A myopia epidemic is sweeping the globe | Hacker News Reader

A myopia epidemic is sweeping the globe

nature.com

163 pointsrntn72 comments

There's a husband and wife team of optical scientists who have been studying myopia and theorize that high contrast across the retina signals the eye to elongate which leads to myopia. "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." As a result, they patented glasses that blur your peripheral vision, and a trial has shown them to be more than 50% effective at reducing myopia.

https://newsroom.uw.edu/news-releases/glasses-stop-myopia-ar...

https://bjo.bmj.com/content/bjophthalmol/107/11/1709.full.pd...

https://patents.google.com/patent/US11493781B2/

So, to avoid having a blurry vision and having to wear glasses, their solution is to wear glasses that blur your vision?

That's not a dig at them; more like life having a laugh at us.

I imagine it's like wearing a cast. To fix your broken arm that can't be used, you need to wear a cast that prevents your arm from being used.

These are now commercially available and my kids wear them. It's a basically invisible pattern of dots, not a visible blur, and both have stopped the progression of their myopia in their tracks.

https://www.essilor.com/au-en/products/stellest/

I've been using a Chrome extension with anti-myopic blur based on this principle:

https://chromewebstore.google.com/detail/refractify-myopic-d...

is it any good?

This is a fascinating article. We know that we need to get kids outside more, but aren't able to prioritize that (except in Taiwan). Instead we're trying to find ways that let us keep using classrooms and screens the same way. I'm very interested in the increased indoor light therapy (for my own use). I would really like for it to be as bright indoors as it is outdoors, matching the spectrum of the sun, without being horrifically expensive.

Mirrors

A few years ago I heard about a method of using bundles of fiberoptic cable to "pipe" sunlight from a rooftop into rooms. My impression is that it's cheap as hell but impractical.

I can't find the article, but this seems to refer to the same idea: https://www.quora.com/Can-fiber-optic-cables-be-used-to-carr...

You can buy "skylights" that are essentially internally mirrored tubes that accomplish essentially the same thing. I don't believe they're super cheap right now, but I imagine they could be if they became more widely used.

I know someone who installed one in their bathroom and have been surprised at how well it works.

As a building science scholar, I do not recommend skylights or solar tunnels, as they increase the likelihood of roof leaks in the future (as any roof penetration does). Also impairs thermal management due to lack of insulation between the conditioned space and the exterior.

I installed a Velux skylight on one of my previous remodels (replacing an existing low quality skylight), and I still regret it versus decking over the void and deleting the tunnel.

I'm currently renting. But i just want to add that the skylight in my house is the single best thing about it. I'm in a location which is pretty well shaded on all sides of my house. The windows that i do have are relatively small and do not let in all that much light. My house is permanently dim, great for sleeping, terrible for starting work in the morning.

In this scenario, the skylight in my bathroom while i do the morning ready is a godsend. Are there other better solutions? I'm sure there are, but is the prevalence of issues with properly installing skylights much larger than the prevalence of issues with windows?

Would a faux skylight led panel serve this purpose? Windows occasionally must withstand driving rain, a roof must withstand falling rain (on whatever cadence your climate dictates, Florida vs California are wildly different environments for example). Broad strokes, water is the enemy and you’re attempting to avoid intrusion whenever possible.

This is a rabbit hole :)

In short, no, unless you have tens-of-thousands[1][2] to spend on this panel. Rays of sunlight are parallel, an effect that very difficult to emulate.

There are folks who have developed DIY versions, with impressive results[3], but in that case you're trading off way more effort, potentially requiring maintenance, and a lot more space required.

[1]: https://www.coelux.com/en/home-page/index [2]: https://hometronics.com/about-us/press/item/coelux-the-40000... [3]: https://www.youtube.com/watch?v=6bqBsHSwPgw

I’m talking a $100 LED panel from Home Depot, not a full replacement to create a virtual skylight. Is it the appearance of sky or just the light? The light is easy, seeing sky (real or virtual) is hard.

Example: https://www.homedepot.com/p/JONATHAN-Y-2-ft-x-4-ft-Skylight-...

I'm aware of those--I have one, except mine is 5x brighter. It's just not the same.

It doesn't cast the gorgeous shadows sunlight does. It creates glare that makes having the panel surface directly visible, no matter how obtuse the angle, unacceptable.

