On this episode I welcome Dr. Rupa Wong—Pediatric Ophthalmologist, practice owner, mom to three kids, podcaster and YouTuber.  We discuss the following and so much more!

• The correlation between screen time and visual diagnosis
• Nearsightedness
• Ages (in relationship to eye development) where screen time should be minimized
• Genetic components
• How parents can balance screen time and eye health

Find Dr. Wong online at https://drrupawong.com/. Take her Myopia Management Quiz here: www.drrupawong.com/myopiaquiz and get her additional thoughts on screen time here: www.drrupawong.com/screentime.

00;00;08;29 – 00;00;35;11

Dr. Mona

Hello and welcome back to the PedsDocTalk podcast. I am so excited to welcome one of my social media friends, Doctor Rupa Wong. She is a pediatric ophthalmologist, private practice owner, mom to three kids, podcaster and YouTuber, and she is here today to talk about the relationship between screen time and visual conditions in children. Doctor Rupa, thank you so much for joining me.

 

00;00;35;11 – 00;00;37;08

Dr. Mona

I’m so excited to connect with you today.

 

00;00;37;11 – 00;00;42;28

Dr. Rupa Wong

Oh, thanks so much, Doctor Mona, for having me on your amazing podcast. I’m thrilled to be here.

 

00;00;43;01 – 00;01;03;05

Dr. Mona

Well, I love connecting with you. This is actually the first time we’re talking on a podcast I’ve never met in person. Obviously, we’ve sent audio messages to each other via Instagram. You are my social media friend. I’m sure people don’t realize it. That’s a thing. But it is, especially in the educator community for health care. So thank you so much for all you do.

 

00;01;03;08 – 00;01;08;18

Dr. Mona

And obviously the work that you do for children. So again, I’m just happy that we could have this very important conversation today.

 

00;01;08;20 – 00;01;17;13

Dr. Rupa Wong

Me too. Anything that I can do to bring awareness to kids and visual health is just really awesome.

 

00;01;17;16 – 00;01;40;25

Dr. Mona

And I will be adding all of Doctor Wong’s YouTube podcast links to my show notes. But one thing I will add is that her YouTube channel, she doesn’t do only pediatric content. She obviously does things for adults and everyone for eye health. But definitely, if you have any questions or concerns about pediatric eye surgery and other things, this is your go to on social media and YouTube and podcasts.

 

00;01;40;25 – 00;02;06;22

Dr. Mona

So thanks again. So I chose this topic. We talked to each other about this topic because we both are very passionate about this. Obviously you are a mom of three children. I have a toddler and I think development in general is important, but so is visual health and we’re talking all about screen time. We definitely have seen the increased use of screen time, especially in a pandemic.

 

00;02;06;24 – 00;02;16;15

Dr. Mona

So my first question is, do you see in your practice in the literature or whatnot, a correlation between increased screen time use and visual diagnoses in children?

 

00;02;16;17 – 00;02;41;12

Dr. Rupa Wong

Absolutely. And here’s a caveat, though, because I think screen time in and of itself gets a bad rap. And during the pandemic, with distance learning, everybody was so worried about the actual screen as if the screen itself was dangerous. Yeah, that’s not it. It’s not the blue light being emitted from the screen that’s causing trouble, because I know everybody jumped out and ran and got some blue light glasses.

 

00;02;41;12 – 00;03;03;12

Dr. Rupa Wong

My children wanted them to because they saw all their classmates with them. But you get more blue light from the sun than you do from your device, so I have to lay that as the foundation there. But what we are seeing is screens are near work, and with increasing near work, we are seeing an increase in nearsightedness and huge.

 

00;03;03;14 – 00;03;27;14

Dr. Rupa Wong

So I mean, compared to the 1970s where about 20% of Americans were nearsighted. We’re now over 40% of Americans are nearsighted. And that has to do with just our modern lifestyle factors. You know, the increase in studying, the less time spent outdoors and what screens represent is kids and adults tend to hold them closer than they do conventional books.

 

00;03;27;15 – 00;03;34;24

Dr. Rupa Wong

So again, stressing the visual system in that way, which is what we’re seeing as an increase in nearsightedness.

 

00;03;34;27 – 00;03;38;17

Dr. Mona

And nearsightedness, is also medically called myopia. Correct?

 

00;03;38;19 – 00;03;39;09

Dr. Rupa Wong

Absolutely.

 

00;03;39;10 – 00;03;48;20

Dr. Mona

So I think it’s an important because sometimes parents may get that word at the pediatrician’s office when we do visual screens there. So kind of explain what that means to be nearsighted.

