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  • At some point growing up, my vision changed.

  • And slowly I stopped being able to see past about...

  • this far in front of my face.

  • Basically, anything past...

  • like 10 inches in front of my eyes... is blurry.

  • So eventually I got glasses.

  • And with them, my world turns from this...

  • to this.

  • This whole experience, as inconvenient as it is, is more widespread than it's ever been.

  • -Myopia. -Myopia.

  • - Myopia, am I saying it right? -A rise in short-sightedness...

  • -...and the researchers actually called it an epidemic.

  • -...but they're still trying to figure out why this is.

  • Rates of myopia, or near-sightedness, or needing glasses to see things far away, have been rising for decades.

  • In the US, where I live, just 25% of people were myopic in 1971.

  • By 2004, that number was up to 42%.

  • And if current trends continue it's estimated that half of the world's population will be myopic by 2050.

  • In Hong Kong, Singapore, Taiwan, and South Korea rates are already a lot higher than that.

  • And a growing portion have high myopia, which the WHO categorizes as a prescription stronger than -5.

  • That puts them at risk of losing their sight one day.

  • For decades, researchers thought that whether or not you needed glasses was just a matter of genetics.

  • And it partly is.

  • Having one myopic parent doubles your odds of being nearsighted and having 2 increases the odds 5 fold.

  • But human genetics don't change this fast.

  • The abruptness of this increase suggests that that this change is environmental.

  • Something about the way we live today is making it harder and harder for people to see at a distance.

  • So what could it be?

  • Most people are born with eyes that are too short from front to back.

  • In this shape, the lens focuses images behind the retina.

  • That's the light sensitive tissue at the back of the eye.

  • That makes the eye hyperopic or farsighted.

  • Blurry up close and clear from far away.

  • But as we grow up, our eyes grow too.

  • Until they reach a spherical shape.

  • In this shape, the lens focuses light directly onto the retina and produces a clear image.

  • But sometimes the eye keeps growing longer.

  • In this shape, the lens can focus up close images onto the retina.

  • But at a distance, images focus at a point in front of the retina, making distance vision blurry.

  • So, all of us with myopia just have eyeballs that have grown too long.

  • The eye does not look like a basketball anymore.

  • It looks more like a rugby ball.

  • That's Seang Mei Saw.

  • She's a myopia epidemiologist and physician in Singapore.

  • It is a lifelong disease,

  • so once you're myopic, it doesn't regress.

  • So what's making more and more people's eyes grow longer than they should?

  • The evidence points to the way we spend time in childhood and adolescence.

  • That's when our eyes grow fastest.

  • So it's when most people's myopia develops and then stabilizes.

  • Though it can develop later if you abuse your vision enough.

  • Two factors in particular have the biggest influence.

  • Near work, or the time that we spend looking at things up close, and how much time we spend indoors.

  • In a healthy eye, muscles have to squeeze the lens in order to focus up close images onto the retina.

  • So some experts theorize that if your eyes grow up straining to look at things up close a lot of the time,

  • they'll just grow longer to reduce that strain.

  • But the evidence on this explanation is mixed.

  • The stronger explanation is time spent indoors.

  • Exposure to bright outdoor light stimulates the production of dopamine in the retina.

  • This neurotransmitter regulates the eyes growth.

  • Without enough dopamine, the eye doesn't know when to stop growing.

  • In indoors, it's hard to get enough.

  • The light from the sun has up to a 100,000 lux on a sunny day.

  • Whereas in the room, the light levels generally are only about 200 to 300 lux.

  • But between electronic devices and early emphasis on academics eye experts believe that

  • children today are growing up with a combination of too little daylight and too much time doing things up close.

  • And nowhere is that more apparent than in East and Southeast Asia.

  • Children in Asia are not spending that amount of time outside.

  • This could possibly be because of the education system has become much more competitive.

  • The children have a lot more homework,

  • they attend teaching centers,

  • and you spend more time reading and writing.

  • Needing glasses or contacts to see for the rest of your life is obviously inconvenient.

  • But in the long term, the consequences of that distorted eyeball shape can become serious.

  • University of Houston, Professor of Optometry, Mark Bullimore, explained this to me.

  • You know, you're born with a finite amount of tissue that make up the various coats of your eyeball.

  • Excessive elongation of that quite simply places additional stress on those structures.

  • The retina has been stretched so much that it starts to break,

  • and then sort of peel off like an old piece of paint.

  • The longer those eye structures are stretched the higher the risk of disorders

  • like myopic macular degeneration, retinal detachment, glaucoma, and cataracts.

  • So, we're finding this almost linear relationship between them.

  • The amount of myopia and the risks to your vision later in life.

  • We used to think about myopia as an optical defect.

  • Now, we think about it much more as a disease.

  • And the earlier a child becomes myopic the more serious their myopia can become

  • and the greater the risk of debilitating conditions.

  • Which means it's important to intervene as early as possible.

  • So, what does that look like?

  • For those who start to develop myopia, there's treatment.

  • First are multifocal soft contacts and glasses.

  • They make peripheral vision intentionally blurry, which appears to slow the progression of myopia.

  • Then, there's orthokeratology, or ortho-k lenses,

  • hard contact lenses worn only at night that reshape the wearer's cornea while they sleep,

  • so that they can see at a distance during the day.

  • And there are atropine eye drops,

  • low doses of a substance that temporarily paralyzes the eyes' focusing muscles,

  • which seems to reduce the development of myopia.

  • But the first line of defense is prevention.

  • The simplest and most effective way to prevent myopia is to get kids to spend more time outside.

  • In Taiwan, the government introduced a nationwide program in 2010,

  • encouraging schools to get students outside for 2 hours every day.

  • It appears to have successfully reversed a 40 year-long increase in myopia rates.

  • And since 2001,

  • Singapore has funded public education promoting time outdoors

  • and conducted annual vision screenings at schools.

  • And it seems to be working.

  • Right now, these rates may be higher than ever,

  • but the future of myopia will only look like this if we keep doing things the same way.

  • And we've never been in a better position to change.

At some point growing up, my vision changed.

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