TOO much school work, TV and digital gadgets can cause squinting and near-sighted children. Giving tiny kids iPads with Tang poems and fairy tales is bad for them too. Zhang Qian takes an up-close look at the problem.

For children who haven't been chained to schoolwork, it's been a summer of watching TV, playing video games, surfing the net and tinkering with iPhones and iPads. Now, with school around the corner, eye doctors are seeing children who have been using their eyes too much.

Lin Zimin now finds her 11-year-old son often squints when he watches TV or looks at something in the distance. An eye exam showed he is seriously near-sighted.

"The two weeks before school opens is the peak time for parents to take their children for eye checks," says Dr Ji Guifang, director of the Ophthalmology Department of Shanghai Children's Hospital. "When they finally got permission to watch TV and play video games in summer, many children just couldn't tear themselves away from the screen. And that often contributes to a quick deterioration in eyesight."

Near-sightedness, or myopia, is a serious problem for many children and teenagers in China.

Shanghai health statistics for 2010 show 38 percent of primary school students are near-sighted, 70 percent of middle school students are myopic and 86 percent of high school students have trouble seeing things in the distance. Heavy school work is a major cause, as is access to computer screens and digital devices - and lack of outdoors physical activity.

Research by the Center for Disease Control and Prevention in Shanghai shows that middle school students spent more than 2.8 hours a school day on average watching digital screens, and around four hours on weekends. Hours go up on holidays. Doctors recommend no more than two hours a day.

Bad habits

Though genetics can be a factor in myopia, bad habits play a bigger role, says Luo Chunyan of the Center for Disease Control and Prevention. Poor lighting, harsh lighting, staring at digital screens and using the eyes too much and without breaks also contribute.

Parents who press for early "intelligence" development can be part of the problem by providing children access to TV at too early an age; they also may push for computer learning, calligraphy, painting and piano lessons before children's eyes can handle complicated tasks and before children have proper hand-eye coordination.

"The wide use of digital projects such as iPads has aggravated the situation," says Dr Ji.

She said parents install programs like Tang poetry, fair tales and paper folding for toddlers and babies to watch - rather than teach the babies themselves. Gadgets also keep children occupied.

"I have even seen children of only 1-2 years old watching iPads, which is terrible," says Dr Ji. "The shining colors are too strong and provide too much stimulation for the vulnerable eyes of children. Some children play with an iPad while walking, which makes the situation even worse."

The eyes develop fast up to the age of three and eye strain during that period can easily lead to problems of near-sightedness," says Dr Li. Another crucial phase for eye development is adolescence, she says. Long-term strain frequently leads to myopia.

Frequent blinking can be a sign of eye strain, so parents should be alert.

"I advise parents to set time limits for children to stare at screens - 10 minutes every time for a little baby, 20-30 minutes for children about 10 years old."

Children should not spend more than an hour reading printed books each time.

Outdoor activities in which children move around and move their eyes can help prevent problems with near-sightedness. Games that involve watching balls - ping-pong, badminton, kicking shuttlecocks - are recommended because children must shift between near and far vision; these games also relax the eye muscles.

Eye exercises like moving the eyeballs and shifting between near and far vision is helpful.

When children appear to have vision problems, it's important to consult a doctor. The incidence of pseudomyopia (sudden intermittent near-sightedness) is relatively high among pre-school children. It can be cured with proper treatment, massage and medication. Eyeglasses at an early age may lead to true near-sighteeness if pseudomyopia cannot be treated effectively.

However, getting the right lenses in time is important for children who are truly near-sighted.

"So far, there is no effective medicine to cure near-sightednews, though some medicated eye drops can help relieve the condition a bit," says Dr Li. "Prevention is what we should focus on."


Good food for good eyes

Dark green leafy vegetables (kale, spinach, turnip and mustard greens)

Best source of lutein and zeaxanthin which are especially important in preventing macular degeneration in older people. The dark green color "disguises" beta-carotene.


Broccoli

Contains high levels of lutein, zeaxanthin and vitamin C.


Carrots and yams

Also pumpkins, squash, orange-yellow-red bell peppers. Rich in eye-healthy antioxidants and very high in beta-carotene, the pigment in bright orange fruits and vegetables and a precursor of vitamin A. Vitamin A is critical to normal vision and plays a major role in preventing night blindness and maintaining a healthy cornea.


Gouqi (wolfberry), jue ming zi (semen cassiae torae) and green tea

Eye-reinforcing drinks.


Orange-colored fruits (oranges, papaya, mangos, melon, peaches, persimmons)

Rich in vitamin C, lutein and zeaxanthin.


Flax seeds and flax oil

Rich in omega 3 fatty acids (also oily, deep-sea fish like salmon) thought to ease effects of dry eye syndrome.


Garlic, sunflower seeds, nuts, black walnuts, oatmeal and brown rice

Contain selenium, a mineral that helps absorb antioxidants and prevent eye problems.


Garbanzo beans, kidney beans, oatmeal and whole wheat bread

Contain zinc, an important mineral that works with antioxidants to promote overall eye health.


Wheat germ, soy and safflower oil

Rich in vitamin E, as are pistachios, peanuts and particularly almonds.


Note: Sugary desserts, sodas, drinks and fried foods should be eaten in moderation. They are high in acid, which can contribute to eyeball malfunction.