tugas

1. Tugas MKDU PPDS Januari 2022
Evidence Based Medicine
Disusun oleh
Anci Winas 04032722226002
Mistur Rozian Sari 04032722226005
Dina Fatma Dwimarta 04032722226009
Widya Wira Putri 0403272222010
Sp-1 Ilmu Kesehatan Mata
PEMBIMBING
Dr. Iche Andriany Liberty, SKM, M.Kes
Fakultas Kedokteran Universitas Sriwijaya
Rumah Sakit Mohammad Hoesin Palembang
2022

2. THE EFFECTOF GADGET USE ON THE DECREASINGOF
CHILDREN'S VISUALIMPAIRMENTDURING ONLINE
LEARNINGDURING THE COVID-19 PANDEMIC : A
SYSTEMATICREVIEW
Mistur Rozian1, Anci Winas1, Widya Wira1, Dina Fatma1
1Faculty of Medicine: University of Sriwijaya, Departement of ophthalmology
___________________________________________________________________________________
Abstract
The pandemic felt in Indonesiahascaused variousproblemsin all sectors, including the
health and education sectors. These various problems that arise certainly have a big
impact on the eye health of school-age children who carry out learning activities
through digital media. This study examines how the influence of gadgets on reducing
eye acuity in children in online learning during the covid-19 pandemic. Descriptive
research is research used by researchers in this study. Researchers describe facts, data,
and information obtained from literature studies such as books, journals to research
results related to the research topic. In this study, it is explained that gadgets have a
significant effect on children's eye health, namely the decrease in the sharpness of
children's eyes with the emergence of myopia disorders and eye fatigue in children.
This problem will become more serious if not handled wisely. The government and
society need to make concrete efforts to overcome the covid pandemic so that it does
not have a worse effect on the health of all levels of society, especially children as
national assets.
Keywords:
Covid-19 Pandemic, Gadgets, Eye Health
Abstrak
Pandemi yang dirasakan di Indonesia menyebabkan berbagai permasalahan pada
semua sektortidak terkecuali sectorkesehatan dan pendidikan. Berbagaimasalah yang
timbul ini tentu memberi dampak yang besar pada kesehatan mata anak usia sekolah
yang melakukan kegiatan pembelajaran melalui media digital. Penelitian ini mengkaji
tentang bagaimana pengaruh gadget terhadap penurunan ketajaman mata pada anak
pada pembelajaran online di masa pandemi covid-19. Penelitian deskriptif adalah
penelitian yang digunakan peneliti pada penelitian ini. Peneliti mendeskripsikan fakta,
data dan insormasi yang diperoleh dari kajian kepustakaan seperti buku, jurnal hingga
hasil penelitian yang berhubungan dengan topik penelitian. Pada penelitian ini
dijelaskan bahwasannya gadget mempunyai pengaruh yang signifikan terhadap
kesehatan mata anak yakni menurunnya ketajaman mata anak dengan munculnya
kelainan myopia dan mata lelah pada anak. Permasalahan ini akan menjadi lebih serius
apabila tidak ditangani dengan bijak. Pemerintah dan masyarakat perlu melakukan

3. upaya-upaya kongkrit untuk mengatasi pandemic covid sehingga tidak berefek
semakin buruk pada kesehatan semua lapisan masyarakat terutama anak-anak sebagai
asset bangsa.
Kata kunci:
Pandemi Covid-19, Gadget, Kesehatan Mata
INTRODUCTION
At the end of 2019, Indonesia and the world were experiencing a crisis in all
aspects of life due to the COVID-19 pandemic. The impact resulting from this pandemic
is felt in all sectors, including the education sector. As an effort by the government to
minimize the impact that Indonesia facesin the realmof education, the governmenthas
made a policy to close various educational institutions (Bawelle et al., 2016). This is
done because the closing of schools as an educational institution is expected to reduce
the transmission of Covid-19 massively by reducing direct contact that occurs in the
educational environment. The closure of these schools has made the education deposit
experience a new paradigm revolution that has taken place as a whole. So that it forces
many parties to do their learning and work at home (Work From Home) (Mubin, 2021).
Not only that, the phenomenon of social distancing that occurred during this
pandemic is an additional factor that hinders the learning process at school. With the
social distancing policy implemented by the government to minimize the spread of
COVID-19, it encourages all educational institutions to activate classes even though
schools are closed. This closed school is one of the best mitigation steps taken at this
time to prevent the spread of COVID-19 (Syaputra et al., 2021). The solution offered to
overcome the closure of schools as a place for this learning process to occur is to
implement learning at home using facilities that can support the learning process (Sari
et al., 2020).