 

00;03;48;22 – 00;04;10;25

Dr. Rupa Wong

So this is a really common question. So being nearsighted means and sometimes especially nowadays we have kids who are nearsighted and the parents aren’t. So they don’t really understand what is their child see. So being nearsighted means that kids are able to see up close or adults, and you have difficulty seeing in the distance. So you’re able to see near, but not far away.

 

00;04;10;26 – 00;04;34;06

Dr. Rupa Wong

Now, if you’re extremely nearsighted, then even seeing up close can be very challenging and require glasses as well. But usually it starts out with meeting glasses to see the board at school, or to see the TV or to watch movies, and then it’s progressive worsens every year. That is the natural tendency for myopia or nearsightedness.

 

00;04;34;09 – 00;04;52;18

Dr. Mona

Are there other visual diagnoses? So obviously we’re talking about nearsightedness as myopia. Are there other sort of things that can be concerning or happen with the screen time? You, such as parents, often ask about something called astigmatism, like is that related to screen time? Use or is that just something different? I’m sure parents always may ask you that question too.

 

00;04;52;25 – 00;05;12;21

Dr. Rupa Wong

Yes, astigmatism is a huge one because there’s a lot of confusion as to what that is. And astigmatism really has to do with the shape of the eyeball. So the front structure, the clear dome shaped covering of the eye is the cornea. And in people who do not have astigmatism, it’s perfectly round, like you cut the top of a basketball off.

 

00;05;12;24 – 00;05;39;28

Dr. Rupa Wong

And people who have astigmatism, it’s more like you cut the top of a football or an egg off so it can make things more oblong, kind of like a funhouse mirror, either tall and skinny or short and wide. So it introduces that little bit of aberration to the vision, but it’s not the same thing as nearsightedness. And there have not been any studies which have shown an increase in and stigmatism with devices, because it really has to do with the shape of the eyeball.

 

00;05;39;28 – 00;05;52;17

Dr. Rupa Wong

And you’re typically born with the astigmatism. It can worsen as you age because of the pressure of the eyelids, but that we’re talking like 70s 80s at that point. So for the most part, your stigmatism remains constant throughout your life.

 

00;05;52;19 – 00;06;12;04

Dr. Mona

Thank you so much for differentiating or talking about that. I know we’re talking about more so nearsightedness in myopia, but it is a common question I get asked. I commonly get screenings done in our office. We do the, visual screening where they use the light like they shine the light in the eyes. We do that and we commonly pick up astigmatism.

 

00;06;12;07 – 00;06;30;10

Dr. Mona

Parents are panicking and worried, and I have to explain to them and I’m like, you know what? Here we go. We can talk about astigmatism on a different episode, but one of the big, I guess, questions I have with what you’re saying is, you know, I have a two year old and, you know, screen time use, not even talking about visual concerns.

 

00;06;30;10 – 00;06;51;10

Dr. Mona

I’m just talking about language development and all the other things that we say, let’s balance screen time with, other interactive play. Is there a certain age that we’re concerned about for that eye development where screen time should be minimized, like, is it that school age child? Is it that toddler? Is it all of it? What is kind of the literature show or just your own experience?

 

00;06;51;13 – 00;07;15;12

Dr. Rupa Wong

So it really is all of it. So the American Association of Pediatric Ophthalmologist, we really don’t recommend any screen time younger than 18 months, even educational programing. And it’s for the reasons you mentioned, not so much. Only for the development of the visual system, but because of, you know, children need that interactive play, right? That’s how they’re evolutionarily wired so far.

 

00;07;15;12 – 00;07;43;12

Dr. Rupa Wong

And we haven’t caught up yet to the advent of digital technology in our lives. But what we’re seeing is especially and I thought this was so compelling, the evidence when we looked at what happened during distance learning and home confinement. We saw in young kids in six year old kids at three times increased in nearsightedness compared to the eight year old kids had a 1.4 times increase in nearsightedness.

 

00;07;43;15 – 00;08;03;14

Dr. Rupa Wong

And then the kids that were even older, the middle school age kids really didn’t show a worsening in their nearsightedness because of distance learning. So that tells you that when the visual system is really plastic at the younger ages, you’ve got to be a little bit more careful about introducing all of this near work type activity.

 

00;08;03;16 – 00;08;23;20

Dr. Mona

And we often hear and parents will say, oh, I had glasses when I was young. You know, I have nearsighted, far sighted, whatever it may be. Is there a genetic component to this that if you or your partner were nearsighted, that there’s an increased chance? Or is it really do you feel more environmental? Is it a combination? Do we know.