Sunlight's parallel rays make it so that it's not your window that's bright, it's the things that your window shines light on that are lit up. You can look at your window or the sky all day without any discomfort. And that's just not the case for traditional light panels.

I’ve got a skylight that I hate (faces southwest so in the high summer sun it turns into a heat ray of death) and was planning to have removed, decked over and shingled. Since you are a building science scholar, I am wondering if the tunnel actually needs to be deleted or if I could just put some rigid insulation board at the bottom of the tunnel and then drywall over it?

No need to remove the tunnel if you prefer not to. Rigid foam to a depth that meets the R value for your zone and AHJ requirements (“local code”). Check if any inspection is required before drywalling over the rigid foam.

Thank you

Happy to help, enjoy the project!

Yes, I encountered one for the first time in the bathroom of a holiday let and, having no idea what it was, got very confused as to how I was supposed to turn it off. Fortunately we had an experimental nuclear physicist in the party who was able to explain that turning the light off would actually be a very bad idea.

If we just turned it off for an hour each night, we could solve global warming.

https://en.wikipedia.org/wiki/Light_tube

Is it now known that light is the primary mechanism?

It's crazy that we still don't know for certain. Being outdoors also often means just looking at things that are further away as well as more eye movement.

Yeah, IIRC, it was in Taiwan or maybe Singapore that they started to see a reverse in the myopia trend in nothing less than one year after having mandated full days outside in school.

But that doesn't have to be the light. That could be having to focus on further away objects.

Probably both equally and correlated.

Myopia gets worse in poor lighting conditions.

Look at those poor moles. :o)

I spent the majority of my life outdoors until my mid 20’s and have quite bad myopia. So perhaps helpful at a population level, but not a magic fix for everyone.

That’s effectively what the documentary I saw concluded (it was a French documentary).

There is a big part of genetics to start with but the impact of the environment is so big that it can make the difference between no correction needed at all up until unmanageable myopia.

Of course you can have a genetic baseline that makes you even more at risk and sensitive but it seems that’s pretty rare overall.

Also I’m curious of what you call quite bad myopia. As an example, my myopia is currently around -7 or -8 and to my surprise, I’m the only one being myopic in my whole family tree. Even my son have a perfect vision.

And it’s true that when I was young, I wasn’t frequently outside and even more rarely in wide open areas.

quite bad might be an exaggeration. Im now at -7.00 in both. I more meant bad in that it’s not something that’s going to be corrected or reversed to any meaningful extent beyond corrective lenses.

In my case though I have glasses, as does my mum, grandmother and both aunts. Clearly a genetic lottery winning family.

> Getting kids to go outdoors is a tough sell.

The problem isn't the kids. It's the adults.

Sometimes I truly feel like I'm living in a parallel world completely separate from contemporary media. Where I'm at, kids play outside constantly and everything is very rural and low tech. Many kids spend their free time at the voluntary fire force - basically forcing them to be out and about in the village. It's this way in almost every community all over my country.

Almost no-one I know here needs glasses and if they do, they're far-sighted.

>> This uniformity of focus is what tells the eye to stop growing, contends Ian Flitcroft, a paediatric ophthalmologist at the Centre for Eye Research Ireland in Dublin. “An effective stop signal is where the whole retina is seeing a clear image,” he says.

Driving. Driving cars is one of those rare activities where your eyes are constantly refocusing on objects at radically different distances, often several times per second. I would be very interested in a study tracking myopia in truckers. Imho, the end of human-controlled cars will result in a profound uptick in myopia.

From this small, recent study in India, it looks like Hyperopia was more common (slightly) than Myopia: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9359264/

Driving isn't really an option for children, which is the focus of these studies. Outdoor activities such as sports is a better idea.

It's been ~10 years since I reversed my myopia and I'm surprised that it's still a mystery to the medical community. Mine started around 2014 I worked at a law firm and was constantly looking for files up close all day every day. My distant vision got VERY blurry and it freaked me out. It stayed like that for about 1 year. I just thought it was my "time" because a lot of people around me had glasses. I went to Clarkson Eyecare for and they gave me a prescription for long distance glasses. My gut didn't trust it. So I read a bunch of (what was at the time) conspiracy theories on what caused myopia.

