In Asia, short-sightedness is becoming ubiquitous
economist.com
economist.com
My suspicion is that staring at objects closely and under dimly lit conditions causes pseusdo-myopia which is later exacerbated by wearing glasses, causing actual axial elongation in the eyeballs through hormesis. Especially since this is what seems to happen in other animals when we dissect them.
Having explained this to my optometrists they will take me seriously and give me most any prescription I want, though unfortunately I don't exactly know what to do. I just make sure I have dedicated outdoor glasses and limit screen time with them.
I avoided wearing contacts for a while due to this but also other concerns. I think this may have limited my romantic success somewhat, at least at the time. In retrospect contacts with readers may have been the better option.
I keep holding out for LASIK but don't know how much longer I should.
I think the Holy Grail should be eye surgery that is a permanent fix. Current options wear off with age (and not that many decades at that), and then you are back to corrective lenses. There are usually very few who can qualify for another surgery later in life...and then it wears off again anyways. It's a consumable elective surgery that consumes the benefit and the body, so in my opinion it is a net loss over the long haul.
Must people need different lenses over the years, so it's inherently a temporary fix. And one that comes with the risk of going blind and is almost guaranteed to come with various sight issues a few years after the operation such as having more issues seeing in the dark ("night blindness") etc. Wearing contacts comes with it's own risks however, so if glasses aren't an option for the patient, LASIK isn't that dangerous.
I could've gotten the operation for free (paid by my insurance) but decided against it, as my superlight glasses really aren't that bad and the risks just weren't worth it to me.
Are you implying that cell phones could be a factor?
The human eye (specifically the ciliary muscles) are most at "rest" when staring at objects in the distance.
The human eye doesn't seem to be as well-suited for staring at distance less than ~20 feet for long periods of time.
I imagine learning how to read and write in general, the shift from an agrarian society to cognitive labor, and the invention of glasses all were just as important factors.
Your theory about 20 ft is literally correct.
Atropine is successfully used to relax the cilliary muscles.
However, there is lots of anecdata that rigid contacts don’t make your eyesight worse over time.
I'm a little sceptical about that theory, but my own rx did not go increase much when I wore RGPs. After that I did have some progression, but also a million other things changed, so who knows.
RGPs however, are quite distinct in that they give absolutely perfect vision. better than soft contacts by a mile. Maybe some refractive thing as well, optometrist told me numerous times under-correction would lead to further progression.
Ortho-K is popular in Asia for prevention, those are rigid lenses worn at night. Deforms cornea a little, so it's like a reversible lasik thing. So, in this case, not only its rigid lenses, they also have weird geometry. Many report significant success.
I dont understand why people especially shortsighted people still use the same glasses for everything. Why don't octometrists know better?
Its a horrible user experience
It's not a hyperbole, glasses are massively inconvenient to those of us handicapped without, and having to hot-swap then depending on subject is massively more inconvenient.
PS: you are right, maybe instead of only at the desk, just wear a "near sight" pair all the time, when you're indoor, and a far sight pair when you are out. Point is you dont have to hot swap.
And yes, most will just use short-range glasses all day as their only pair, which is exactly the thing you insisted that you did not understand ("I dont understand why people especially shortsighted people still use the same glasses for everything. Why don't octometrists know better?").
Sometimes it might make sense to just ask those with the handicap rather than make baseless assumptions about their situation as an "outsider".
Also don't use them while walking, they bother me. I feel like my eyes dry out or something, very unpleasant. It's a bit blurry but don't really notice it, also -2 is not really advanced myopia. I can't read car plates from the distance but I sure see the car coming and know not to bump into people.
Bad UX for switching, and my "reading" glasses have too short of a clear vision range to use at my computer without having to lean in.
It's just a comment that so wrong it's not wrong.
Prescription glasses restore your range of focus to original which is why I said it aims for looking at far objects, at relaxed eyes.
Problem with myopia is that you overwork your eyes' muscles by staying in close focal lengths too long.
And books, too.
Go out and play (no citations needed)!
