes, we have to take advantage of the fact that we are Hispanic and we are used to live outside our homes.

Interviewer: So we take notes of all these tips, Dr. Ignasi Jürgens, Medical Director of the Institut Català de Retina. Thank you very much and good evening.

Dr. Jürgens: A pleasure. Good evening and good health to all.

We provide the link for those who want to listen to the interview in Catalan: