Meta-analysis finds children with myopia experience higher levels of depression | Hacker News Reader

Meta-analysis finds children with myopia experience higher levels of depression

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72 pointsCenk59 comments

I was so self-conscious about wearing glasses, I hid my myopia for years. And I was really short sighted! I noticed first when our class got shuffled around and I was moved from the front row to the back and I suddenly couldn't read the blackboard any more. It was pretty clear I was supposed to be able to so I knew something was up but I hid it due to the fear of getting glasses for years. The thought of having to come in one day suddenly with glasses, and be (I imagined) the centre of negative attention, from everyone, for a whole day.. it was just too much. Silly now to think of it. One day's pain would have saved me so much anxiety for years.

I was hyper-attentive in class to make up for it, had a few close calls. The most amusing was the yearly sight test from the school nurse. We did it in a group so I made sure I wasn't first and just memorized the letters others called out. The nurse then asked "are you sure you can see that alright? It's really strange, your sight has improved since last year". It was not my sight that had improved but my memory..

Of course I finally had to submit to reality, but I managed to hold it off til University, where was I able to reinvent myself somewhat and have the glasses be part of my identity from the start. Never gave up hating them. (Got laser eye-surgery eventually, biggest life enhancement I ever had).

> (Got laser-eye surgery eventually, biggest life enhancement I ever had).

I will never not upvote a comment that mentions something like this. Laser eye surgery (well, LASIK, specifically) is biggest external boost to my happiness that I've managed[1]. I would strongly recommend that anyone who can get it, absolutely should.

[1] https://old.reddit.com/r/KidsAreFuckingStupid/comments/p2c7v...

does the surgery still worth doing for 35+ people?

Absolutely. The older the better in some cases, as your prescription will change over time. I'm actually starting to get long sighted now as I age.

I'm about -2.50 and can function around the house without glasses most of the time - because I almost never wear glasses, I hate wearing them. I wear contacts otherwise and don't find them much of an imposition besides when camping. My main concern is probably eye health given I'm lazy with changing/cleaning contact lenses.

At 45yo, should I bother?

I have family members that had their operation at around 40 and they say it's worth it. You might get 10 years of no glasses/contact lenses before you need glasses again for presbyopia. I personally had -2.5 too and honestly it's been the best decision I've made.

Am I correct in thinking that the presbyopia is coming regardless, and I'll be able to avoid contacts/glasses for general distance stuff (driving/camping/existing) for a solid length of time?

I have a three month camping trip coming up and wondered about trying to get my eyes done before then. Of course, I should've done them back in my 20s, but better late than never.

I honestly don't know if it's coming regardless. I'd talk to an ophthalmologist because as usual, it depends. I'd assume that for distance stuff you could avoid any correction, but I'm not sure about that.

> I have a three month camping trip coming up and wondered about trying to get my eyes done before then.

My recovery took a few days (I had the more invasive procedure due to dry eye concerns) and I think they tell you to not do any activity where your eyes could get damaged during a few weeks just to be sure, so try to plan around that.

Thanks for sharing the info - I appreciate it.

Agreed. For me, it was the coolest living in the future thing imaginable. My eyes were crap, something that in days gone by might have condemned me to the scrapheap, and it got fixed, by science. With a LASER. Just an incredible barometer of progress.

A blade cutting my eye sounds terrifying though. Did you go completely under?

No, you don't. You get eye drops to anaethetise the eye, that's it. BUT.. it's not as horrible as it sounds. Even this initial cutting of the flap is all done with a automated thing that covers your eye, it's not like some guy sways up to you with a scalpel wobbling in his hand. You don't 'see' anything other than your view being obstructed, you certainly don't feel anything. (There is some discomfort afterwards, but they give you eye drops which work wonders)

There is a slight smell of something burning, which is a little disconcerting, I can't lie.

I had TransPRK, where the experience really just came down to "a light shines in your eye for 20s, then another 20s in the other eye, and you're done".

A day of pain afterwards though, which wasn't great. But zero regrets, even on that day. And you have that with LASIK too, though not with LASEK, IIRC.