I don't follow this. The articles use blood serum concentrations of Vitamin D in their methodology, are you saying there is a separate Vitamin D production/concentration in the eye's vitreous?
[0]: https://www.optometrytimes.com/view/time-outdoors-and-myopia...
The evidence is actually pretty clear, what's causing this vast increase in myopia is not spending enough time in bright environments (i.e. outside) during one's formative years. In that regard cellphones (since they can be used outdoors) are a huge improvement over e.g. television.
If we actually cared about fixing the problem, we'd be making it easier for children to spend time outside and making outdoor environments more welcoming for them. But that would require parents to allow children some freedom, or maybe even actually make some lifestyle changes of their own, whereas the revealed preference of parents is to lock their children up indoors all day and night doing something that looks like "studying" (i.e. pointless drills).
I'd like a source on that. AFAIK the leading factor is so called "near activities", or more specifically, lack of "far activities" (i.e. lack of looking at a distance, which makes your eyeballs get and keep proper shape and characteristics).
> In that regard cellphones (since they can be used outdoors) are a huge improvement over e.g. television.
Again, environment brightness, AFAIK, is way less important than the distance at which you are looking. Hence, looking at the TV is better than at your phone. And I suspect both are better than reading a paper book.
It has been determined very conclusively that myopia is caused by spending too much time looking at close objects. That was in my highschool textbook like 20 years ago.
Yes kids should spend more time outside but it has nothing to do with bright environment.
Cos I am very serious about having proper lighting on the room I work in. But always thought the screen should be dimmer than the room for some reason.
Thanks for taking the time to share your POV.
Ophthalmologists tend to be better at complex medical management, especially when there are systemic manifestations and own anything requiring surgical intervention.
Optometrists do a 4-year doctorate. Ophthalmologists do a 4-year MD that includes the full spectrum of medical training (gen surg, ob-gyn, neurology, etc.) and then a 1 + 3 residency that includes 1 year of general medicine or surgery and 3 years of medical and surgical ophthalmology.
There are, of course, optometrists who are very good at medical management and ophthalmologists that are very good at refractive issues (e.g. refractive surgeons). We mostly work cooperatively although things occasionally get spicy. I I enjoy working with and learning from my optometrist colleagues. I go to an optometrist friend when I need a refraction and an ophthalmologist friend for my annual.
I just don't happen to know any ophtalmologists, or anyone with a PhD who specializes in this, and in any case a good optometrist has overlapping expertise and concerns with ophtalmology and current research. Take it for what it's worth, no more, no less.
I'm not sure why you'd think they wouldn't be honest with me: you should assume good faith.
Their big breakthrough in understanding myopia occurred in 2008 when they studied a particular group of people who had a genetic form of myopia that’s very severe. They discovered a gene mutation that was causing the myopia.
“It turns out it was a mutation in the cone photoreceptors,” said Jay Neitz. “We then realized that it’s really just the way that the images are being encoded on the retina.”
What’s supposed to happen as your eye grows, is that things should begin to go out of focus in the periphery of your vision. That’s a signal for the eyes to stop growing.
But as long as things are still clear in the periphery, the eyes think this person must still be farsighted, because in the natural world things in the periphery are far away.
Neitz said his team was able to design a lens to make central vision clear and in focus, and give the peripheal vision much lower contrast.
“It recreates what is supposed to be going on with our eyes before we started putting all of these things in front of our face like computer screens and tablets,” he said.
After two years of wear, 85% of children wearing the innovative spectacle lenses showed less than one diopter of myopia progression.4 Moreover, the study also showed that 41% of the children wearing spectacle lenses with Diffusion Optics Technology™ showed no clinically meaningful progression in refractive error after two years versus only 17% in the control group.5“
See https://www.coopervisionsec.eu/news-two-year-clinical-trial-...
Not sure if they'd figured out the mechanism, but speculation was that bright light is involved in signaling the eye to stop lengthening at the right time.
IOW the cause is, basically, school. In Winter months, kids may hardly see the Sun at all, with very short days and recess often indoors (too cold, too snowy, too wet) especially as schools have seemed to grow more wary of taking kids out in poor weather, over the last few decades. Plus anything else that keeps kids indoors, sure (video games, social media[0]) but school seems to be a lot of it.
