Shortsightedness has become an epidemic

Almost all children are born hypermetropic (far-sighted). The growth of the eyeball is calibrated by the amount of defocus (blur) experienced. More defocus, more growth, which reduces hypermetropia.

My hypothesis is that less sunlight means wider pupils and more defocus (contrast to a pinhole camera), so more eye growth.

Even with perfect eyesight, there's a 2-diopter difference between focussing blue light and red light due to chromatic aberration. Only narrow pupils can reduce this blur in white light.

I'm also curious whether older TVs with big blurry pixels (or low res images upscaled and smeared onto newer screens) trigger the same mechanism. These days I certainly feel physically uncomfortable looking at media like that, like my eyes aren't focussing quite right.

The other problem is that once eyes have grown too long and are myopic (near-sighted) they experience even more defocus and grow more. See for example [1] which discusses how under-correction of myopia accelerates progression.

[1] https://reviewofmm.com/does-the-undercorrection-of-myopia-in...

I wore glasses for a few years in high school because I had trouble seeing the blackboard from anywhere but the front row. I started hiking and kayaking every day, especially in places where I could see for many miles. I also migrated from CRT to LCD to LED screens, and more recently to e-ink devices when possible. Very fine print in a dark space is hard to read, but I can read a moving US license plate from six blocks away. Yesterday I recognized a friend a mile and a half away by their paddle-stroke. I am able to differentiate a bald eagle from an osprey at two miles based on the shape of the wings, and see a fish in talons at about a mile. (Friday I observed an osprey dive, catch a fish, head towards the nest, then get chased for thirty minutes by a bald eagle. Nasty, opportunistic birds, bald eagles. I get why Benjamin Franklin held them in such contempt. I lost the pair when they went behind a mountain about three miles away.) In speaking with ophthalmologists, there is wide support for my hypothesis that the near-daily outdoor activity and frequent change of focal distance–from a nautical chart on my foredeck to the bow wave of a tanker eight miles out–has preserved and likely improved my vision. The data: 20/20 in primary school, 20/23 in high school, 20/20 during my higher education, and 20/13 and improving as I approach retirement. A fun trick is to describe an approaching vessel before others have seen it.

My child is following in my footsteps and has been prescribed glasses for nearsightedness. Her optometrist told us she should be watching TV rather than reading books. This was both surprising and upsetting, especially since she loves reading.

This lead me on an interesting deep dive into existing research. What surprised me were the massive gaps in understanding. Scientist have at best established correlation between close up work and nearsightedness, and a negative correlation with spending time outside. The actual mechanism in play is unknown, for example the theories about sunlight are still untested. The specific types of close up work that cause issues is unknown. Some scientists have proposed that it's the contrast between white pages and black text that actually causes issues with reading.

My conclusion was that anyone who confidently asserts that $x causes nearsightedness is wrong (this thread is a case in point).

Honestly, myopia is not complicated (Kepler pretty much had it right in 1604 already). There's countless studies showing that axial length (eyeball length) changes in both directions, where elongation increases myopia. How do you change it? You get defocus (blur) which makes the eye adjust in the direction to reduce the blur.

Practically: use weaker (around 1.5 diopters) or no glasses during close-up work (reading, computer work, smartphones) and your regular or .25D weaker glasses for distance vision. Always use your full strength glasses for driving and safety critical activities.

You can expect around a .75D decrease in myopia per year. Personally, I started with around -5.5D and am now (1.5 years later) at -2.5D.

Obviously I didn't come up with this myself, there's a huge group over at https://endmyopia.org

Don't get put off by the sarcastic tone of the website. Look into the studies regarding axial length, pseudomyopia and lens induced myopia if you'd like. You can find plenty of studies linked as well as the practical steps on endmyopia. Note: You don't have to buy the guy's courses, just read his blog and free email guide.

In my early teens I had 20/15 vision. By the time I went to college I was wearing glasses for nearsightedness.

I'm pretty sure it's because I got interested in computers, and started spending all day staring 3ft ahead instead of glancing around outdoors.

Some friends in my computer science program passed around each other's glasses and found we all had nearly the same prescription. That didn't seem like a coincidence.

