Online classes causing spine pains & eye problems in children.

: Dr Himanshu Tyagi /Dr Meghana sahasrabuddhe

7-year-old Yasharth has been suffering from back and neck pain for the last three weeks. He is a student of class 3, studying in a reputed school. Since the lockdown was announced on March 22nd this year, his entire education has shifted to online mode now. As a result, he has been having 5 to 6 hours of online classes daily since almost the last 2 and half months.

This recent onset neck and back pain are primarily due to poor sitting posture during the online classes & lack of exercises these days.

The situation is even worse for those students who are not having proper laptops or desktops available to them and are somehow managing to use mobile phones for online classes.

As per the data available, Internet connectivity is less than 50% in urban settlements and less than 20% in the rural population till date. Talking about high-speed internet (to support good quality video calls)it is still less than 8% even in urban settlements.

Medically speaking,  sitting in a bad posture for long hours is taking a toll on these young children leading to muscle fatigue, spasm, strain and postural pains.

These virtual schools are not only causing problems related to orthopedics but also causing eye-related problems in children like eyestrain, headache, watering, dryness, refractive errors and dryness leading to frequent eye rubbing.  These ophthalmic problems are primarily due to infrequent blinking and constant focusing on mobile/laptop during online classes. Another contributing factor here could be excessive TV viewing because of the lockdown.

An indirect effect of these virtual classrooms is on the mental health of the children as well. This fact is well exemplified by the suicide of schoolgirl in Kerala who could not attend online classes because of the unavailability of mobile with high-speed internet.

The Mental health-related issues include irritability, loss of concentration, behavioural changes like an argument, refusal, defiance, opposition and withdrawal.

Karnataka has already imposed a ban on virtual classrooms for children under grade 5 and Gujarat is also moving towards the same direction (a PIL is under consideration in the Gujarat High Court for banning online education for children under the age of 6 years).

The possible solutions –

Neck/back pain –

# Encourage children to use only study table or dining table during classes and make sure that they maintain a good posture throughout the class. (back well supported, no slouching, arms supported on the armrest)

# Do not allow children to sit on the sofa or lie down in bed during classes. (Unsupported spine for long hours can lead to pain).

# Encourage them to play or do physical activities inside the house so that they maintain healthy muscle strength to support the spine.

# keep their diet rich in calcium and Vitamin D by including milk, cheese, paneer, yoghurt, Soybeans & calcium-fortified orange juice, oatmeal, and cereals.

# The mobile or laptop screen should be kept at the child’s eye level, so that he/she doesn’t have to bend his/her neck down. (This is the most damaging posture for neck)

# There should be a break every 20 minutes in class during which children should be encouraged to do stretching and play around.

# Schools should be advised to have a compulsory yoga or dance class every day to have a minimum amount of physical activity/ fitness in the curriculum for the day.

Yoga or exercises period – most important.

Eye strain/irritation –

1) Children should be encouraged to sit relaxed with eyes closed in between classes and blink eyes frequently during classes.

Give rest to eyes in between

2) Cell phones/ laptops should be kept at least one arm’s distance away from the face.

3) TV viewing should be restricted for kids as it would increase the total screen time on a given day (class +TV). Also, kids should be asked to look 20 feet away in between, to relax eye muscles.

4) Lubricating eye drops or teardrops should be used (after consulting ophthalmologist) if the child is complaining of red-eye or irritation or watering from the eyes.

5) If the child frequently complains of headache post classes or during the day, parents should consult ophthalmologist in view of slipping eyesight (need for spectacles).

6) Children should sit in a well-illuminated room with laptop/ mobile screen not very bright (illumination) and should avoid frequent eye rubbing.

7) Always prefer laptop, desktop or  iPad in comparison to mobile phones for classes (bigger screen is better)

Mental/Emotional support –

1) Since virtual classrooms mean no real friend to interact and share the feeling. Be a friend to them.

2) Children are becoming silent spectators and sometimes victims of all the stress and tension going in the house due to lockdown/Covid-19. Understand them well.

2) Don’t try to recreate school at home. It’s not possible……and also not required.

3) Encourage them to talk to their friends over phone or video call. Have virtual birthday celebrations for them.

4) Speak up and give your feedback to your child’s school about the length of classes, teaching methodology, breaks and comfort of your child during the class.

5) Children below the age of five years should not have any class longer than 30 minutes at a stretch.

6)  Parents should be encouraged to spend time with kids, especially if it’s a nuclear family. Best is to have a dedicated time for kids & family.

It is high time we take care of our kids now. Education is important but not at the expense of their eyes, spine or mental health.

About the Authors –

1) Dr Himanshu Tyagi : Senior Orthopaedic Surgeon, Delhi

2) Dr Meghana sahasrabuddhe: Senior Ophthalmologist, Mumbai.

For more queries or details, visit Dr Himanshu Tyagi @ –

www.drhimanshutyagi.in

Or call – +919654095717