4. During this pandemic, online learning is a solution that can be done to continue
existing learning. Online learning is defined as an effort made in the realm of education
to transfer knowledge through website forums and digital technology trends such as
the use of audio, video, text communication using software supported by the internet
network. The hallmark of this online learning is the integration of technology and the
variety of innovations carried out by continuously interacting online (Muallima et al.,
2019). Online learning in this pandemic period certainly encounters many obstacles
and problems. Considering that during a pandemic like this time, location and distance
become a big problem, such as the added expenditure of parents of students to prepare
additional internet quotausage,different internet network locations to variousimpacts
caused by communication tools, namely smartphones used during learning. Surya,
2017).
The development of technology and information has a positive impact in
supporting online learning in schools. However, if the utilization and use are not
managed wisely, it will have a bad influence. Due to the unwise use of smartphones,
students will likely experience a decrease in visual acuity. Various studies have shown
that the use of smartphones for a long period will cause problems related to eye
discomfort and various eye complaints such as myopia in school-age children (Kartini
et al., 2021). The increasing eye disorder, namely myopia, is predicted to be even
greater in line with the development of technology and information considering that
children have a high enough need to use smartphones to participate in learning and in
completing school assignments (Paramita & Leonard, 2021).
Based on this background the author will conduct research on the Effect of
Gadget Use on Decreasing Children's Visual Acuity during Online Learning during the
Covid-19 Pandemic Period. The aim is to find out what impacts are experienced by
elementary school-age children related to eye health during this pandemic so that
strategic steps can be formulated to reduce and minimize these impacts.

5. METHOD
This study uses a literature review research design, namely research that
examines and criticizes scientific knowledge, ideas, and findings that have an academic
orientation. This research was conducted by conducting a systematic selection which
was traced from an international database by limiting inclusion and exclusion. The
author searches for data sources from various databases, including using the
Indonesian Scientific Repository (https://www.neliti.com/id/), and Google Scholars.
Research articles that have been deemed worthy are included by the researcher in the
research and a quality assessment process is carried out by the research methodology.
The purpose of the research is to obtain data about facts and issues that have occurred.
This study will describe and explain the effect of using gadgets on school-age children
in conducting distance learning during the COVID-19 pandemic. 6 articles that have
been reviewed for quality are synthesized in the final report of the study from the
literature.
Diagram 1. Diagram Prisma
Identificati
on
Screening
Eligibility
Synthesized
articles
Articles identified through database (n=20)
a. Neliti: 10
b. Google Scholars: 10
Articles are checked for
duplication and screened
n= 20
Articles are read in full and
with good article categories
n= 6
Issued (n=14) because:
a. Articles are issued by
title (n=10)
b. Articles are issued based
on abstract (n=1)
c. Article is not original
research (n=3)

6. RESULT AND DISCUSSION
The Effect of Increasing Gadget Screen Time During the COVID-19 Pandemic on
Decreasing Visual Acuity
The results of the articles reviewed regarding the decrease in visual acuity in
children during distance learning during the pandemic are described in table 1 below
Table 1 Related reviewed articles The Effect of Gadget Use on Decreasing
Children's Visual Acuity during Online Learning during the Covid-19 Pandemic
No Researcher Article
Type
Location Understood
Domain
1. (Putri et al.,
2021).
Cross
Sectional
Study
Indonesia Eye Health
2. (Wati, 2021). Cross
Sectional
Study
Indonesia Eye Health
3. (Darmawiyah
& Noventi,
2019)
Qualitative Indonesia Visual Acuity
4. (Sihombing
et al., 2021)
Quantitative Indonesia Vision
Decrease
5. (Anwar et al.,
2020)
Qualitative Indonesia Myopia
6. (Angmalisang
et al., 2021)
Cross
Sectional
Study
Indonesia Visual Acuity
Based on circular letter Number 15 of 2020, the Ministry of Education and
Culture established a policy regarding distance learning carried out at home during the
COVID-19 pandemic emergency. Distance or online learning that is carried out at home
is carried out continuously by complying with all existing health protocols (Putri et al.,
2021). Although the Ministry of Education and Culture as the government has issued
this policy with the aim of minimizing the spread of the COVID-19 virus, it has actually

