Does TV cause myopia?

An appropriate amount of TV doesn’t cause myopia or its progression, but poor TV habits can contribute to digital eye strain.

When my son was diagnosed with myopia, I couldn't help but wonder if TV played a role. As a myope, I was brought up with the belief that my excessive TV was the cause of my high myopia. But is it a fact or a myth?  

In this article, we'll delve into the current evidence around the relationship between TV and myopia, and uncover the facts behind this widespread belief.

Does TV cause myopia in children?

The findings from various research studies on this topic have been mixed. However, medical experts, in general, lean towards TV doesn’t cause myopia or its progression.

A comprehensive research study conducted in 2022 analyzed cross-sectional data from six Asian population-based studies, involving a total of 12,241 children. The study aimed to investigate the association between risk factors and myopia. The results showed that increased reading and writing activities, as well as reduced outdoor time, were associated with myopia. Interestingly, screen time, including TV viewing, was not found to be associated with myopia.¹

Similar findings have been observed in studies conducted in Western countries as well. For instance, a Polish study involving 5,601 students aged 6 to 18 found that activities such as reading, writing, or using a computer were associated with the development of myopia, while watching TV had no influence on its incidence.²

Surprisingly, a Finnish study conducted between 1983 and 1984 recruited children with myopia and tracked them for 23 years. The study revealed that myopia was more prevalent among children who watched TV for less than 3 hours daily compared to those who spent more time watching TV. However, further analysis indicated that, in this study, the children who spent more time watching TV also dedicated more time to outdoor activities – but less time to reading. Remarkably, even when combining outdoor activity and TV viewing time, a negative correlation still existed, suggesting a reduced risk of myopia.³

These findings underscore the importance of gaining a comprehensive understanding of TV habits to better ascertain their impact on the risk of myopia. For example, an Indian cross-sectional study involving 9,884 children with a mean age of 11.6 identified watching TV for over 2 hours per day as a risk factor for myopia. Similarly, a study conducted in China, which encompassed 1,770 students with a mean age of 12.7, discovered that watching TV at a distance of less than 3 meters was associated with increased axial length.⁴

Excessive TV can lead to eye strain

Excessive TV time, along with other digital activities like working on a computer, laptop, or tablet, using a smartphone, or playing video games, can contribute to a condition known as digital eye strain (DES). This group of vision-related problems is caused by prolonged exposure to digital devices. Symptoms of digital eye strain can include eye fatigue, blurred vision, headaches, dry eyes, and neck and shoulder pain.⁵

When we spend too much time staring at a screen, such as a TV, our eye muscles can become tired, leading to eye strain and fatigue. These symptoms can worsen throughout the day, making it more difficult for our eyes to focus properly. Additionally, continuous screen time can cause a decrease in the blink rate, resulting in dry eye-related problems.

Interestingly, the discomfort experienced in excessive near-work activity, such as reading or writing, is similar to the symptoms of digital eye strain, fueling the speculations that excessive TV may contribute to myopia.

(Read more about does digital eye strain cause myopia?)

Tips for better TV habits?

When it comes to healthy TV habits for your child with myopia, here are some important tips to follow:^5,6,7 

• Viewing distance and screen size: Avoid sitting too close to the TV or having an oversized screen. Maintaining a viewing distance of at least 3 to 4 times the height of the display can help minimize eye strain and headaches associated with digital fatigue.
• Screen time: Limit TV time to an appropriate amount. Excessive TV time can still strain your child’s eyes. They should have a healthy balance between TV and other outdoor activities.
• Take breaks: Breaks for the eyes are essential, especially for children with myopia. Taking a five-minute break and looking at objects more than 20 feet away every hour or more frequently. (Note: See a recent publication on why 20/20/20 might not be enough)
• Blink regularly: Remind your child to blink regularly while watching TV. Staring at the screen for extended periods can lead to a decreased blink rate, resulting in dry eyes and discomfort.
• Wear prescribed glasses: If your child has been prescribed glasses for their myopia, it's important that they wear them while watching TV.  Uncorrected or under-corrected vision can potentially worsen myopia progression.  
• Indoor lighting: Pay attention to the lighting in the room. Improving indoor environments with illumination levels of over 500 lux may be beneficial.
• Encourage outdoor activities: Finally, don't forget to encourage your child to engage in outdoor activities. Spending more time outdoors has been associated with a protective effect against myopia.

Conclusion

Based on the available evidence, medical experts generally agree that an appropriate amount of TV doesn’t cause myopia or its progression. However, poor TV habits can contribute to digital eye strain.

Remember, balance is key! Encourage outdoor activities, ensure appropriate screen time, and take eye breaks. After all, too much TV can be a real sight for sore eyes!

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1. Lanca, Carla et al. “Near work, screen time, outdoor time and myopia in schoolchildren in the Sunflower Myopia AEEC Consortium.” Acta ophthalmologica vol. 100,3 (2022): 302-311. 
2. Czepita, Maciej & Kuprjanowicz, Leszek & Safranow, Krzysztof & Mojsa, Artur & Majdanik, Ewa & Ustianowska, Maria & Czepita, Damian. (2016). The role of reading, writing, using a computer, or watching television in the development of myopia. Ophthalmology Journal. 1. 53-57. 
3. Pärssinen, Olavi et al. “The progression of myopia from its onset at age 8-12 to adulthood and the influence of heredity and external factors on myopic progression. A 23-year follow-up study.” Acta ophthalmologica vol. 92,8 (2014): 730-9. 
4. Saxena, Rohit et al. “Prevalence of myopia and its risk factors in urban school children in Delhi: the North India Myopia Study (NIM Study).” PloS one vol. 10,2 e0117349. 26 Feb. 2015, doi:10.1371/journal.pone.0117349
5. Kaur, Kirandeep et al. “Digital Eye Strain- A Comprehensive Review.” Ophthalmology and therapy vol. 11,5 (2022): 1655-1680.  
6. American Academy of Ophthalmology. (2020). Computers, Digital Devices and Eye Strain. Retrieved July 19, 2023, from https://www.aao.org/eye-health/tips-prevention/computer-usage 
7. Jonas, Jost B et al. “IMI Prevention of Myopia and Its Progression.” Investigative ophthalmology & visual science vol. 62,5 (2021): 6.