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May 30 - A myopia epidemic is sweeping the globe. Here’s how to stop it



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 2 weeks ago '16        #1
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May 30 - A myopia epidemic is sweeping the globe. Here’s how to stop it
 

 
A myopia epidemic is sweeping the globe. Here’s how to stop it
Time spent outdoors is the best defence against rising rates of short-sightedness, but scientists are searching for other ways to reverse the troubling trend.

The COVID-19 pandemic didn’t just reshape how children learn and see the world. It transformed the shape of their eyeballs.

As real-life classrooms and playgrounds gave way to virtual meetings and digital devices, the time that children spent focusing on screens and other nearby objects surged — and the time they spent outdoors dropped precipitously. This shift led to a notable change in children’s anatomy: their eyeballs lengthened to better accommodate short-vision tasks.

Study after study, in regions ranging from Europe to Asia, documented this change. One analysis from Hong Kong even reported a near doubling in the incidence of pathologically stretched eyeballs among six-year-olds compared with pre-pandemic levels1.

This elongation improves the clarity of close-up images on the retina, the light-sensitive layer at the back of the eye. But it also makes far-away objects appear blurry, leading to a condition known as myopia, or short-sightedness. And although corrective eyewear can usually address the issue — allowing children to, for example, see a blackboard or read from a distance — severe myopia can lead to more-serious complications, such as retinal detachment, macular degeneration, glaucoma and even permanent blindness.

Rates of myopia were booming well before the COVID-19 pandemic. Widely cited projections in the mid-2010s suggested that myopia would affect half of the world’s population by mid-century (see ‘Rising prevalence’), which would effectively double the incidence rate in less than four decades2 (see ‘Affecting every age’). Now, those alarming predictions seem much too modest, says Neelam Pawar, a paediatric ophthalmologist at the Aravind Eye Hospital in Tirunelveli, India. “I don’t think it will double,” she says. “It will triple.”

Research already points to a simple solution for curbing the tide: more outdoor activities during childhood, a time when changes in eye structure are most likely to occur.

Randomized trials from East Asia have shown that about one hour of extra outdoor breaktime daily can markedly reduce the incidence of short-sightedness3,4. But it has proved difficult to implement such changes consistently, particularly in societies with a strong emphasis on academic achievement or in urban areas with limited access to safe, green spaces.

“Getting kids to go outdoors is a tough sell,” says Nathan Congdon, an ophthalmologist at Queen’s University Belfast, UK, who has worked in China for nearly 20 years.

So instead, researchers are working on ways to bring the outside in — glass classrooms, special lighting rigs, nature-themed wallpapers and light-emitting spectacles — interventions that do not demand overhauls in child behaviour, educational systems or parenting techniques. They are also exploring other light-based and pharmaceutical interventions.

Some of these approaches are showing promise. But there’s a stumbling block when it comes to testing them: researchers don’t fully comprehend what it is about outdoor exposure that helps to prevent myopia. Clinical trials are still preliminary and many animal studies remain inconclusive.

A firmer understanding would help scientists to develop better treatments, says Christine Wildsoet, an optometrist at the University of California, Berkeley. “Because once we know the key features,” she says, “then we can bring some of them indoors.”

As the eye develops, it constantly fine-tunes its shape in response to certain visual cues. If those cues indicate that the eye is too short, it stretches to bring objects into focus. Conversely, if the eye becomes too long, it will receive ‘stop’ signals, which are crucial for preventing myopia.

The source of these stop signals has been a subject of much debate in the myopia research community. Studies in monkeys, tree shrews and chickens — all common animal models for myopia research — have pointed to the release of the neurotransmitter dopamine in the back of the eye as a likely trigger. The neurotransmitter is thought to increase in response to high ambient-light levels found in sunlit surroundings.

But an alternative theory holds that the protective benefits of outdoor exposure might be less related to light and more associated with the patterns of blur experienced across the retina in different visual environments.

The visual landscape outdoors is rich and textured, and elements of it are typically viewed at such great distances that the vast array of details merge into a more uniform image. 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.

By contrast, interior spaces are filled with jumbles of objects at varying distances, surrounded by flat walls that typically lack detail. Such conditions require constant adjustments of focus, which, according to Flitcroft, deprives the retina of the necessary stop signals for regulating healthy eye growth.

Going outside offers the benefit both of bright sunlight and the enriched visual experience of wide-open spaces — with the bonus of physical activity and improved well-being to boot. But only a few places have managed to encourage children to go outside more.

