Impact of Digital Dependency on Eye Strain, Fatigue, Grip Strength and Cognitive Development in Children

Abstract

Background: Excessive use of digital devices has become increasingly prevalent among children and is associated with emerging concerns regarding visual health, fatigue, physical function, and cognitive development. Prolonged screen exposure during critical developmental periods may predispose children to digital eye strain, generalized fatigue, musculoskeletal weakness, and potential cognitive effects, yet evidence integrating these outcomes in younger age groups remains limited. Objective: To evaluate the association between digital device use and ocular surface symptoms, fatigue, hand grip strength, and cognitive failures among children aged 8–14 years. Methods: A cross-sectional observational study was conducted among 186 children in Lahore, Pakistan. Screen exposure was assessed using a structured screen-time questionnaire. Ocular symptoms, fatigue, and cognitive failures were evaluated using the Ocular Surface Disease Index, Chalder Fatigue Scale, and Cognitive Failures Questionnaire, respectively, while hand grip strength was measured using a dynamometer. Associations between screen-time categories and outcomes were analyzed using chi-square tests and Spearman’s correlation. Results: High screen exposure (70–105 hours/week) was reported by 84.9% of participants. Increased screen time was significantly associated with greater ocular surface symptoms (χ²=27.21, p<0.001), higher fatigue severity (χ²=18.79, p=0.001), and reduced hand grip strength (ρ=−0.179, p=0.015). No significant association was observed between screen exposure and cognitive failure severity (χ²=3.20, p=0.202). Conclusion: Excessive digital device use in children is strongly associated with ocular discomfort, fatigue, and reduced physical strength, while its relationship with self-reported cognitive failures appears limited. These findings highlight the need for early preventive strategies promoting balanced screen use and physical activity in pediatric populations.