The different usage of words and their meanings in English is interesting and makes me think this weird miscommunication is why we have so many arguments. In my everyday, the article would be referring to nearsightedness, short sighted would be when someone doesn’t think through all the possible things, lacking foresight. By definition it’s both but in every day use it’s not.

Not just with light, spending more time indoors means kids don't have to focus their eyes on longer distances these days. There would be a correlation between the amount of time spent indoors during the formative years and the chances of becoming myopic in the future.

For several decades it has been known that myopia (nearsightedness) and intelligence are correlated[1][2]. Initially it was speculated that reading caused nearsightedness, and through that higher intelligence. There is probably some truth to that.

But with modern DNA sequencing techniques researches has found genes that seem to affect both[3][4].

The hypothesis is that one (or a set of) genes affects both eye size growth (myopia is often caused by the eye being "too long") and neocortical size (associated with intelligence).

Although this probably won't surprise anyone in this research field, I recently read about it -- with my non-nearsighted eyes :) -- and found it interesting. So I wanted to share, since it's somewhat related to this topic.

[1] https://jamanetwork.com/journals/jamaophthalmology/article-a...

[2] https://europepmc.org/article/med/2904062

[3] https://www.nature.com/articles/srep45977

[4] https://pubmed.ncbi.nlm.nih.gov/19127804/

I noticed my eyesight gets better after many hours outside not looking at any screen. And worsen after many hours in front of a screen. Is there a name for that?

>Sedentary, white-collar jobs are less arduous (and less lethal) than manual work. They also promote obesity and heart disease.

I'm always baffled by the dismissive wave of the "activity level causes obesity and heart disease" trope--because it's mostly wrong. The first world diet is the primary cause of obesity and heart disease, and it's well-proven. Starch and sugar, processed foods, a diet primarily consisting of carbohydrates. Diet is the driver, not activity level.

Seeing this is the economist, I thought they meant shortsightedness of our business and industry leaders. Was a bit dissapointed that instead of much needed self-reflection, the topic is far more pedestrian.

This has me perplexed, if it has to do with sunlight, wouldn't then Nordic countries have a very high level of shortsightedness?

I'm hopeful that the shift to VR from PC gaming and perhaps also office productivity will help with myopia. Might seem counter-intuitive given the VR lens is next to the eye but focus in VR is in the distance. Even productivity in VR is usually done on huge screens further away from the user than traditions pc screens.

I wonder if indoor lighting at the appropriate temperature would help prevent this?

In the UK we don't get a lot of sunlight in the winter months. It would be nice to know that we can turn on a "sun lamp" or whatever for homework time to help alleviate the issues.

Could we just have rooms lit as strongly as outdoors?

Pretty sure in the recent times COVID has worsened this. I do exercise often these days. But its nothing like the morning workout, lunch time socialising, and tea time walks with colleagues before COVID.

These days apart from the workout in the morning I get no outdoor activity, its just staring at every decreasing(sizes of) screens. I'm showing early symptoms of Shortsightedness. Several other colleagues tell me the same, there's also additional problem of people getting obese staying at home.

Though schools have opened. Last two years were equally worse for kids, no play, classes on smartphones and laptops.

Humans have not evolved to live like this.

Why can we have 2-lense glasses that move the focus to infinity?

ELI5: In opticals, “rays” coming from a near object (=mobile phone) are angled, while rays coming from afar (=end of a landscape) are parallel. The job of pupils is to bend the rays from the focal point ahead to the focal point on the receptors in the eye. The eye is a rest when looking afar, because rays come parallel, and thus there isn’t much to do. The eye is strained when trying to focus one something closer.

I’ve always wondered why we all had that UV filter on screens and never took care of making the rays from the computer screen parallel, using a lense.

I usually don't agree with The Economist but I agree with them on this one, people spend too much time indoor and that's why there is an epidemic of shortsightedness.

I would actually call it pandemic because it is affecting all developed countries because majority of their workforce works indoor and then goes home or to the gym....again indoor environment.

