Myopia, also known as nearsightedness, is a condition in which distant objects appear blurry while objects up close appear clear.
Historically, it has been thought to be primarily a genetic condition, as having a parent with myopia is a major risk factor. However, recent observations by optometrists such as Dr. Marina Su have noted an increase in children with declining vision, despite having parents with no vision problems.
This has led to speculation that technology, specifically prolonged screen use, may be contributing to the rise in myopia and could potentially lead to a future epidemic of blindness, according to Dr. Michael Repka, an ophthalmology professor at Johns Hopkins University.
Rise of Myopia: A Growing Epidemiс
The incidence of myopia, or nearsightedness, has been on the rise in recent years, particularly in East Asia, and is projected to continue to increase over the next half century.
In response to this trend, the American Academy of Ophthalmology (AAO) created the Task Force on Myopia in 2019 to address the growing global problem of myopia and its associated complications. According to a report from the Task Force, the number of people affected by myopia is expected to increase from 22.9% of the population in 2000, to 49.8% of the population in 2050. Additionally, high myopia, or severe nearsightedness, is also predicted to rise, from 2.7% of the population in 2000 to 9.8% in 2050.
In certain regions of Asia, myopia is especially prevalent, with over 90% of university students affected, and 80-90% of young adults in East and Southeast Asia showing myopia, with 10-20% having high myopia. This increase has been linked to prolonged hours of studying and performing near work with eyes.
As reported by The Atlantic:
“In the past, British physicians have observed that myopia is more prevalent among students at Oxford University than in military recruits, and in urban schools compared to rural schools. A medical guidebook from the late 1800s even recommended treating myopia by spending time in different environments and avoiding activities that involve prolonged use of the eyes, such as taking a sea voyage.’”
The growing incidence of myopia is a cause for concern, as it goes beyond the mere inconvenience of needing to wear glasses. The reality is that the way technology has become so ingrained in our daily lives, from early in the morning to late at night, has resulted in significant changes in the way we use our eyes in a relatively short amount of time.
Optometrist Liandra Jung from the Bay Area said to The Atlantic, “Humans used to be hunters and gatherers, so we relied on our sharp distance vision to track prey and find ripe fruit. Nowadays, our lives are much more close-up and indoors. Instead of foraging for food, we just order it through Uber Eats.”
Beyond Glasses: The Serious Risks of Progressive Myopia
The early onset of myopia in children and its high progression rate is a cause for concern, as it could lead to an “epidemic of high myopia” even among children as young as 11 to 13 years of age. Myopia, or nearsightedness, results in the elongation of the eyeball, which is irreversible and increases the risk of severe vision problems later in life. According to the AAO Task Force, by age 75, 3.8% of people with myopia and 39% of those with high myopia have “uncorrectable visual impairment.” This means that myopia increases the risk of conditions such as retinal detachment, cataracts, and glaucoma, even when myopia is of low to moderate severity. The AAO task force highlights that the widespread clinical and societal impacts of increasing myopia prevalence require a “coordinated global response” , as the earlier the onset of myopia, the faster the progression tends to be.
As per AAO:
“The number of people who will experience uncorrectable visual impairment due to myopia is expected to rise by 7 to 13 times in high-risk areas by 2055. Myopia not only poses direct costs associated with optical correction, but also a significant public health burden in terms of socioeconomic impacts and reduced quality of life as a result of visual impairment.”
In China, efforts have been made to curb the increasing prevalence of myopia in children. Measures include limiting access to video games, not administering written tests before third grade, and installing metal bars on school desks to encourage children to maintain a greater distance from their work.
Is Technology and Lack of Outdoor Time the Cause of Rising Myopia?
As technology continues to advance rapidly, it was not foreseen that society would become so heavily reliant on screens, to the extent that they now dominate our waking hours. This has led to negative effects on vision.
Experts writing in the journal Progress in Retinal and Eye Research have identified that prolonged education and limited time spent outdoors are major risk factors in the growing epidemic of myopia.
They said:
“The concentration of the myopia epidemic in certain regions appears to be a result of the high educational demands and limited opportunities for outdoor activities in those areas, rather than being genetically predisposed to these factors. Studies have shown that increased time spent outdoors in schools can prevent the development of myopia, and that the high prevalence of myopia and high myopia in certain subgroups such as Jewish boys in Orthodox schools in Israel compared to their sisters in religious schools and boys and girls in secular schools, is linked to high educational pressure. Combining increased time outdoors in schools with methods to slow the progression of myopia could control the epidemic and prevent major health challenges. Furthermore, reforms to the educational system to reduce intense competition for early advancement could also be important in addressing the issue.”
The AAO has reported that spending too much time indoors can increase a child’s risk of nearsightedness, and that spending more time outdoors in natural light can reduce this risk. French researchers also note that outdoor activities are one of the most effective treatments for myopia in children. The COVID-19 pandemic has led to an increase in myopia among children, as lockdowns kept them indoors even more.
Studies have found that home confinement and increased digital screen time during the pandemic have contributed to this increase. The American Journal of Ophthalmology has also warned of a potential “myopia boom” caused by digital screen time during the pandemic.
Preventing Myopia: Moving Towards Effective Solutions
As nearsightedness in young children continues to worsen, methods of myopia control and management are becoming increasingly popular. Myopia-control clinics have been established in affluent regions throughout the US and are also prevalent in China. These treatments aim to slow the progression of axial elongation, a symptom of the disorder.
Treatment options include atropine eye drops, multifocal soft contact lenses, and orthokeratology lenses (OrthoK) which are worn overnight to reshape the front layer of the eye and improve vision. However, it is important to note that none of these treatments can cure myopia, they can only slow its progression.
Therefore, prevention is a better approach and for young children, spending more time outdoors and less time on screens is crucial.
Screen Time and Blue Light: A Growing Concern
Technology is affecting eyesight in multiple ways, not only because people are spending so much time focused on close-up screens, but also because they’re being exposed to blue light in the process. Data presented at the 60th Annual European Society for Pediatric Endocrinology Meeting further revealed that longer exposure to blue light was associated with earlier onset of puberty in rats, along with reduced levels of melatonin, increased levels of certain reproductive hormones and changes in the ovaries. This can lead to an increased risk of chronic health conditions such as metabolic disorders and cancer.
LEDs found in many screens have virtually no beneficial infrared light and an excess of blue light that generates reactive oxygen species (ROS), harming your vision and possibly leading to age-related macular degeneration (AMD), which is the leading cause of blindness among the elderly in the U.S. LED lights may also exacerbate mitochondrial dysfunction leading to chronic conditions ranging from metabolic disorders to cancer.
“Although not conclusive, we would advise that the use of blue light emitting devices should be minimized in prepubertal children, especially in the evening when exposure may have the most hormone-altering effects,” Dr. Aylin Kilinç Ugurlu said in a news release.
To protect yourself from these potential risks, it’s essential to take steps to reduce your blue light exposure, particularly when viewing screens at night. You can install a program to automatically lower the color temperature of your computer screen. In addition, when watching TV or other screens, be sure to wear blue-blocking glasses after sundown. Better yet, eliminate the use of screens entirely after sunset, particularly in young children who are most susceptible to their deleterious effects.
