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Comment by stevebmark | Hacker News Reader

We know how myopia works now. Low dose atropine and glasses with fogged edges reliably slow or stop myopia progression. Myopia is not reversible by natural means. Sunlight is maybe related but it is more likely the proven mechanism of near work, specifically keeping peripheral vision in focus which tells the eye to grow longer (there is no brain involvement, the eye does this alone). Myopia discussions are terrible, they are filled with people offering advice and guesses on something they don’t know anything about, and people claiming it’s curable.

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This article includes interviews from multiple experts, citing data from both retrospective and case control studies, plus the pandemic which effectively provided an even broader, country-wide study that again matched their data.

I’d love to understand why you would post such a dogmatic dismissal without so much as a citation. Are you an ophthalmology researcher yourself who is familiar with contrary and well-vetted research? Are you someone with a strong personal experience that you have a hard time squaring with the data? Or are you someone who forms strong beliefs, firmly held, regardless of whatever new information life offers?

Emmitropization is a fact. Peripheral over focus causing myopia is well documented and peripheral defocus is also well studied. Peripheral defocus lenses and low dose atropine are well studied. The mechanism is understood, and proved by multiple different ways to interfere with the mechanism.

Optometrists are clothing salespeople. Only some ophthalmologists even know about atropine as an option.

Yup. If you spend time all day at a computer but never wear glasses, I can magically guess that your prescription is around -2. That's not a coincidence, just calculate the focal length and it comes out to exactly the computer screen distance.

And when you wear your full prescription without correcting for target distance, you just restart the process all over again. For some lucky people the axial length seems to be fixed after some point, but for most people that sets them on the path of increasing power.

> I’d love to understand why you would post such a dogmatic dismissal without so much as a citation

Is this your first time on hacker news?

Indeed.

As someone with an education in healthcare, nothing goes off the rails, and I mean really off the rails like a health related thread on HN.

You get some of the most ardent believers in some of the wildest hypotheses who are quick to dismiss a century or more of actual data.

That’s not to say that some early hypotheses won’t turn out to be correct, but there is a big difference between “I read this interesting paper with an interesting hypothesis” and “Hey guys, all of current medicine is 100% wrong and your doctor is conspiring to keep the truth from you (or so inept they probably can’t tie their own shoe).”

Found these for the curious.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6328548/

https://www.nih.gov/news-events/news-releases/low-dose-atrop...

No, we don't. Or at least you don't.

https://www.nih.gov/news-events/news-releases/low-dose-atrop...

So far our best guess is to make sure kids get enough sunlight every day and spend time outside, because looking at things in the distance is what regulates eye lengthening during growth. Since things are typically further away outdoors, it helps normal eye development and slows down nearsightedness.

> Sunlight is maybe related but it is more likely the proven mechanism of near work

My impression was that near work was previously a leading hypothesis but that, in agreement with this article, sunlight exposure is now considered the most likely explanation. However, I don't think there's ironclad proof either way, and a scholarly consensus is lacking.

Do you have a link to a recent review article that adjudicates between these hypotheses?

You don't know how it works until you know how to fix it.

Until you have a fix you are going to suffer these terrible discussions, after all is it more terriblier than having actual myopia?

>glasses with fogged edges I would like to know more about this. My glasses have this and I've never realized they had a purpose.

Just research "peripheral defocus."

It’s definitely reversible. My left eye got better by about a whole point in my mid to late 20s.

There is no known way to reverse myopia outside of surgery. A single diopter change is irrelevant in this discussion.

> proven mechanism of near work

Proven how? The article is pretty explicit about the relationship between near work and myopia being just a correlation, not causation.

What are glasses with fogged edges? is it same as rimless/frameless eyeglasses?

Just research "peripheral defocus."

Why do fogged edges slow or stop myopia?

Essentially when things in your peripheral vision are in focus, aka things close to your eye like screens, your eye thinks it’s over focusing, and it grows longer to defocus, causing myopia. Preventing focus in peripheral vision removes this signal. The eye is very dumb, it grows on response to light focus. The brain is not involved.

Aren't there ongoing debates about the cause? I recall a Chinese government project to add sunlight to primary school classrooms. So it seems there is controversy still about what the actual cause is.

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