You got lucky if you didn't need follow up surgeries. The most common cause of myopia is eyeball length, which laser eye surgery doesn't address. So folks end up getting their cornea shaved and sculpted up, in a barbaric way (lasers wow!?) and then their eyeball length accommodates and they need the surgery yet again. There's only so much cornea that can be cut away.. in fact, often folks end up with chronic dry eye from the surgeries. The cornea is really not meant to be cut up, it's extremely delicate, and scars and ulcerates easily.

Here's my full comment: https://news.ycombinator.com/item?id=31834633#31860661

Well, it's my eyeball and I can do what I like with it. Calling something barbaric is a nonsense to me when it doesn't hurt and is done with informed consent (and it works!) I'm sure there are risks, and you might have some haloing at night or whatever, but I went from -4.75, -5.75 to 20/20 vision! And if I end up slightly long sighted.. small price to pay for 20+ years free of glasses. Lasers wow indeed!

Of course people should make informed decisions. I'm sure enough of the operations have been done to get a very informative risk breakdown. And if you are happy with glasses more power to you.

-5.75 is pretty awful vision, so I can understand the desire. We likely could have fixed that naturally through changing your habits, getting you more accurate scripts, and 3+ activity-specific scripts. I discuss in my comment, how most folks don't really have genetically bad vision but rather persistent biological compensations that can be ameliorated. But sure, if you were looking for a quick fix that doesn't last, I suppose it's effective and I don't demean you for your choices.

I'd love to believe it could have been fixed naturally, at the time that branch of treatment all seemed woo-woo, be fascinated to hear if there is any hard evidence for it working now.

But anyway, sorry for the previous sharp reply. It wasn't warranted.

Agreed on the LASIK. Huge step-level increase in quality of life.

For some people, it’s not a permanent fix. I got it in 2003 and needed glasses again by 2013

Indeed, I am sorry that happened to you. The reason is that it doesn't fix the root of the problem, eyeball length. Instead, it barbarically carves a lens shape into one's cornea.

Here's my comment about all of this: https://news.ycombinator.com/item?id=31834633#31860661

Very similar story, minus the compensating attentiveness. Probably partly to blame for some late blooming tendencies in my life.

Contacts were a life changer in confidence for me.

Contacts, even the newer gen ones, with superior O2 permeability and H20 saturation and DkA values, are a nightmare from a health standpoint. Over time, contacts can cause indentation/ulceration, in a circular pattern, on the cornea. These scars are pretty much permanent. I recommend wearing glasses, vanity is overrated.

I've been wearing them for 25 years, and they changed the trajectory of my life. You know what else is overrated? Self loathing.

Being able to play sports and like the way you look are healthy. My eyesight seems to be doing ok, too.

Occasional use for sports and events is okay but as a consistent vision substitute, they are pretty unhealthy.

Eyesight won't suffer from contacts - it's the corneal surface that will.

What is the impact?

In some cases, permanent scarring. This would be noticed as an indentation in the cornea, that can occasionally cause some itchiness but would generally be asymptomatic.

https://eyeguru.org/essentials/corneal-abrasions-ulcers/

It's extremely rare but sometimes the ulcers can cause vision impairment. With contacts, the ulcers are generally ring shaped, and not anywhere near the actual focal plane, thus, they are only superficial, even if they end up scarring.

Kids wearing glasses are more likely to be less active because glasses gets in the way and are more likely to be staying indoors (as myopia seems to correlate with staying indoors). Exercise and exposure to sunlight seems to be crucial against depression, so I can't say I'm surprised.

I’ve noticed a correlation between my depression getting stronger on days I don’t put my contact lenses in. Granted, if I’m not putting my contacts in I’m not leaving the house but it’s an interesting correlation nonetheless.

I think it comes from not being able to experience the world in full clarity. There’s a strong relationship with tinnitus and depression for what I’d think are similar reasons.

And cataracts, though I heard that was possibly from yellowing causing lack of blue light and affecting circadian rythym.

I kinda noticed this myself. As a young child, I had perfect vision. Apparently sometime by middle school my vision started declining. But, I really didn't know it. I mean, I could generally read the blackboard, all good right? But everything was so...drab.

Finally saw an eye doc and caved on getting glasses. Wow what a difference. The first thing I noticed was that I could see blades of grass, and leaves on trees, and hairs on squirrels. They're not just green or brown blobs afterall. And people...they looked so different. Some better, some worse. I could see hairs, and wrinkles, and subtle visual cues I'd been missing. I must have spent 2 weeks just amazed at the world I'd been missing out on.