 

00;08;23;22 – 00;08;45;16

Dr. Rupa Wong

It’s completely a combination? So some of the studies have shown if one parent is nearsighted, there’s a 1 in 3 chance that your child will be as slow. And typically what I see in my office is that tends to present about a year younger than what the parents had when they were younger. So I’ll always ask the parents when they’re in my office, okay, when did you start wearing glasses?

 

00;08;45;16 – 00;09;08;15

Dr. Rupa Wong

And if they say third grade and this is a second grader, that makes a lot of sense. And that’s partially, I think, again, because of the way that our lives are in terms of just the consumption of all the near work. But also, I think just because pediatricians like you, Mona, are doing a better job of picking up the eye health conditions earlier than they were 30 years ago.

 

00;09;08;15 – 00;09;37;18

Dr. Rupa Wong

So I think it’s a combination of both. And then if both parents are nearsighted, then there’s actually a 1 in 2 chance that your child may be nearsighted. So it is a combination of your environment, how much time kids spend outdoors. Because outdoor time is actually protected, two hours a day of being outdoors. And sunlight has been shown in several studies, ranging from China to Australia, to decrease the worsening of nearsightedness.

 

00;09;37;18 – 00;10;03;08

Dr. Rupa Wong

That tends to happen every year, and that effect lasts into your early 20s. I actually even have on my website, on my clinic website, a little quiz for people to take so that they can figure out what the risk of nearsightedness is in their children. And from the questions, you’ll see that it is partly genetic. It’s partly what they’re doing, how much time they’re reading, how much time they’re on devices and how much time they’re spending outdoors.

 

00;10;03;08 – 00;10;04;10

Dr. Rupa Wong

So it’s a combo.

 

00;10;04;13 – 00;10;23;01

Dr. Mona

Oh, that is great. And I will attach that to my show notes to, because I also want to touch your website. So that’s a great resource. Now this is very fascinating because I had glasses, my husband had glasses, and my concerns were more strabismus, which for anyone not familiar, I had a eye that my muscles were, I guess I don’t know how you would describe it, but like more weak, I guess.

 

00;10;23;08 – 00;10;43;02

Dr. Mona

On one side, yes. So I had to do patching and I think flea patching worked for me. I didn’t have to do surgery long time ago, and I developed amblyopia because of that strabismus. So I had glasses from a young age for that reason. But then, you know, me and my husband will talk, my husband’s nearsighted, and we’re like, oh, you know, Ryan could potentially have glasses.

 

00;10;43;02 – 00;11;07;01

Dr. Mona

And yes, you know, a lot of our feeling is, is is something that’s inevitable or is it something that we can avoid? Not that I think glasses are a bad thing. If some kids will need it and we have it. I think this is a really great segue to kind of describe or kind of explain to parents how we can balance screen time, close up learning with eye health, you know, like, what do you do, I guess is a great example.

 

00;11;07;01 – 00;11;19;14

Dr. Mona

You know, being a mother, knowing all the things that, you know, and also you having three children who probably like to watch screen time, you know, do work, that’s kind of close up. How do you balance their eye health with all of the things that they have to do for school and whatnot?

 

00;11;19;16 – 00;11;35;13

Dr. Rupa Wong

Okay, this is a great question and I want to dive into it. But first I want to address something that you talked about initially about you and your husband wearing glasses and whether or not it was inevitable that Ryan might need glasses if that’s okay. Because yeah, here’s the thing. Obviously glasses are not bad. I am a pro glasses person.

 

00;11;35;13 – 00;11;59;03

Dr. Rupa Wong

You know, I want to normalize it. I want children to feel like really just confident and wearing their glasses. But what can be problematic and can actually affect the health of the eyes is if children are extremely nearsighted. So anything over a -5.5 carries with it risks of retinal detachments, cataracts, glaucoma, myopic, MacKillop, athlete, all of these things.

 

00;11;59;03 – 00;12;23;17

Dr. Rupa Wong

So taking charge of the environmental factors is one aspect. And I’m going to talk about how I do that in my house. But now for the first time, there are actually treatments to slow the progression of nearsightedness and maybe even prevent a lot of kids in my practice who come from two parents who are really, really nearsighted, like minus ten -13, they’ve needed laser for retinal detachment, or they’re just concerned.

 

00;12;23;19 – 00;12;43;14

Dr. Rupa Wong

And it’s not just how thick the glasses are. I want to prevent that elongation of the eyeball, because that’s what leads to serious ocular health consequences down the road. So it’s not inevitable anymore. And that’s kind of like a whole different topic. But there are eye drops and there are contact lenses that can slow that progression, which is really pretty amazing.