Is dopamine playing a role? Like social media use on top of less sunlight? Some of the genetics linked to myopia involve dopamine:

https://www.revieweducationgroup.com/ce/how-environment-and-...

"Some of the loci identified include those involved in dopamine and light processing. These genetic findings provide further support for mechanisms of myopia development involving light exposure, defocus and contrast.

Despite these important findings informing potential genetic locations and mechanisms of myopia development, these studies have identified less than 5% of the variation in refractive error due to genetic variants.42 Clearly, the dramatic rise in myopia cannot be due to genetics alone, but is likely due to a combination of both genetic susceptibility and increased environmental triggers."

Anyone have an unlocked link?

When I was a kid, we had a "no TV when the sun is up" rule. That included computer screens, which were literally TVs when I was a kid. Of course I violated that rule when my parents weren't looking, but for the most part I spent a lot of time playing outside, especially in summer.

This is of course anecdotal, but I'm 45 and still don't need glasses.

I'm trying to do the same with my kids, but sometimes it's just too easy to hand them an iPad when I want to get something done....

I've written about this before, but it bears repeating. However good your vision is when you're young, it will change as you get older.

Most people become more farsighted as they age. Typically it starts when you are around 40 and changes rapidly for the next decade. After that it tends to settle down.

More importantly, the lenses in your eyes become more rigid, losing their ability to focus at different distances.

When I was younger, one eye was a bit nearsighted and the other a bit farsighted. This allowed me to get away without glasses longer than I should have. Even if I wasn't seeing clearly with both eyes, I could see at most distances with one eye.

As my eyes' focus distance lengthened, my nearsighted eye attained close to normal vision, and my farsighted eye was focused past infinity. Not good.

When I got my first pair of prescription single vision computer glasses, it was life-changing. Now I could see my laptop screen perfectly. I told my optometrist I wanted something like single vision reading glasses, but adjusted for the distance to my laptop screen, about 20", unlike the typical 16" focus distance of a reading prescription.

In fact, this started to make me fussy about using high-DPI displays (~200 DPI) instead of the low-DPI displays (~100 DPI) I'd previously used. On a low-DPI display I could see the pixels!

It does mean that when I use external monitors with the laptop, I need to have them also at this 20" distance. So to augment the laptop screen, I have a 24" 4K monitor in landscape mode immediately above it, and a second 24" 4K monitor in portrait mode to the left.

Both of the external monitors are at about the same 20" distance from my eyes, and each of the three displays is angled differently so the center of the monitor is aligned with my vision: the laptop display at a typical laptop angle, the one above it closer to vertical (but still tilted a bit), and the one on the left at an in-between angle. The bottom of this monitor is about a half inch above my desk, just enough room to let cables run under it.

This is a fairly glorious setup. All three displays are in focus for me, and the portrait display is great for reading documentation, especially PDF files that are so awkward on a landscape display.

The key to this is the single vision glasses. I have seen so many people try to use progressive lenses with their computers, and they are always craning their neck back so they can see through the lower part of the lens that has a closer focus distance. Single vision lenses let everything be in focus at once, especially with the portrait mode monitor.

Another key is that the computer glasses should have a fairly tall profile, not the truncated rectangular lenses that are so popular. This greatly improves the field of view.

On my last visit to the optometrist they suggested lenses with a blue light filter. I said no thanks on that. Sometimes I do photo editing, and the blue light filter shifts everything to a warmer color. The way I solve the problem of too much blue light is that I simply don't turn my monitor brightness up so high. It is set so a white background is about the same brightness as a piece of white paper in the same lighting.

I also have progressive glasses that I use for everything else when I'm not at the computer. These have magnetic clip-on sunglasses, which are pretty great. Indoors I can leave the sunglasses off and just use the progressives on their own. Because I wear aloha shirts with a pocket, I can keep the sunglass lenses in my pocket and I hardly know they are there. When I step outside or go driving, I just snap on the magnetic clip-ons and I'm good to go.

The frames with magnetic clip-ons are a bit uncommon these days, but they are well worth finding.

If anyone is curious I can look up the brand and exact model number for both the round single vision and the progressives I'm using.