The websites explained: (1) Do NOT to use distance glasses because they actually elongate the eye even more over time and you'll have to get more and more powerful glasses as the years go by. (2)Get lots of UV sunlight without sunglasses so the eye can "regenerate". (3) Myopia is caused by looking at things very upclose for long periods of time and the eye muscle that focuses the eye to look that upclose over time gets "stuck that way" and trains the eye to elongate.

To stop and reverse moderate or beginning stage Myopia you need to wear 1x to 2x magnification glasses anytime you are doing upclose work. This way your eye muscle doesn't activate to focus the eye on the extremely upclose object. Get lots of outdoor time to relax the muscle. Move computer monitors back, avoid gaming or reading on your phone. Move objects away from your face, give it more space. When you are on the computer, wear the 1-2x magnifying readers.

After 1 year my myopia went away. The distance is crisp and sharp. This began my distrust of the medical community. Why didn't they tell me this was a treatment option?

I don't know why you're being downvoted, this has been my experience as well.

I had a problem with my eyeglass prescription creeping up by about 0.5 diopters every visit to the optometrist! I started wearing glasses that were about 0.75 diopters less powerful than my 20/20 prescription and my prescription stopped increasing.

Didn't get better, but it did stop increasing.

I've been wearing the same prescription (the correct one) since my mid-20s and it's not changing anymore. Plus I can actually see properly.

I've been nearsighted since I was a kid. My guess is that myopia isn't so much a disease, but rather your eyes becoming specialized in what you use them for. Lots of close range and dim environments (like indoor lighting) = eyes that are good at seeing in that environment.

One of my eyes is significantly more myopic. One eye was about -4.5, the other -6.5. Despite that I will frequently use my phone without glasses. This made me realize that the "worse" eye can actually focus on what I'm looking at a slightly closer distance than my "better" eye.

Interestingly, when I switched to HO during Corona, I put my glasses away as I was working on a notebook (sometimes even outside). My eyesight has improved markedly over these last years. I still need glasses gut the effect is definitely unexpected for my optometrist. I even joked that he might not see me ever again if this trend continues.

I'm nearsighted, and as I get older, I've started taking my glasses off more and more when I work on the computer.

But it's not my eyes getting "better" due to anything I'm doing - from what I recall, people naturally tend to get more long-sighted as they age. So it's just counter-acting my near-sightedness.

Does HO stand for home office in this case?

Take myopia into your own hands, is my best suggestion. Communities/movements like endmyopia (and many other forums) help understand what you can do.

Unfortunately I haven't found an easy way to keep up with the exercises that really improve things. If anyone has a way to make them easier to accidentally do, would love to know.

woah, what kind of sorcery is this?!

how does that work? ophthalmologists would say that it's impossible, but it feels like most physicians are probably 10-20 years behind the bleeding edge...

Safeeyes is a timer for Linux that every 15 min tells you to perform a simple eye exercise.

(I'm using 10m intervals and slightly longer exercise time and my eyes are better the more I spend in front of PC working - program doesn't stop movies and games).

Doesn't help with astigmatism tho, bugger :\

There is a mac alternative called Eye Leo

If anyone has a Windows version, pls post it. I'd love to get my mom on that.

I thought the Taiwan study showed this didn't really do much.

Isn't this the Bates method, a pseudoscientific snake oil cure that roped in Aldous Huxley?

No, the endmyopia stuff specifically rejects the bates methods (which include staring at the sun?? "palming"??).

Mostly it focuses on learning to focus at the edge of what you currently can at a distance, and then as you improve getting lighter and lighter prescriptions. I got as far as -1.5 better, but now sit at around -1 better. Also ensuring lots of super bright outdoor environments, and focusing at a distance regularly.

Whether it's a cure or studied well, I dunno. I just encourage folks to try it out if it helps them. I have an astigmatism as well, and I haven't seen any improvement there. So definitely not a panacea.

My prescription has been stable for years. Won't improving just make my glasses not work well anymore?

I have terrible astigmatism so can't get away without them.

My wife and I are both from multi generation lines of nearsighted people. I saw a study about how kids of Sigapor parents have less myopia if they grow up in Australia. When I was discussing w a physican parent of my kid's classmate, he mentioned that a theory is that switching focus far and near back and forth prevents this. I taught my kid to look at roof and other far details and the shift local. He's 15 and eye Dr gave him a clean bill of health that he avoided childhood myopia.