 

00;12;43;14 – 00;13;05;08

Dr. Rupa Wong

So I wanted to put that caveat there, because I’m in the same boat in that I didn’t wear glasses growing up, but my husband is extremely nearsighted and his whole family has retinal detachments in his family. So this is really personal in making sure that’s probably why I’m so militant as well, because I want to make sure that my children don’t have to go through any of those surgeries and don’t have to risk going blind.

 

00;13;05;10 – 00;13;32;19

Dr. Mona

This episode is brought to you by the New Moms Survival Guide, an online digital e-course and community created by me, a board certified pediatrician and mom to guide new mothers through their first year of motherhood with modules on parenting, newborns sleep, newborn feeding, infant sleep, introduction to solids development and play, teething and safety. This is the one resource you will need to guide you and support you through your baby’s first year.

 

00;13;32;21 – 00;13;46;26

Dr. Mona

For more information, visit Pete’s Doc Talk a.com or visit the link in my show notes to answering that second part of the question. I really appreciate you diving into that, but how are you balancing all of this with, you know, your children and screens and work and school work and whatnot?

 

00;13;46;28 – 00;14;09;23

Dr. Rupa Wong

So it’s a challenge. My kids are eight, ten and 12. They were doing distance learning during the pandemic. I was lucky that they were able to get back into the classroom pretty quickly, but I’m pretty strict about screen time because of this family history. And here’s the thing I definitely, definitely do not advocate for parent shaming. I don’t want people to feel guilty.

 

00;14;09;23 – 00;14;31;06

Dr. Rupa Wong

We all do what we need to do to get our lives and our families to work. So there certainly are days when my children have way more screen time than I personally want, but I need to get stuff done. So you have to know you’ve got to average everything out. I don’t want people to feel so guilty. Oh my gosh, I’m damaging my child’s eyes and look at this study and it shows three times.

 

00;14;31;07 – 00;14;53;12

Dr. Rupa Wong

No, that’s not the goal here. It’s just to make better informed choices overall with kind of a game plan in place for the family. So for us, because especially my kids at their school are on devices a little bit. They’ve got iPads, they’re doing things projects with their iPads, not exclusively, but I do know that they are getting some screen time in the classroom.

 

00;14;53;12 – 00;15;18;13

Dr. Rupa Wong

Especially. My 12 year old has so much homework when he comes home on the computer, right? So we actually have a rule in our house that during the week there’s no recreational screen time. And that works for us because I found it really challenging to draw the line. And for me, a cold turkey type approach was really helpful at just making sure that we get everything done.

 

00;15;18;13 – 00;15;48;07

Dr. Rupa Wong

We also pick up our kids really late. They’ve got a lot of after school activities. There’s just not a lot of time to watch TV or to, you know, scroll YouTube for them. And so this just helps everyone stay on task and the extra time we’d like to be able to spend it with them. So during the week we have a no screen time, additional screen time role, and then on the weekends it’s much more loose and we permit it and they are be doing anywhere from about 2 to 3 hours on a Saturday and on a Sunday.

 

00;15;48;10 – 00;16;11;06

Dr. Rupa Wong

But it’s really finding that balance that works for your family and how you can incorporate those things that are important for you. We have screen free zones in our house, no devices at the dinner table. Our children don’t have devices. They don’t have their own phones or anything like that, but they have iPads that are recycled from our office, which they used to FaceTime their grandparents in North Carolina.

 

00;16;11;13 – 00;16;28;23

Dr. Rupa Wong

So, you know, they can’t have any of that at the dinner table, though, to be honest, it’s my husband and I. Absolutely. That’s all for it. Yes. You know, so that’s the thing. We are the ones I feel like sometimes that we have to be like, oh my gosh, you know, like watching. It’s like, hey, yeah, no device.

 

00;16;28;23 – 00;16;46;15

Dr. Rupa Wong

And the kids will call us out on it. Nothing like a kid. They will call you out on it. So we actually we have charging stations. We have a little mud room is the best part of the renovation we ever did in my house. And we put little lockers with charging stations. So that’s where we try to get the kids to charge their devices overnight.

 

00;16;46;15 – 00;17;07;17

Dr. Rupa Wong

And I am really trying to keep my device there as well during those time. You know, the hours when I want to be more connected with my kids. So I’m not looking at my phone or scrolling because it’s addicting. I can especially since I do a lot of educating, just as you do on social media. It’s very easy to feel like, well, I’m working, but that’s not the example that my kids see.

 

00;17;07;17 – 00;17;09;11

Dr. Rupa Wong

They just see me on a device, right?

 

00;17;09;11 – 00;17;28;01

Dr. Mona

So, oh, these are great tips and those are great tips. And I think, every family needs to come up with their screen time roles. And this is the first time I’m having someone on the podcast talk about the visual impact. Usually I talk about the language and the development, like I said, for toddlers and stuff, but this is such an important conversation because this is part of development, right?

