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Why so many people need glasses now

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By Solomon wisdomPublished 3 years ago 3 min read

During my upbringing, my vision gradually deteriorated, limiting my ability to see objects beyond a certain distance from my face. Anything farther than approximately 10 inches became blurry, prompting me to get glasses. This experience, although inconvenient, is becoming increasingly common. Myopia, or near-sightedness, rates have been steadily rising for decades. In 1971, only 25% of people in the US were myopic, but by 2004, the number had increased to 42%. If current trends persist, it is estimated that by 2050, half of the global population will be myopic. Rates are even higher in Hong Kong, Singapore, Taiwan, and South Korea, where a significant portion of individuals suffer from high myopia, increasing the risk of future vision loss.

For a long time, it was believed that genetics solely determined the need for glasses. While genetics do play a role, the rapid increase in myopia suggests an environmental influence. Our modern lifestyle seems to be making it harder for people to see at a distance. Most people are born with eyes that are too short from front to back, causing the lens to focus images behind the retina, resulting in hyperopia or farsightedness. However, as we grow, our eyes usually reach a spherical shape, allowing the lens to focus light directly onto the retina and produce a clear image. In myopia, the eye continues to grow longer, causing close-up images to focus correctly on the retina but distant objects to focus in front of it, leading to blurred distance vision. Essentially, myopic individuals have eyeballs that have grown too long, resembling a rugby ball rather than a basketball.

Seang Mei Saw, a myopia epidemiologist and physician, explains that myopia is a lifelong condition that doesn't regress once it develops. The evidence suggests that the way we spend time during childhood and adolescence is a significant factor. This is when our eyes experience the most rapid growth, and it is also when most cases of myopia occur and stabilize. Two factors have a substantial impact: near work, or the time spent focusing on close objects, and the amount of time spent indoors. In a healthy eye, muscles squeeze the lens to focus on nearby objects. Some experts theorize that excessive near work strains the eyes, causing them to grow longer to reduce the strain. However, the stronger explanation is the lack of exposure to bright outdoor light, which stimulates dopamine production in the retina. Dopamine regulates eye growth, and without enough of it, the eye continues to elongate. Indoor light levels are significantly lower than outdoor light levels, contributing to this issue.

The phenomenon is particularly evident in East and Southeast Asia, where children spend less time outside due to the highly competitive education system, increased workload, and emphasis on academics. Requiring glasses or contacts for life is inconvenient, but the long-term consequences of myopia can be serious. Excessive elongation of the eyeball places additional stress on the eye structures, leading to potential disorders like myopic macular degeneration, retinal detachment, glaucoma, and cataracts. The risk of these conditions increases as the degree of myopia worsens.

Early intervention is crucial, and various treatments are available for those developing myopia. Multifocal soft contacts and glasses intentionally blur peripheral vision, which appears to slow the progression of myopia. Orthokeratology lenses, worn only at night, reshape the cornea during sleep, allowing clear distance vision during the day. Low-dose atropine eye drops, which temporarily paralyze the eyes' focusing muscles, also reduce myopia development. However, prevention is the primary defense. Encouraging children to spend more time outdoors is the simplest and most effective way to prevent myopia. Programs implemented in Taiwan and Singapore, such

as increasing outdoor time in schools and public education campaigns, have shown promising results in reversing the upward trend in myopia rates.

While current myopia rates may be alarming, we have the opportunity to make a significant impact and change the future trajectory of this condition.

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