The key is shifting focus near and far out doors or looking outside.

Why not make lightbulbs that produce the 350-400nm wavelength to stimulate/prevent eye elongation? I’m sure companies like Philips would love to sell you therapeutic LED bulbs at premium.

It’s probably the brightness, too. Outdoors during the day under a big tree is brighter than basically any indoor lighting you see outside a movie set.

Brighter, and not by a small amount. It's not entirely visible light, but insolation is roughly 1000 W per square meter at noon. I'm not sure I have 1000 W of bulbs in my entire house.

I read an interesting article by someone that set up "daylight" lighting in their home by essentially tiling their entire ceiling in high-efficiency LED panels. He offset the electricity costs using solar power and batteries.

The gist of it was that it very markedly improved the mood and general wellbeing of his entire family, and visitors would often comment about how "nice" his house was without being able to explain precisely why they felt that way.

Conversely, imaging living and working in a dark cave.

Link?

According to the article, it’s also the textures of the outdoors that narrows the field of view

My eyesight deteriorated significantly during 2020-2022 to the point where I could no longer legally drive without glasses (I had been 20/20 or better my entire life). I bit the bullet in 2023 and had LASIK, which brought me back to the baseline I'd been used to for 35+ years. Age definitely played a part, but the speed of decline was really wild to experience and I attribute at least some of that to my lifestyle and work changes during covid (working 12+ hours per day from a small bedroom in San Francisco). LASIK is amazing, for anyone who is considering it.

LASIK is amazing when it’s no side effects. I’m needing to repair my corneas about 7 years post LASIK through stem cell therapy. My eye surgeon told me that LASIK severs an incredible amount of nerve endings and many eyes basically stop producing tears. The surface of the cornea then slowly erodes away. There are alternative procedures that don’t destroy as many nerves. I wasn’t aware of any of this before I went under the knife, wish I did.

If you had to do it over again, which procedure would you choose, or would you skip it altogether due to the potential risk?

Alternatives like implantable contact lenses? I hesitated because something with cataracts and them needing replacement every ten years.

My eyes are -10.5 each and my biggest risk is retinal detachment.

I got ICLs 16 years ago and my advice is I would think twice about it.

Right after the surgery and ever since I get very bad halos in high contrast environments. I haven't been able to drive at night ever since because the halos from street lamps and headlights obscure a significant portion of my vision making it very dangerous.

In addition I had an eye checkup several years ago and was told I had cataract and would need to keep an eye on it. I tracked down the surgeon who did my operation all those years ago and got a second opinion. He told me my eyes were actually fine, and wrote a letter to the first optometrist explaining what she was seeing and recommended me a different optometrist who he knew had experience with ICLs.

I recently needed glasses to drive again as my vision has gotten slightly worse over time as it does naturally.

On balance I have extremely mixed feelings about it.

Is this also true for PRK?

Why is it that no sort of eye exercise can encourage a reversal of myopia?

Most of the research I see is on preventing or slowing down the progression of myopia.

There are exercises that have worked for some people to reverse myopia.

https://www.losetheglasses.org/ https://endmyopia.org/

I like the first blog - it's reasonably sceptical about the method and just describes their experience. The author seems scientifically minded, and doesn't promise more than they can.

The second link directs to a website about parascience (which it is, but without self awareness of the first link) that tries to convince me that glasses are just a devilish trick opticians made up:

>Nearsightedness Is Not An Illness (But A $100 Billion Business)

Please. Strong turn off for me.

We started ortho-k for my son at age 9 when he was -1.00 in both eyes. It’s been successful so far in stopping progression.

Interesting. Can you please expand more on "ortho-k"? Where can I read more about it?

https://en.wikipedia.org/wiki/Orthokeratology

Go outside and touch grass every day. Go for a walk if you can. It will improve your mental and physical health, and can even help you solve problems. If it also keeps your eyes healthy, that is a bonus.

what time is good for outdoor activities?

any experiment that shows no statistically difference in myopia progression between sunbright and no sun periode?

what is the best time to do outdoor activities? morning? noon? evening? night? dusk?

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