 

00;17;28;01 – 00;17;45;23

Dr. Mona

Our visual health is development and it’s part of our well-being for our child and for ourselves. And I think this balance is key. Now, does the type of device matter more? Meaning, you know, we’re talking about a screen that’s close to our face, like a iPad or a cell phone, versus sitting on a couch watching something far away.

 

00;17;45;27 – 00;17;51;07

Dr. Mona

Does that matter in terms of how we are allowing our child to consume the screen, too?

 

00;17;51;09 – 00;18;11;21

Dr. Rupa Wong

Absolutely. From a visual health standpoint, a TV is better. Yes. So that is actually what I will make my children do if they, let’s say, want to watch YouTube, but then they watch on the Apple TV. So that way it is a distance target. My son now I finally caved and we got him a Nintendo Switch, my ten year old.

 

00;18;11;21 – 00;18;22;07

Dr. Rupa Wong

And that’s something we have to keep a tight leash on, because he’ll tend to just play it on that tiny little screen that it’s like six inches from his face. And so, you know, my husband’s like connect it all the HTML, whatever.

 

00;18;22;10 – 00;18;23;06

Dr. Mona

He’s the exact.

 

00;18;23;08 – 00;18;45;08

Dr. Rupa Wong

Science that’s on those connections so that he can game but through the TV because I want him sitting on the couch. I want him six feet away and everything that I can do to minimize the amount of near work that they’re doing. I want to save their work for their reading and writing, which is more important to me than gaming or consuming recreational media.

 

00;18;45;11 – 00;19;01;28

Dr. Mona

You mentioned that the iPads and cell phones like Brian’s too, and we do not do phones, iPads, anything like that. And I for a while, we’re hoping I mean, I’m eventually it’s going to happen, but because of that reason, right? I mean, I am still trying to balance not even just for, the visual help, but just having a screen right in your face.

 

00;19;02;03 – 00;19;18;00

Dr. Mona

I don’t even like it. How? It makes me feel like it gives me a headache. It’s not good for I feel drained. My eyes feel. Yes, you by having to, like, cross. Almost like you’re crossing your eyes. So it is. Only imagine for a young child. With visual stimulation too. You know, like if they’re watching a cartoon or whatever they’re watching.

 

00;19;18;00 – 00;19;19;14

Dr. Mona

So I totally agree with that.

 

00;19;19;17 – 00;19;38;19

Dr. Rupa Wong

And that’s the thing too. And you’ll see this term called computer vision syndrome or visual fatigue syndrome. And a lot of that really is is simply all the things that happen when you’re looking at something super up close. Because when we are on a device, we tend to blink less than when you’re having a conversation.

 

00;19;38;19 – 00;19;39;10

Dr. Mona

With someone.

 

00;19;39;13 – 00;20;00;04

Dr. Rupa Wong

And you need a good blink to lubricate the surface of your eye. You don’t think about it, but your tears are actually what’s responsible for a good part of the clarity of your vision. And for that I fatigue feeling. So that’s why I tell every kid that comes in my office 20 2020 rule. You know, every 20 minutes, take a 22nd break where you’re looking at something 20ft away.

 

00;20;00;04 – 00;20;25;09

Dr. Rupa Wong

And that’s also why I do recommend a lot of just watching whatever it is with your child, so that you can remind them to take breaks because it’s so easy to get sucked in. I mean, I’ll be on social media or I’m Netflix binge watching my favorite episodes of my, you know, Fixer Upper. That’s like three hours later and your eyes do feel tired and they feel crossing because you’re converging your eye muscles to be able to look up close.

 

00;20;25;09 – 00;20;45;10

Dr. Rupa Wong

So following some really simple guidelines is helpful just also for parents because if anything, our eyes tend to get more dry. So that was something I had sent to all the teachers when we were doing distance learning. And so I loved it. They actually set timers and they started instituting that as part of their distance learning, which was really awesome.

 

00;20;45;13 – 00;21;02;04

Dr. Mona

You know, that is very helpful. And I think that would have been so helpful for everyone to hear that in the pandemic, with all that distance learning that was happening and even just with increased screen time. Yes, because I agree. I think the invention of iPads and cell phones and all of that have really, caused a lot of issues.

 

00;21;02;04 – 00;21;20;24

Dr. Mona

Like, I’m not against screens if you can balance it, but I’m going to be very honest, I am actually. It’s actually for young children, like toddlers like under five. I’m really, really like, I don’t want to have small devices if I can avoid it. Like, I mean, I, I try, you know, we don’t do it for Ryan. I don’t want parents to feel bad if they’ve done it.