While I am all for the idea that we need to have more sunlight indoors, I am not at all convinced that's the cause for the condition. TV watching wasn't big when I was a kid, and I didn't have the patience for reading, yet I've got it.

So yeah. I am sure prolonged focusing contributes a lot but not sure it's the main cause.

I feel like this has always been a rather obvious thing...for at least what nearly a century or more? The whole trope of glasses are for nerds. Kids who spend time reading a ton are nearsighted. I understood this in elementary school, when the only kids with glasses were the smart ones. (I hated reading, and did not wear glasses, so was not a 'smart one').

I became nearsighted not long after getting a home computer, for similar reasons. My father, an avid farmer and naturist, is farsighted. It seems pretty obvious your eyes adjust to whatever you spend all day looking at.

That all said, is it bad? Mine was cured with a rather cheap PRK procedure...and I sure wouldn't give up all I've learned for perfect natural eyesight.

See also https://www.nature.com/news/the-myopia-boom-1.17120 (2015)

Myopia has been an epidemic for many years now. And the future prospects look grim. Fortunately, there are research groups tackling this issue hoping to develop some gene-therapy approach.

From the headline I really thought this article was about the other shortsightedness, which is perhaps better described as a pandemic by now.

Surprised to see it was actually by eyesight

no, the real epidemic is MENTAL shortsightedness

Read the headline and thought the article would be about something different. How ironic.

Everything in nature is fractal-shaped, while most things in our artificial environments are made of flat surfaces. If you think of light as a kind of "food" for the eyes, we are effectively eating junk food all day every day.

Allow me to say this, emphatticaly no!

"Governments are well placed to solve such collective-action problems..."

As I suggested in the past, it would be helpful to add [PAYWALL] before or after titles for links that have a paywall.

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!

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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...

I read the title and immediately agreed, but i had misinterpreted "short-sightedness" as the inability to consider the long-term effects of our choices and habits, at least to the effect of making positive changes, rather than the ocular deficiency.

I didn’t realize the evidence is strong that daylight keeps kids from becoming near-sighted. Making young kids study all the time is killing their eyesight!

Pet peeve about language use:

I thought it was obvious that short-sightedness (Exclusively Short term thinking) is an epidemic, nobody on Wall Street can see past the next Quarter's numbers. I don't need the economist to point that out.

Nearsightedness is what this article is about... a completely different thing. I've dealt with that my entire life... and just went through the knock-on effect of retina detachment, and surgery to correct the same. Having a bubble of C3F8 gas in your one good eye is pretty damned effective at taking you out of commission for about 4 months. Looking down hurts! I hope to be up and about, and able to drive again by the start of September, once the bubble has gone, my eye has stabilized, the surgeon has made a final check, and finally after I get new glasses.

I strongly suspect the amount of light outdoors is NOT really the issue. If you're always focused on things close at hand (as the above mentioned folks on wall street), you never allow the eyes to focus on the far horizon for an appreciable fraction of the time.

I'm surprised to learn that there's no consensus on how the eye actually focuses on objects at various distances[1]. It is also well know that the smaller an iris in a camera (or eye), the larger the range of distances that appear in focus. It seems reasonable to me that if you spend your time looking at only nearby objects (like above mentioned Wall Street residents), you'll lose the ability to see things further out that might be coming to get you.

[1] - https://en.wikipedia.org/wiki/Accommodation_(eye)

It may just be a pet peeve, but it rankles me a bit when the term "epidemic" is used to describe widespread conditions that are not communicable/infectuous. Looking at the dictionary it appears the usage here is legitimate, but my guess would be that it is a misuse that has become accepted, like using the term "begging the question" to mean suggesting the question.

When I read the title, I thought they meant not thinking ahead. This makes much more sense though!

It is caused by mass literacy (reading) and now mass-cellphone use.

But too much sunlight will cause retinal damage. Damned if you do, damned if you don't.

I paid nearly $1500 for my kid myopia treatment plan: specialized drop, checkin every 2 months. Nothing helps. They now recommend I do contacts for my 9 year old and I kindly say hell no. I think this is scammy at best.