So while not clinically depressed or anything, I can confidently say the world is more depressing when it's blurry.

When I got glasses as a kid everything became unbearably sharp. It took some time to adjust to being attacked all the time by so many details I wasn't interested in.

Seeing the grass across the road from the optometrist when I tried on the test glasses was a very memorable moment for me as a teenager. Couldn't believe things could look so sharp!

FoF report I once heard: "I didn't know the trees had leaves."

Maybe depressed children spend more time indoors, causing myopia?

https://www.premiumtimesng.com/news/137695-children-who-stay...

From the article:

> Strabismus surgery significantly improved symptoms of depression (SMD: 0.59) and anxiety (SMD: 0.69) in children.

s/spend/are kept/

These days most young kids get little choice about where they are dragged (or not) by their parents.

There is a sort of inverse Bode's law for how far kids can roam, over each generation.

Is this due to myopia itself, or having to wear glasses? My son certainly was less than thrilled about starting to wear them: "I used to be cool but now people think I'm a nerd" etc.

That's hilarious. I remember having the same thought when I had to wear glasses as a child. Turns out I WAS a nerd.

My daughter, 8yo, has started wearing glasses, she had similar feelings but we went to several opticians and got glasses for her that suited her face shape, they gave her so much more confidence. She's trialling Ortho-K lenses now as she enjoys sport but I think glasses are an easier thing to manage.

Sad to hear this.

Glasses are actually cool. Being a nerd is also cool.

Don't let him think otherwise.

Source: have been wearing glasses for my myopia & astigmatism since middle school, am a nerd and am cool. ;)

Nice, now you and my mom think I’m cool!

2 people down, nearly 8 billion to go.

But seriously I agree, glasses are amazing. We shouldn’t look at it like we have to wear them; it’s amazing that we get to at all. They’re a marvel. It’s not always great to wear something on your face, but it’s a small price to pay for what they make possible.

You are cool. That's 3 of us.

I’ve been wearing glasses since I was 8. They’re not cool and never will be.

They're not particularly cool, but they do tend to have at least one positive stereotype (that someone is learned), which is more than can be said for most assistive devices.

You wouldn't have been cool in my school.

Being pretend nerdy is cool among Gen Z now.

I suppose photochromic glasses would go a long way in increasing the coolness factor, considering that they turn into shades in the sun.

But don't take my advice at face value - I'm a parent to a toddler, so literally the uncoolest person in the eyes of a pre-teen, not to mention teenagers.

When I was a kid glasses were fine, but transition lenses were mocked. Most of time they are a shade in-between glasses and shades and look terrible.

Yep, my advice should definitely not be followed.

As a recent kid, I can tell you that those sorts of glasses are the only uncool kind.

> Strabismus surgery significantly improved symptoms of depression (SMD: 0.59) and anxiety (SMD: 0.69) in children.

What about optical correction like glasses?

call me crazy, I think whatever fixes their lazy eye helps

(I got surgery, not glasses)

+1 for including the sample size in the title. Good way of distinguishing from click-bait.

For reference:

> n = 700,000

Most cases of myopia (nearsightness), involving progressively worsening vision, are largely due to inaccurate lens prescriptions and bad habits. An optometrist or optician will have you sit with your head in the phoropter asking "better/worse" while flipping lenses - pretty much a binary search type of approach. But this is often done hastily and results in inaccurate prescriptions.

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Unfortunately, inaccurate scripts are often inflicted upon children which as I will describe later, compounds into worsening vision over time, with the opticians/optometrists prescribing higher and higher power lenses that are only solving an issue that is created by the previous history of inaccuracy! Telltale signs of inaccurate scripts include:

- minor corrections

Eyes are not static objects and vision actually does vary from month to month, day to day, lighting conditions, blood pressure, etc. If a correction is minor, it's almost always unecessary and harmful.

- slightly different prescriptions for left (OS) and right (OR) eyes.

99.9% of folks have equivalent vision in both eyes. Like I said above, if a difference is minor, a correction would almost always be harmful.

- minor cylinder corrections (astigmatism.)

Astigmatism is extremely rare and when it does occur it's almost never minor. These corrections are especially egregious as they cause distortion compensation.