 

00;21;20;24 – 00;21;39;23

Dr. Mona

But it’s really just like trying to really say, do we really need this right now? Because again, we’re trying to balance all the things that we’re mentioning. And on a bigger screen I’m fine. But parents are often like, well, when I was younger, I watched Sesame Street on the television. I’m like, yeah, but you didn’t have the accessibility that now parents have of taking a device on the go.

 

00;21;39;23 – 00;21;55;27

Dr. Mona

So we tend to overuse it. You know, we tend to say, oh, well, my kids fussing. Let me just hand them the phone and hand them an iPad. I’m like, no, no, no, no, no. They can be bored. If you’re going for a walk like, yeah, let them be bored. Like let them look at the nature. That’s what you’re going out for a walk for, right?

 

00;21;55;29 – 00;22;13;19

Dr. Mona

I know people are going to like, okay, that’s what I do. But I really like when you’re going for a walk or going out to play in nature. That is what we should be doing. Like that is the goal like to be in nature and to be playing with the ball. But it’s one thing that I just wish parents would do less of is screen time on the go during walks, because that is what you’re saying.

 

00;22;13;19 – 00;22;25;23

Dr. Mona

Like being outside in nature and just being outside where you have to focus things at distance and then move to things that are close up like that is great for our visual help, rather than being focused on a screen outdoors, you know.

 

00;22;25;26 – 00;22;48;05

Dr. Rupa Wong

Because that’s the thing. A screen for now is still two dimensional, right? And our visual system wants that three dimensional dimensionality of the world. So, you know, that’s also why we’re very strict with screen free zones and, and creating a family media plan with, I mean, back when we used to go out to restaurants a lot pre-COVID, we didn’t have devices for our children at the dinner table.

 

00;22;48;05 – 00;23;08;29

Dr. Rupa Wong

I brought all these puzzles. I had little, little like, you know, brain teasers. And we kept them occupied. We played hangman, we played, you know, bingo, we played chess. We have little travel chess. I had a box of things on a bookshelf right next to our garage door that I could just grab a bag of. Okay, here’s the little toys and books and whatever else that we need to do to keep them occupied.

 

00;23;08;29 – 00;23;10;07

Dr. Rupa Wong

It’s a lot more work.

 

00;23;10;11 – 00;23;11;02

Dr. Mona

It is a.

 

00;23;11;02 – 00;23;33;14

Dr. Rupa Wong

Lot more work, but I think it is for us, it’s worth it because now that my children are older, they don’t equate eating food with being on a device. And I mean, you know, better about. Yeah. Yes. Other health implications of that. So I think that’s really important. But you know, I wise I think our brains have not caught up.

 

00;23;33;14 – 00;23;52;25

Dr. Rupa Wong

And you have to think about it. It is a visual system that’s connected to your brains. And our brains have not caught up with technology. So children’s ocular health and their visual systems, they for things like strabismus that you had, which is misalignment of one eye, the goal is to get your two eyes to see together and to see 3D.

 

00;23;52;25 – 00;24;16;09

Dr. Rupa Wong

Right. And that’s what life is. Everybody always ask me what kind of exercises. Hey, the only exercise is most of the time is life. Yes. Like you’re saying, taking walks, looking at nature, whatever it is and taking those breaks from devices. But I understand the tremendous benefit that you get from digital. I mean, like information is available at our fingertips at a moment’s notice.

 

00;24;16;09 – 00;24;28;05

Dr. Rupa Wong

I love it, you know, my daughter likes making little YouTube videos, which is super cute, but we’re really, really strict about not just passively consuming things. I guess for me, that’s also really important.

 

00;24;28;05 – 00;24;48;21

Dr. Mona

So yeah, and I think, you know, there’s so many things here about like, you know, you think about evolutionarily like in the back in the day, the cave, I always talk about the cave been era. Yes, yes. No one had access to glasses because they didn’t have any of these things that cause visual issues. I mean, you basically were in nature and your eyes adapted to all the things that you have to do and focus and build things and whatnot.

 

00;24;48;29 – 00;25;07;10

Dr. Mona

And I think you bring up a good point that we talk so much about this in development. There are so many convenience items out there, right? And I use screens as a convenience item. It’s nothing wrong with using it. But we also have to think about that, the visual aspect, the developmental aspect. And I also like to go down to basics of how we were raised.

 

00;25;07;10 – 00;25;25;20

Dr. Mona

Like when you went to restaurants, you all were together talking, I don’t remember, we didn’t have screens, there was no TV watching. Right? We survived, we survived, and we actually did, I think better because you were social and that’s what meals are. And I, I am very big on those screens at meal times too. That’s actually one of my big that the bedroom.