[0] And actually, the social media factor likely kicks in well after it matters. Ditto video games unless your kid becomes a gaming addict in the 3-7 age range and you just let that happen.
(My understanding is that the thing changing the shape of the eye over time is the development of the orbital socket bones — so nearsightedness and MBD could have more in common than it seems.)
I think genetics has a larger predictive effect than sunlight.
We know this isn’t true because Singapore is practically on the equator and went from less than 10% myopia to over 90% in ~50 years.
Perhaps it is roof opening...
I’ll grant that with indoor malls and public transit there’s less exposure to direct sunlight, but you still can’t avoid being exposed to the sun daily in Singapore.
There is/was a very strong aversion to being outdoors, especially during peak sunlight hours (lunchtime). This compounds with both study culture and digital culture (videogames + tv + phones) and less of a celebration of sports to mean many kids get less direct sunlight than you'd think. Especially now everyone is terrified of UV
I don't think OP mentioned being in the direct sunlight, but being exposed to it (visually, as in a source of bright light). Unless you sequester yourself in a room without windows all day, to get anywhere you're likely to need to walk outside to a bus stop, an MRT station, or to get a Grab. And unless there's a tunnel connecting office buildings to hawker centers, folks probably need to walk outside to get lunch (exceptions are malls connected to food courts).
Singaporeans probably get more sunlight than say Swedes over the course of a year.
> Singaporean children had shorter reported time outdoors and lower light levels, relative to their counterparts overseas. In the current study, reported time outdoors was 1.7±1.6hours/day and average light levels were 458±228lux. In contrast, children of similar ages in Australia and the UK reported time outdoors of at least 2–3 hours/day.18 22 Likewise, higher average light levels of 1072 and 1627 lux were reported in Australian (age 10–15 years)16 and American (age 5–10 years) children,20 respectively. Differences in educational demands (homework load and afterschool enrichment classes),23 lifestyle and sociocultural factors may account for the lower reported time outdoors and light levels in Singaporean children
I can't remember exactly how many hours of exposure to sunlight the studies mentioned, but I think it was something like 2-3 hours --- and it might have to be more than just, e.g., being near a window. I'm Singaporean too, and that excerpt from that paper accords with my experience. I highly doubt that I and most of the people I grew up with had that much sunlight exposure per day.
My own personal (and very anecdotal) observations are that people really go out of their way to avoid exposure to the outdoors. Depending on your lifestyle, it is really possible to spend the day having only been outside for minutes of a day.
I think things are changing but I feel like the last 20-50 years have not really celebrated an outdoors lifestyle. Whereas my time in Europe is somewhat different in that plenty of people optimise to spend time outdoors - probably due to less oppressive weather and kids were encouraged to play outside a lot more
Although one possible nuance is that sunlight to the eyes != sunlight to the skin. In cold climates you wear thick clothes which will block out sunlight to the skin (vit D deficiency) but you may still get plenty of UV to the eyes. Throw in some mountains for distant gazing and suddenly nations that love skiing could be simultaneously vit D deficient but guarded against myopia.
Pure conjecture of course - IANA(Biologist/Opthamologist/Doctor)
I don't think historically (at least in the past 40 years) most people (barring construction workers and certain jobs) from that region were ever out for 12 hours a day in the bright sunlight.
Which is obviously wrong. The main variable is the time the eye spends at a short focal length. Like every other part of the body, the eye adapts to the stresses it experiences. Focusing on nearby objects for extended periods is stressful for a normal eye and as is the case for so many stressors, the body adapts[1]. This is easily seen in that ceteris paribus a person with myopia can comfortably focus on much closer objects than someone with normal vision.
Incidentally this means that corrective lenses can actually cause myopia to progress. Contrariwise a prescription can be written such that there is an effective training stimulus to reverse myopia[2]. However, that won’t fix the decreased focal range due to age related hardening of the lens of the eye.
[1] See Selye for details.