In 2010, public-health officials in Taiwan introduced a programme called Tian-Tian 120, meaning everyday 120, which encourages a minimum of two hours of outdoor activity daily. It is widely credited with having curbed the rapidly increasing rates of myopia in the region5.

And although there was a minor increase in myopia cases in Taiwan during the pandemic, this uptick was substantively smaller than those observed in other parts of East Asia at the time, according to data compiled by Pei-Chang Wu, a retinal surgeon and myopia specialist at the Kaohsiung Chang Gung Memorial Hospital in Taiwan. What’s more, the outdoor programme does not seem to have hurt students’ test scores in mathematics, reading or science, which remain among the highest in the world.

For some, the message is clear: when it comes to promoting more outdoor time, “wide-scale implementation now seems feasible and likely to succeed”, says Ian Morgan, a myopia researcher at the Australian National University in Canberra — if only more governments were willing to recalibrate their educational agendas to do so.

Until then, however, Taiwan stands as an exception. Other regions in Asia, where myopia rates are among the highest in the world, have not seen similar broad-scale successes, and most regions continue to prioritize treating myopia over public-health measures to prevent it. “There is certainly a lot of emphasis on clinical interventions at the moment,” says Morgan.


 https://www.nature.com/ar .. 86-024-01518-2
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16 comments

 2 weeks ago '17        #2
Its 
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That's wild
+2   

 2 weeks ago '07        #3
yola  topics gone triple plat - Number 1 spot x91
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“Getting kids to go outdoors is a tough sell,”
this sh1t so wild to me, you could barely keep me indoors when i was young unless it was bad weather and even that wasn't a guarantee

even if i didn't have something to do, i'd be outside more often than not, even hangin out with friends, we'd end up outside unless it was cold or late

my mom would routinely shut the TV off and tell me to go outside or pick up a book, or both

in fact, the the normal punishment was being "grounded" which meant you couldn't go anywhere

now i guess parents take the phone away and that's somehow the equivalent of not being able to go anywhere

but it ain't all kids, 10 years ago i was visiting and staying with a friend, it was July and i noticed his teenage daughter was always on the couch or watching Netflix in the middle of summer

i asked him about it and he gave the "kids these days" rehearsed response, but then i asked his daughter why she never goes anywhere or does anything

she kinda snorted, then sighed with resigned frustration and said "my parents never let me go anywhere or do anything that isn't heavily, supervised, structured, traditional and corny"
+11   

 2 weeks ago '17        #4
Jdmficial 
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Simple, go outside.

This is primarily caused by the eyes not getting enough sunlight. Go outside regularly and it will take care of itself.
+4   

 2 weeks ago '16        #5
00010111  topics gone triple plat - Number 1 spot x24 OP
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 Jdmficial said 🔗
Simple, go outside.

This is primarily caused by the eyes not getting enough sunlight. Go outside regularly and it will take care of itself.
It is simple but it's the parents (and wider society) who have the kids indoors all day.

And society is set up for most of us to be locked away in an office, warehouse or some other institution during daylight hours. It's a terrible way to live.
+3   

 2 weeks ago '10        #6
eashawty 
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 yola said 🔗
this sh1t so wild to me, you could barely keep me indoors when i was young unless it was bad weather and even that wasn't a guarantee

even if i didn't have something to do, i'd be outside more often than not, even hangin out with friends, we'd end up outside unless it was cold or late

my mom would routinely shut the TV off and tell me to go outside or pick up a book, or both

in fact, the the normal punishment was being "grounded" which meant you couldn't go anywhere

now i guess parents take the phone away and that's somehow the equivalent of not being able to go anywhere

but it ain't all kids, 10 years ago i was visiting and staying with a friend, it was July and i noticed his teenage daughter was always on the couch or watching Netflix in the middle of summer

i asked him about it and he gave the "kids these days" rehearsed response, but then i asked his daughter why she never goes anywhere or does anything

she kinda snorted, then sighed with resigned frustration and said "my parents never let me go anywhere or do anything that isn't heavily, supervised, structured, traditional and corny"
Folks be scared to let they kids just be outside like that nowadays they think they gon get kidnapped or shot in a drive by or sumthin other highly unlikely sh1t. & then it ain’t like it used to be where all the adults in the community were familiar wit each other so even if u was outside all day somebody grown could keep they eye on u & yo parents felt comfortable wit it, these days most folks don’t even speak to they next door neighbors
+10   

 2 weeks ago '17        #7
Ymmot  topics gone triple plat - Number 1 spot x6
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 00010111 said 🔗
It is simple but it's the parents (and wider society) who have the kids indoors all day.