 

00;25;25;20 – 00;25;41;07

Dr. Mona

Like there’s certain things. Yes. Yeah. That’s our family screen time rules. But just the developmental perspective. I’m like, if you’re going out to eat, this is a social event. I mean, this is something that we’re trying to do. I get the young age parents, like, I just want a moment of peace, but then we can utilize it if you really want to.

 

00;25;41;07 – 00;25;57;24

Dr. Mona

But you’re school age kid. I mean, that’s awesome that you bring activities and that’s what we did. I vividly remember enjoying going out to eat and coloring with the crayons and, you know, playing with my family, friends. And there was no screens. We were huddled up watching a cartoon or anything. That’s what we did if we were at someone’s home.

 

00;25;57;24 – 00;26;13;12

Dr. Mona

And that’s what the plan was. But out there it was. It was family time and it was dinner time and all these convenience items we have, whether it’s screens or, you know, we talk about like Bumbo seats and all these things for, you know, children, development. I always say I’m like, we didn’t really need all of these things growing up.

 

00;26;13;12 – 00;26;35;06

Dr. Mona

So think about balancing and really saying to yourself, we thrived without all of these things. So now if we implement this, how can I implement it with the resources I have with my balancing my child’s development, all of these things? It’s so important. I think parents sometimes don’t want to do that. Introspection because they feel that they’re being attacked like, this is not being attacked.

 

00;26;35;06 – 00;26;53;19

Dr. Mona

This is, hey, maybe I’m over utilizing screens. Maybe I can make changes in this way. Like Doctor Rupa said, you know, like, maybe I can do this with doctor Mona said, like, there are different ways that you can look at something and say, I agree, I’m probably using it a little too much. Or maybe I can be a little more lenient in this way.

 

00;26;53;19 – 00;26;57;12

Dr. Mona

And I think that’s what parenting is all about. And finding that healthy balance.

 

00;26;57;14 – 00;27;20;22

Dr. Rupa Wong

Totally. And, you know, it’s interesting, especially since, you know, my kids are a little bit older than Ryan is my ten year old has friends who really have unlimited screen time. And he came home one day and he said to me, why are you so strict, mommy? You know, blankety blank. He can do it. He does, you know, Fortnite 8 to 10 hours a day and I only get two and it’s ten years old.

 

00;27;20;22 – 00;27;40;09

Dr. Rupa Wong

So I said, listen, babe, this is why. And I printed out the papers. I don’t expect him to read these articles. This is what I do for a living. You know that this is the risk to your vision, and this is also the risk to your development. And I don’t want you to have these complications. And I know this information.

 

00;27;40;16 – 00;27;57;06

Dr. Rupa Wong

So I don’t know if their parents know it, but I know it. And it’s way easier for me to give you a screen because right now you are whining. I’m ready to lose it. Yeah, I need to get some work done, but I need to go with what I know is in your best interests and that’s what for me, parenting is.

 

00;27;57;06 – 00;28;14;03

Dr. Rupa Wong

It is not easy. I am not a perfect parent by any means. I lose it with my children for sure. But that for me is one of those hard and fast rules like I’m not feeding them, you know, fast food. Every day we make a point of cooking. Those are the things, the daily decisions that we have made.

 

00;28;14;03 – 00;28;27;20

Dr. Rupa Wong

And it’s okay if they’re bored, they’ll come on board. I’m bored. They’ll say they’re bored for about 20 minutes, especially Aria. And then I go find her. I printed out some coloring pages for her and she’s coloring. Or she’s making a card for someone else, or she wrote a song.

 

00;28;27;24 – 00;28;31;23

Dr. Mona

She literally wrote a song. So yes, look at all this stuff.

 

00;28;31;23 – 00;28;54;27

Dr. Rupa Wong

That this creativity that can come out. It’s 20 minutes of paint. I’m gonna tell you when your kids or my kids are persistent, which will serve them really well later in life, but sometimes can be very hard when you’re a mom and I work from home some days, so I get it. I really get it. But just I think there are other ways you can make really small changes.

 

00;28;54;27 – 00;29;11;10

Dr. Rupa Wong

So it doesn’t feel super overwhelming at first. And and there’s absolutely no judgment in any of this. But these are just the little things and the hurdles I have to overcome a lot of whining, a lot of, you know, yelling about, why can’t I do this and why can’t I be like my friends? But this are the.

 

00;29;11;10 – 00;29;27;10

Dr. Mona

Rules for our house. And I love this. This is such a great conversation. And yes, I agree with all of that balanced conversation. The boredom conversation that you just mentioned. Oh, yes. Like, I mean, this goes down stream, like so many of us are so afraid of our kid being bored. I’m like, no, no, no, no, no.