[2] Inexplicably, most optometrists refuse to do so.
Parents nowadays blame screens for short-sightedness, but the truth is back then my classmates are almost all doing reading and writing all the time, and nobody was using screens (Symbian Nokia only took off years later).
It's only me and the other two boys who spend all the time and money on online video games - the other two guys were almost score zero in every single exam.
Classic (i.e. in paper) reading/writing is much worse than screens.
> It's only me and the other two boys who spend all the time and money on online video games
the most important factor, AFAIK, is "outside time", i.e. the amount of "medium/far distance looking" that you do every day. A lack of it has been proven to cause myopia.
You live in a small apartment above a large shopping mall and connected to the metro.
School is indoors, book learning is prioritised over outdoor physical activity.
Kids would spend their entire childhoods indoors.
No wonder myopia is so prevalent.
I was astonished at the number of people wearing glasses in the country. Especially women.
At first I thought it was some kind of fashion statement, but it seemed to be prescription lenses for the most part.
I’m in no way saying that the article explains any of this - it’s just an observation.
(I guess Economist must have a theme week on this...)
https://www.aao.org/eye-health/glasses-contacts/what-is-orth...
It seems to be a common trend that Asian countries are getting western afflictions along with westernization.
https://www.dailymail.co.uk/news/peoplesdaily/article-298798...
It seems to be a common trend that Asian countries are getting western afflictions along with westernization.
https://www.dailymail.co.uk/news/peoplesdaily/article-298798...
Then again 2 out of 3 Asians I've dated wore glasses. My first girlfriend and mine's frames touched when we kissed.
The 2 were both Americans, so it would point to a generic explanation.
Then again a geneticist friend of mine pointed out the egg that made you was actually created inside of your grandmother. So bad nutrition, due to famine perhaps, can easily affect multiple generations.
Rather depressing to think about how the grandmothers of most people likely suffered though some form of famine. It's really great to see global poverty decrease to such a level this won't be the case in 100 years.
This seems suspect, and a quick google search disagrees with you. Where did you get this information?
Not a single doctor has agreed with this sentiment and I've never found any significant studies conducted that support this claim. If it were true you would expect it to have a lot more actual backing than it does, especially given how long the theory has been around now.
It isn't like your eyes are healing or anything. This isn't what we are doing with glasses because your eyes aren't injured. Using glasses is more akin to using crutches when your leg simply will never work - neurological disorders, permanent disability, and so on. The crutches help you get along. Or maybe you aren't using crutches, but instead a brace for drop foot or some other sort of support.
What you are referring to is something that will heal - an injury. And crutches are good when you are healing, too - those times you do not want to put weight on a leg. In these cases, you don't want to use crutches too long lest you have atrophy or stiffness. But this isn't like glasses at all: In this case, for eyes, you'd use things like a temporary, protective contact and/or an eye patch (There may be cases for glasses, but I'm a layperson and simply cannot think of any right now)
I don't know of any research offhand that definitely says it does or does not permanently effects your vision, but it isn't hard to get confusing or contradictory results if studies aren't well prepared specifically because your eyes can change focus slightly through concentration and can also get tired and will effect the maximum focal change possible at different times.
Whenever I switch glasses my vision gets much worse.
If I stay on a prescription for a while I'm stable.
This geneticist should lose their degree and their job.
Not sure how a single cell from your grandmother could pass along “eggs”.
Jesus.
Hope that helps
Your mother is born with a birth defect which causes you to be born early.
As your born early you suffer from numerous health issues.
https://mountainx.com/living/a-haunted-legacy-the-multi-gene...
>Switzer talked about how her husband, who served in Vietnam from 1968-1969, was recently diagnosed with prostate cancer. She also shared that both her son and her granddaughter were born with birth defects. Switzer mentioned higher rates of miscarriage, stillbirth, learning disabilities and asthma among the children of veterans as well. “All you vets out there, we need you to get your medical records and give them to your family. And us — we need to put down on our own medical records that our husband or father was in Vietnam and exposed to Agent Orange,” she said.
Or, maybe integration poverty causes all of your kin to eat poorly