Myopic visions
Issue 152 - 24 Aug 2023 (7-min read)
Did you also get told off by your parents for reading a book under covers at night? Or stopped from watching the TV too close to the screen? Perhaps you’re young enough to be reprimanded for spending too much time on your iPad? No matter the medium, every parent had the same concern. This will ruin your eyesight.
Turns out, nearsighted activities, such as reading in poor lighting or being too close to a screen, are not causing poor eyesight, especially not at the scale that we are witnessing. So join us in this week’s The Global Tiller as we look into why more and more of us need corrective glasses. How prevalent is the epidemic of myopia, what’s causing it and what’s the cure? Will solving this crisis require we fix our myopic vision of the future too? Let’s dig in.
Myopia, or what we commonly call nearsightedness, happens when the eyeball gets too long—it deforms from a regular football to an American football—and then the eye focuses light not on the retina but slightly in front of it, making distant objects appear blurry.
According to a report from the Brien Holden Vision Institute in Australia, almost half the world will be nearsighted by 2050, and require some form of corrective lens. This is up from a quarter of the global population in 2000. The prevalence also varies across different regions. In low- and middle-income countries, myopia rates tend to be lower – Bangladesh and India for example report rates of about 20-30% in adults – but this is changing. In Africa, for example, myopia used to be comparatively uncommon, but over the past 10 years the prevalence of childhood myopia has been rising fast.
In China, up to 90% of teenagers and young adults are myopic — this figure was only 10% in the 1950s. A 2012 study in Seoul found that an astonishing 96.5% of 19-year-old men were nearsighted. Among high schoolers in Taiwan, it’s around 90%. These numbers far exceed Singapore, which was called the 'myopia capital of the world' with a rate of 80% in young adults. In the US and Europe, myopia rates across all ages are well below 50%, but they’ve risen sharply in recent decades. The global cost of myopia from lost productivity was estimated to be $244 billion in 2015. And if these trends continue, it’s likely that millions more people around the world will go blind much earlier in life than they—or the societies they live in—are prepared for.
For Taiwan, this realisation came inadvertently during a college ceremony when government officials delivering speeches were blinded by the sunlight reflecting off hundreds of pairs of glasses in the audience. In fact, warding off an alien invasion just by asking Taiwanese students to look up became a popular joke and a wake-up call for their government to take action.
However, conventional wisdom blamed the rise in myopia on reading and staring at computer screens, but little evidence supported that hypothesis. Early studies into myopia looked at lifestyle changes and figured prolonged activities that required near vision, such as reading, was causing this problem, or it was genetics. This led to solutions like fixing desk heights or lighting in classrooms, or introducing eye relaxation exercises, such as the 30/10 rule: a 10-minute break to stare into the distance after every half hour of reading or looking at a screen.
In China, interventions to address myopia included limiting children’s video gaming to a set amount each week, while Singapore relied on technical advancements, such as special contact lenses or glasses. But these interventions didn’t work.
What works is simple: spending time outdoors. A 2008 study by Australian researcher Ian Morgan confirmed that myopia was not caused by more and more children going into classrooms and reading but by the fact that they were not spending enough time outside. Hence, the simple solution to overcoming this global epidemic is making sure children are spending at least two hours a day outdoors.
The small island nation of Taiwan is showing the way. Its Yilan County now runs one of the most ambitious myopia prevention programs in the world by screening children for pre-myopia and intervening early enough that those children may never need glasses at all. In just two years of starting this program, the county managed to drive down the prevalence of myopia in the region by 5 percentage points. Even Singapore is following suit by doubling outdoors time at preschools and scrapping exams for younger grades to reduce time spent on doing homework.
These kinds of solutions were showing good results until the Covid-19 pandemic hit. Data from China showed that the lockdowns dealt a blow to young children's eye health by raising myopia rates from 5.7% among six-year-olds in 2015-2019 to 21.5% in June 2020. Turkey, Hong Kong, India and even Taiwan showed that myopia worsened during lockdowns.
This pandemic gave us a glimpse into what our future lifestyle could be like if the planet continues to heat up as predicted. So the collective task ahead of us is not just making sure that children are getting enough outdoors time, but making sure that outdoors is safe enough. This is essential not only to avoid the high cost of eye care in our future, but to be able to literally see what the future holds.
Until next time, take care and stay safe!
Hira - Editor - The Global Tiller
Dig Deeper
We don’t have to imagine what global warming feels like. There is an entire community in Australia that’s forced to live underground to cope with extreme heat. You can read about how they live here, and wonder how prevalent myopia would be in this community.
…and now what?
How shortsighted are we about the future? We tend to look at the future, or whatever represents it, through a very deformed lens: every illness of the modern society is blamed on progress or technology or whatever new object or idea we can think of.
So if we are literally losing sight, it must be because of TV or computer screens: not only are they bad for our thoughts but they are probably bad for our eyes too. Why? Because they’re new and everything that existed before we were born is naturally good for us.
But, as we can see, screens are not the culprit here. So maybe we should remember that when it comes to progress or the future, we should avoid falling down into this easy intellectual myopia that considers that everything new to be bad by nature.
It’s also important to remember that when it comes to solutions about our modern and coming world, it may not be as complicated or radical as we would think intuitively. Technology is not always the bad guy, nor is it the ultimate solution! Sorry to cringe any transhumanists in the room but we may not need to invent the latest ultra-tech brain implant to restore vision. Even if AI or tech can prove incredibly efficient in solving problems, it should not be the primary outcome of every search for solution. In the case of eyesight, going outdoor is the way to go (out).
Could it be the same for every societal problem? Well, that’s a bit of a long stretch but this case shows us that when it comes to social issues, it’s important to remember a few things:
Our perceptions of problems are biased, so we need to make sure that we have the appropriate lens of understanding of it: asking questions and challenging our assumptions are good first steps;
Occam’s razor should be a rule of thumb when looking at solutions: the simplest one could be the most efficient. We should always start there, experiment and develop additional tools if needs be;
Expanding our vision is key: when facing a problem, we should always take a step back from it and looking at what’s happening elsewhere and how problems are tackled. We too often tend to think that “we are special”, that the problems we’re facing are ours alone, when eventually it usually turns out that many others are facing the same issues, they may have thought about it and it’s through collaboration that we may be able to find better, more sustainable solutions.
So if there’s one thing that the myopia epidemic teaches us is that when it comes to solving the world’s problems, it’s not about seeing the world through rosy lenses, it’s about remembering that, by expanding our peripheral vision, looking ahead far enough and adjusting our thinking to our reality, we may be able to move forward positively into the future!
Philippe - Founder & CEO - Pacific Ventury