Commentary: Online school in COVID-19 pandemic: Impact on lifestyle and ocular health.

The World Health Organization (WHO) declared a global pandemic after the outbreak of coronavirus disease 2019 (COVID-19), which rapidly spread all over the world, including India. To contain the spread of the deadly COVID-19 virus, many academic and educational institutes were closed by the central and state governments. The major lifestyle change that happened during the pandemic was shifting physical school to online teaching e-learning methods.

Although this lifestyle change protected children from COVID-19 infection, that affected their education; to compensate for this, online schools engaged them for 2–5 hours in e-classrooms depending upon the age of the child by using laptops, tablets, and mobile phones.[1]

Thus, the e-learning methods in school, in addition to a restriction imposed on outdoor activity, led to an increased time spent on the gadgets for entertainment.

Mohan et al.[1] showed that 96.3% of the children attended e-classes in India, compared to 54% in Europe.[2] It was interesting to note that the average time spent in front of digital devices by Indian children was more than 5 hours.[13]

Saxena et al.[4] the authors of this paper in the current issue have very aptly highlighted the behavioral changes in children for on-screen time and outdoor activities during the COVID-19 pandemic. Authors observed an 81% decline (by 6.9 hours/week) in the time spent by school students on outdoor activities and a 69% rise (by 13.6 hours/week) in the time spent on operating digital devices during the pandemic.

Many Indian studies[45] have shown lifestyle behavioral differences between the two genders, where girls were found to spend more time indoors and less time using digital devices, contrary to boys engaging themselves in digital devices for academic as well as entertainment such as playing video games and operating smartphones.

Saxena et al. showed two important risk factors for lifestyle behavioral modification with respect to the time spent on the electronic media by their children: 1) the type of school in which children are enrolled, and 2) the educational qualification of the parents. It was noted that the children from government schools spent more time outdoors and those from private schools had greater time on-screen compared to government schools during the lockdown. This can be due to the more extensive digital learning approach seen in private schools and greater accessibility of the private school children to digital devices.[56] The education qualification of the parents showed an inverse relationship with the duration of the outdoor activities of children[4]

Behavioral lifestyle modification of the online school had a deleterious effect on ocular health, such as digital eye strain, computer vision syndrome, myopia progression, dry eye, and video game vision syndrome.[156] We need to promote policies for healthy digital habits for online schools and awareness among parents, teachers, and students. The only way forward to tackle ocular health is evidence-based measures such as the rule of 20-20-20 for dry eyes, 1-2-10 rule[7] for the distances for digital devices, digital detox by parents’ supervision on screen time and content,[8] and AAO recommendations of a minimum distance of approximately 25 inches (about an arm’s length) from the screen when using a computer.[9]