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So why do eye professionals commit these cardinal acts of eye destruction upon their patients? Well we already discussed hastyness but that is clearly a vice that is going to result in bad outcomes in any profession.

What else? Well, eye professionals are taught to seek out as perfectly sharp an image as possible, and then back off the power a bit to reduce the possibility of eyestrain, headache, and dizziness. Some professionals don't even back off the power though..

In order to accomplish this task of perfect sharp vision, they add all of these minor corrections. When these ill-fitting lenses are worn for months on end, the body has a somatic response. The eyeballs elongate, which pushes the focal plane back, causing further myopia. [1]

The patient goes back to the eye doctor and now receives an even more incorrect script based on the transient state their eyes are in, induced by a cascading patterned history of harmful scripts.

In the worst case, the eye doctor recommends laser eye surgery which shaves the corneal lens of your eye into an artificial lens. Essentially, they carve your current harmful prescription straight into your eyeball. And then guess what happens? The eyeball shortens and often, the patients vision becomes progressively worse again. It can take months, but it does happen. [2] And now the fix that they recommend? More laser eye surgery. It's barbaric.

So please, do not get eye surgery before trying what I recommend below. Surgery on the cornea is advertised as non invasive but it can cause life long issues such as chronic dry eye. Please try to assess whether your vision is actually bad, or just a transient state due to a long history of bad prescriptions and poor habits.

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How do you break the cycle and restore your vision?

1) First, look at your current script. How asymmetric is it? How small are the cylinder values, if any?

Lower the scripts power and make the prescription symmetric. Remove the minor cylinder values. So for example, if you had -3.6 and -3.4 with some small astigmatism corrections, just ask for a script for -3.4 SPH in both eyes.

2) Make sure the pupillary distance is correct - eye professionals are notorious for fucking this up because the PD needs be to custom set for the frame the lenses will be going in, otherwise you'll have lenses with a focal center that is not aligned with the center of your eyeball. This causes distortion and uneven focus, causing eye strain and worsening vision.

3) Aspheric lenses - buy good lenses like Seiko double aspherics - just like cinema or photo lenses cost a lot of money because they reduce abberation and edge distortion, your eyes benefit from the same technology. Bottom dollar spherical lenses are okay, but strain is not healthy for eyes, and a good $300 set of Seiko transition lenses with coatings can last 10+ years. It's worth your eye health.

4) Have multiple pairs of spectacles. Use the weakest usable one (or no specs) depending on the task you are doing. For instance, I'm on my phone in bed, so I am not using any glasses. This will improve your vision over time. You can slowly reduce the power of your scripts if you care about it. I went from -4.75 to -3.5 and I'm happy with what I'm at, so I don't spend any effort trying to lower any further. But if you have the money, the time, and the will, you can get to -1.X territory through judicious use of a set of activity appropriate lenses.

Lastly, buy your own frame, buy your own pupilary distance tools, buy your own trial lens kit and trial frame like the Oculus UB6. Take time and figure out the right prescription for yourself without it being rushed. Test it and have it remade if the center of focus of the lenses is not at the center of your eyes. PD is integral!

-------------

An eye professional who cares and understands these things CAN help and even properly measure these values but they are rare. Sometimes if you want something done right, you kind of have to do it yourself. Or at the very least, guide or give your demands. After all, you are the paying customer.

Hope this helps others break the cycle of worsening vision. If anyone has any question, feel free to reach out.

[1] https://www.ncbi.nlm.nih.gov/books/NBK470669/ [2] https://www.webmd.com/eye-health/news/20030410/some-patients...

You claim that using a slightly wrong prescription will harm your eyes and make eye problems worse. This is a bold claim. Your first link contradicts you, stating "The underlying biological cause of myopia is unknown, and there is no widely accepted means of prevention or cure." Please provide some analysis that backs up your claim. Please refrain from posting bold claims as fact without references. Such posts are boring to read.

Here's a contemporary study out of Japan: https://pubmed.ncbi.nlm.nih.gov/32740040/

I don't have access to the article's text. The abstract and summary do not say anything about inaccurate prescriptions for glasses. Would you please explain how their results and analyses support your bold claim?

I often wondered if my lack of clear sight had something to do with my teenage years.

Darn eyeballs got me down -_-

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