7. causedanxiety aboutthe emergenceofvisual impairments experiencedbychildren due
to the use ofgadgets. This occursdue to reducedtime forchildren to carry out activities
outside the home but on the contrary, namely the increased activity of children in
dealing with digital gadget screens for both school and entertainment purposes such as
games, YouTube, and other social media (Wati, 2021).
Several studies have shown that there is an increase in gadget screen time by
children, which is 6 hours or more. This causes the incidence of visual disturbances in
children such as myopia to increase sharply up to seven times compared to when
children attend face-to-face classes at school. If in percentage it is known that before
the pandemic the incidence of visual impairment occurred as much as 10.9%,
increasing to 57.01% during the pandemic (Darmawiyah & Noventi, 2019). Another
study states that the majority of children use gadgets for 4-5 hours longer during the
quarantine period at home with a visibility of 20-37 cm. Not only that, when parents do
work at home (WFH), gadgets are considered to be the most effective media to
accompany children when parents are at work (Sihombing et al., 2021).
Visual disturbances experienced by children are not only nearsighted (myopia),
but other disorders that are the most influential and at great risk are eye muscle fatigue
(asthenopia). This is most commonly found in elementary school-aged children who
follow excessive online learning in the use of gadgets. Cases of visual impairments such
as myopia experienced a significant increase from 2019 to 2020. This period was the
initial period for Indonesia to experience a COVID-19 emergency so that people,
including children, were in a lockdown situation. Whereas empirically it was found that
a long duration of time for children to play outside can minimize visual disturbances in
children (Anwar et al., 2020).
Children aged 6-8 years are basically a very important period in the
development of a child's sense of sight. In this age range, the myopia plasticity of
children is in a vulnerable condition so myopia is more likely to occur compared to
children aged over 8 years. Some predictions indicate that if the COVID-19 pandemic is

8. not handled properly, there will be an increase in the prevalence of myopia in children
by two to seven times the risk in 2050 (Angmalisang et al., 2021). So there needs to be
a real effort to prevent eye disorders in school-age children during the COVID-19
pandemic.
Prevention of Progressive Eye Disorders in School-Age Children duringthe Covid-
19 Pandemic
Currently, people have new paradigms and habits during the COVID-19
pandemic. The implementation of the online learning policy makes all activities carried
out limited to only at home, including work and study activities. Teachers and students
who usually interact at schoolmust conduct distance learningat home. Studentsusually
do activities in groups such as playing outside the house with their peers. This
limitation makes children divert their activities by watching television, computers, and
gadgets. The saturation that occurs makes most students after completing online
classes and doing school assignments distract by playing games and opening other
social media to reduce their boredom (Hasnah, 2022).
As previouslyexplained, activities carriedoutoutside the homewith natural sun
exposureareaprotective factor against the progressionofmyopia in children. With the
conditions of learning at home, parents need an effective strategy in maintaining the
need for sufficient sunlight in children. One thing that can be done is to use the area
around the house such as gardens, terraces, or balconies for approximately one hourto
do physical activity (Simarmata et al., 2020). In addition to maintaining the need for
sunlight in children, this also has apositive impact onincreasing the child's bodypower
in fighting the covid-19 virus infection. Another thing that parents can apply to their
children is to do movements and stretches for approximately one minute every sitting
for 30-60 minutes when the child is doing online learning at home.
Providing education to children, both parents, and teachers, is a must that needs
to be implemented during this COVID-19 pandemic. In addition, children who have a
history of parents experiencing visual impairments such as myopia, should routinely

9. carry out outdoor activities and reduce screen time playing gadgets. Children need to
fill their spare time by doing activities related to physical compared to digital games.
The roleofparents andteachers, in this case, is very much needed,namely by creatively
creating or modifying a fun way of learning for children online such as giving
assignments that involve physical activity and the like that do not involve the use of
smartphones so that there are limitations in their use (Janati et al., 2021). ).
In addition to parents and teachers, health workers also need to provide
recommendations and understanding of the importance of a healthy lifestyle to family
members at home to continue to comply with health protocols. The government can
also take a role in adjusting health protocols that need to be carried out by the
community aswell ascarryingout routinepromotionsaboutthe importanceofphysical
activity and restrictions on sitting for too long (Muis, 2020).
CLOSING
Based on the results of the research and discussion, it can be seen that gadgets
have a great influence on children's eye health during online learning. The eye health
found in this study was a decrease in eye acuity in the form of eye abnormalities such
as eye fatigue and myopia in children. In its development, the use of gadgets in children
must be limited to prevent eye health problems. In addition, the role of sharing parties
needs to be carried out. Parents, teachers, and the government need to work together
to overcome and prevent an impact that is bigger than today.
Korespodensi : Mistur Roziana (misturrozianasari@yahoo.com) 08117306051, Anci Winas
(Anciwinas_013@yahoo.co.id) 082281818585, Widya Wira (widyawira2677@yahoo.co.id)
081293867171, Dina Fatma (dinadwimarta13@gmail.com) 08117301318

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