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Screen Time Strain on Kids

How can I help my child avoid eye and back strain from being on the computer?-

By Gary Kirkilas, DO, FAAP

Traditionally, pediatricians recommended ​only an hour or less of screen time each day for children ages 3 to 10, and two hours or less for children ages 11 to 18. Enter the COVID-19 pandemic. Now, many children are suddenly clocking in 8 hours a day of screen time with a combination of virtual school, online video meetings with friends, and their usual dose of entertainment-related screen time (social media, video games, TV, etc.).

While virtual school has allowed millions of students to keep learning during the pandemic, it also has created some concerns we typically see in adults. ​This includes eye strain and back strain.

Eye fatigue or strain, also known as asthenopia, can cause symptoms such as sore, irritated eyes, blurred vision, and headache. Poor posture habits, like being slumped over in front of a screen for hours, can create muscle strain and tension in the back and neck as well. Fortunately, there are some simple fixes and adjustments that parents can do to help prevent strain and make using the computer more comfortable for their children.

Ways to help prevent eye strain

  1. The 20-20-20 rule. Ideally, children should give their eyes a screen-time break every 20 minutes by looking at something 20 feet away for 20 seconds. Ordinarily, children look at objects at varying distances for varying amounts of time during the course of the day. Prolonged screen time makes the lenses of the eyes focus on a single object (the computer screen) at the same distance for a long time. The 20-20-20 rule lets the lenses of the eyes relax and eases strain.

  2. Proper screen placement. Staring at a screen that’s too high up in a child’s field of vision(often the case children use computers at adult-size desks) makes the upper eyelids open wider. This causes eyes to dry out more quickly. Raise the seat height or lower the computer screen so that the screen is at or slightly below their child’s eye level.

  3. The 1-2-10 rule. Make sure the screen is positioned at the proper distance from the child’s eyes to reduce strain. Ideally, smart phones should be placed 1 foot from the eyes, desktop and laptops at 2 feet, and TVs at 10 feet.

  4. Adjust lighting and screen brightness. It can also strain the eyes to look at a computer screen that is brighter than the surroundings. Decrease the screen’s brightness so that it matches the room’s lighting. Glare on the screen makes the eyes work harder as well. To reduce glare, make sure light sources in the room such as a nearby window aren’t shining directly on the screen.

Protecting your child’s back

  1. Desktop or laptop positioning. A screen that’s not at eye level can cause a child to adopt bad posture to see the screen. This is especially true with laptop use, which often causes children to hunch over the keyboard to view the screen. If possible, have a child use a desktop computer. These can be adjusted more easily to the child’s field of vision. If a laptop is the only option, use books to raise the screen to eye level.

  2. Be aware of posture. A child’s spine, including the neck, should be straight and in a neutral position. Parents should watch for hunching, twisting, or arching of the spine, as well as slumping down of the head and chin.

  3. Have a set work area. Discourage your child from using a computer while on the couch, bed, beanbag chairs, or on the floor. These locations all promote poor posture to see the screen. Try to have a designated workstation with an adjustable chair, if possible. For smaller children, parents may need to use blankets or pillows on their seats to raise their field of vision.

  4. Chair height and positioning. Chair height should be adjusted so the child’s feet can rest flat on the floor to help the spine align properly. Parents can also use a step stool so the feet are supported. Also, to prevent arm pain, wrists should not be resting on the keyboard while typing.

  5. Hit the reset button. It’s important to take frequent breaks in the day from sitting. In between classes, have children get up and stretch or go outside for a short walk or playtime. Setting a timer every hour to remind everyone to take a few minutes to stretch can also be helpful.


While certainly not ideal, more screen time has allowed many children to continue regular schooling and connect with friends and family during the COVID-19 pandemic. Rest assured that most of the eye and back strain children experience during this time will not be permanent if early, corrective steps are taken. If your children continue to complain of eye or back strain, talk with your pediatrician at Kids First. Raleigh: 919-250-3478 or Clayton: 919-267-1499.

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*This article is informational but is not a substitute for medical attention or information from your provider.


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