 

00;29;27;13 – 00;29;47;16

Dr. Mona

This is when they learn things, especially when creativity happens. And I again, going back to your childhood, I have so many memories of there not being any scheduled plan, and me and my sister doing a whole dance routine, coming up with our own things that we had to figure out how to entertain ourselves. And that is awesome. Like our kids do not need to be.

 

00;29;47;22 – 00;30;06;06

Dr. Mona

Okay, well, here’s what I have scheduled for you. Here’s what I’m gonna make you do know they can come up some times and say, yeah, mom, I’m bored. But yeah, you can figure it out. And I think even, you know, you’re talking about your school age and above. Kids like this is such an important concept for toddlers. I mean, under four, I mean, it’s okay if they don’t have your attention at all times.

 

00;30;06;06 – 00;30;24;02

Dr. Mona

I mean, obviously you need to be there because they need you for safety. But you can say, hey, I see that you’re bored, but you have your toys. Do you want to play with your dinosaurs, or do you want to play with your magnets? And you just make that calmly state that thing and it really helps them understand that, okay, mommy’s busy washing dishes or whatever.

 

00;30;24;02 – 00;30;35;06

Dr. Mona

I can entertain myself for ten minutes. It’s like I’m not going to die of boredom. Like it’s totally fine. And then you’re right. This is when they actually learn things. And then the more you do it, the more they’re like, oh, this is actually not so bad. Like.

 

00;30;35;09 – 00;30;50;24

Dr. Rupa Wong

Well, and that’s what I love. So first when my kids say I’m bored, I say great. Yes. Good. I say that is always my response. They hate it now, but they understand it. And then second, my middle son, actually my two younger ones, they then want me to play a game. Well, can you play monopoly with me? Can you do this with me?

 

00;30;50;28 – 00;31;07;04

Dr. Rupa Wong

And there are times, yes, that’s what we do. Yeah, but if I’m working and I need to call a patient pack or I need to take care of something, they also have to understand how to entertain themselves. I think that’s a really important skill, separate from the visual and the ocular health system. That’s just that’s a life skill I love.

 

00;31;07;04 – 00;31;21;06

Dr. Mona

I love that we could segue onto this because I know this is all about visual health, but I obviously being a working mom and obviously you own your own practice and you have three children and you’re doing all that balance and juggle for the last, you know, two and a half years of this pandemic and also even before it.

 

00;31;21;13 – 00;31;34;09

Dr. Mona

So thank you. Oh, this is such a great conversation. Now, I already found your myopia management link. I’m going to be linking that to my shownotes. But where can people find you if they want to stay connected on all of your inspiration and education?

 

00;31;34;11 – 00;32;01;16

Dr. Rupa Wong

So I have my personal website is Doctor Rupa wong.com WW doctor repo on.com. Same handle on Instagram. Doctor Wong where I do share just work life balance and you know life in Hawaii. That is the nice thing. It’s life in Hawaii with three kids and pediatric ophthalmology tips and pearls. Same handle on YouTube. Doctor Rupa Wonky and I have also a little, resource guide.

 

00;32;01;16 – 00;32;20;16

Dr. Rupa Wong

Kind of. It’s got that family media plan like we talked about screen free time, screen free zones in your house and just the effects of the screen time in terms of your eyes. So I have a free downloadable resource which is also on my website. You can just go to Doctor Rupa Wong slash screen Time and it should pop up there.

 

00;32;20;19 – 00;32;51;25

Dr. Mona

Amazing. And I am attaching all of this to the shownotes, including her Instagram handle, and I am sure I’ll have Doctor Rupa on again because I would love to talk about strabismus. First, we can talk about Stigmatism. There’s so much thing in pediatric eHealth, you know, visual screenings, all of these things that I think is so important, not only just because I went through it personally with my own visual health as a child, but I think sometimes dental and visual health gets put to the side for children because you see your doctor for other things, you know, like a general exam.

 

00;32;51;25 – 00;32;56;29

Dr. Mona

But visual and mental health are so important too. So thanks for joining me today.

 

00;32;57;02 – 00;33;01;21

Dr. Rupa Wong

Well, thank you so much for having me, doctor. And this is a real, real treat.

 

00;33;01;23 – 00;33;18;27

Dr. Mona

Awesome. And I’ll talk to you soon. Thank you for tuning in for this week’s episode. As always, please leave a review. Share this episode with a friend. Share it on your social media. Make sure to follow me at PedsDocTalk on Instagram and subscribe to my YouTube channel, PedsDocTalk TV. We’ll talk to you soon.