And society is set up for most of us to be locked away in an office, warehouse or some other institution during daylight hours. It's a terrible way to live.
Glad I'm outside most of the time for my job. fu#k an office job.
+1   

 2 weeks ago '06        #8
nightmare  topics gone triple plat - Number 1 spot x11
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 eashawty said 🔗
Folks be scared to let they kids just be outside like that nowadays they think they gon get kidnapped or shot in a drive by or sumthin other highly unlikely sh1t. & then it ain’t like it used to be where all the adults in the community were familiar wit each other so even if u was outside all day somebody grown could keep they eye on u & yo parents felt comfortable wit it, these days most folks don’t even speak to they next door neighbors
this. when i was a kid, neighborhoods werent as isolated between residents, so there was a safety net within the whole neighborhood as long as people knew you. now its everyone or themselves in a lot of places. i cant say i fully blame people for not wanting their kids out like that, depending on the area
+4   

 2 weeks ago '23        #9
LowCountrySC 
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another good tip, if you work with computers nevermind the blue tint - just take 20 seconds each hour to stare as far off in the distance you can. rinse and repeat.
+2   

 2 weeks ago '16        #10
96jordan  topics gone triple plat - Number 1 spot x3
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 eashawty said 🔗
Folks be scared to let they kids just be outside like that nowadays they think they gon get kidnapped or shot in a drive by or sumthin other highly unlikely sh1t. & then it ain’t like it used to be where all the adults in the community were familiar wit each other so even if u was outside all day somebody grown could keep they eye on u & yo parents felt comfortable wit it, these days most folks don’t even speak to they next door neighbors
It’s also that kids don’t really got spaces to go outside anymore

US infrastructure is so car dominant, barely any parks, they can’t go to the malls anymore

 2 weeks ago '06        #11
nightmare  topics gone triple plat - Number 1 spot x11
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 96jordan said 🔗
It’s also that kids don’t really got spaces to go outside anymore

US infrastructure is so car dominant, barely any parks, they can’t go to the malls anymore
also true, because i lived in the city growing, it was easy to do you even as a kid

depending on where you at, you cant do sh1t until you can drive unless someone takes you
+3   

 2 weeks ago '10        #12
eashawty 
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 96jordan said 🔗
It’s also that kids don’t really got spaces to go outside anymore

US infrastructure is so car dominant, barely any parks, they can’t go to the malls anymore
I mean some of that is true. But I think it’s really kids don’t be outside as much, we used to walk & ride bikes like 15-20 deep other the parks or to other neighborhoods to hoop & play football & sh1t like that. Nowadays I dont see kids outside doin no sh1t like that & parents don’t be wantin they kids venturing too far away from the house when they do go outside no more

 2 weeks ago '20        #13
Bighempin  topics gone triple plat - Number 1 spot x8
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Chid my older kid's once the 1 turned 14 he wasn't outside unless it was football practice. Same wit this younger kid he a homebody but he will rip and run more than the oldest. This liliest one chid can't them in the house. Chid they'll be out in the draws if we didn't say something.

 2 weeks ago '16        #14
BathWaterMelody  topics gone triple plat - Number 1 spot x19
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Boxden members with short-sightedness

double a tundras for days

 2 weeks ago '18        #15
OptimisticCynic 
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 LowCountrySC said 🔗
another good tip, if you work with computers nevermind the blue tint - just take 20 seconds each hour to stare as far off in the distance you can. rinse and repeat.
This. You don’t need to go outside although I’m sure most or all of us would encourage it.

I know I didn’t need glasses until I started to heavily use a cell phone for searching the web, etc.
+1   

 2 weeks ago '21        #16
N0te 
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Boron, zinc an carotene. I dropped 2pts on my prescription

 2 weeks ago '16        #17
96jordan  topics gone triple plat - Number 1 spot x3
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 eashawty said 🔗
I mean some of that is true. But I think it’s really kids don’t be outside as much, we used to walk & ride bikes like 15-20 deep other the parks or to other neighborhoods to hoop & play football & sh1t like that. Nowadays I dont see kids outside doin no sh1t like that & parents don’t be wantin they kids venturing too far away from the house when they do go outside no more
It’s the combo of everything I feel bad for them fr

Gonna be a bunch of anti social weirdos when they get older

say something...

Sign me up
 
 

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