STORY AT-A-GLANCE

 The way technology has infiltrated our lives, in many cases from morning until well
into the night, has dramatically changed the way humans use their eyes in just a short
blip of time
 The prevalence of myopia (nearsightedness) has increased in recent decades, especially
in East Asia, and the numbers are expected to get worse in the next 50 years
 For some populations in Asia, especially university students, myopia prevalence is over
90%
 When a person is nearsighted, their eyeballs become elongated, an anatomical change
that’s irreversible and increases the risk of serious vision problems, including blindness
 Home confinement due to the COVID-19 pandemic was associated with worsening
myopia in children
 No treatments are capable of curing myopia; prevention is a better option, and spending
more time outdoors — and far less time on screens — is key, especially for children

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Myopia, or nearsightedness, causes faraway objects to appear blurry while close-up objects look
clear. One of the greatest risk factors for myopia is having a parent who also suffers from this
vision problem.1 As such, it’s long been considered a primarily genetic condition — until
recently.

Speaking with The Atlantic, Dr. Marina Su, a New York City optometrist, noticed that more
children in her practice had declining vision, even though their parents’ vision was perfect. “If
it’s only genetics, then why are these kids also getting myopic?” she said. 2 Myopia is on the rise
worldwide — not just in New York City — and there’s debate over what’s driving the change.

A frontrunner is the theory that technology — particularly staring at screens all day — is the
culprit, leading to problems with vision at younger and younger ages, which could lead to “an
epidemic of blindness that’s decades down the road,” according to Dr. Michael Repka, an
ophthalmology professor at Johns Hopkins University.3

An Epidemic of Myopia

The prevalence of myopia has increased in recent decades, especially in East Asia, and the
numbers are expected to get worse in the next 50 years. In 2019, the American Academy of
Ophthalmology (AAO) established the Task Force on Myopia to address the “substantial global
increases in myopia prevalence and its associated complications.” 4

In a report from the Task Force, it’s stated that the prevalence of myopia is expected to grow
from 1,406 million people, or 22.9% of the population, in 2000 to 4,758 million people —
49.8% of the population, in 2050.5 Severe nearsightedness, known as high myopia, is also
expected to rise, from 163 million people (2.7% of the population) in 2000 to 938 million
people (9.8% of the population) in 2050.6

For some populations in Asia, especially university students, myopia prevalence is over
90%.7 Among young adults in East and Southeast Asia, 80% to 90% have myopia and 10% to
20% have high myopia. The tendency to study long hours and perform “near work” with the
eyes has long been linked to poor eyesight.8 According to The Atlantic:9

“Historically, British doctors have found myopia to be much more common among Oxford
students than among military recruits, and in ‘more rigorous’ town schools than in rural ones.
A late-19th-century ophthalmology handbook even suggested treating myopia with a change of
air and avoidance of all work with the eyes — ‘a sea voyage if possible.’”

It’s a concerning trend that goes far beyond the inconvenient need to wear glasses. The fact is,
the way technology has infiltrated our lives, in many cases from morning until well into the
night, has changed the way humans use their eyes dramatically in just a short blip of time.

“Long ago, humans were hunters and gatherers,” Liandra Jung, an optometrist in the Bay Area,
told The Atlantic. “We relied on our sharp distance vision to track prey and find ripe fruit. Now
our modern lives are close-up and indoors. ‘To get food, we forage by getting Uber Eats,’” she
said.”10

Progressive Myopia Carries Significant Risks

The increasingly early onset of myopia in children, combined with high progression rates, paints
a particularly poor picture for the future, which could easily lead to an “epidemic of high
myopia” even in children as young as 11 to 13 years of age. 11 When a person is nearsighted,
their eyeballs become elongated, an anatomical change that’s irreversible and increases the risk
of serious vision problems, especially later in life.

According to the AAO Task Force, by age 75, 3.8% of people with myopia and 39% of those
with high myopia have “uncorrectable visual impairment.” 12 In other words, myopia increases
the risk of conditions that can cause permanent blindness, including retinal detachment,
cataracts and glaucoma, even when myopia is low to moderate severity. 13

The AAO task force explained that the widespread clinical and societal impacts of increasing
myopia prevalence require a “coordinated global response,” 14 particularly since the younger a
person is at onset, the faster progression tends to be. 15 AAO added:16

“It is projected that uncorrectable visual impairment resulting from myopia will increase 7 to
13 times in high-risk areas by 2055. The public health burden posed by myopia extends beyond
the direct costs associated with the optical correction of refractive error and includes the
socioeconomic impacts and diminished qualify of life associated with visual impairment.”

In China, large-scale changes have been implemented to combat the growing trend of myopia in
children. Along with restricting video games, no written tests are given before third grade, and
metal bars have even been added to school desks so children are forced to stay farther away
from their schoolwork.17

Screen Time, Lack of Outdoors to Blame?

With the rate of technological development continuing to grow exponentially, it’s unclear if
anyone envisioned how society would become obsessed with staring at screens, such that our
waking hours are dominated by them in one form or another.

Vision is suffering as a result. Writing in the journal Progress in Retinal and Eye Research, a
team of experts identified intensive education (i.e., more studying) and limited time outdoors as
the major risk factors in the epidemic of myopia. 18 They wrote:

“The localization of the epidemic appears to be due to the high educational pressures and
limited time outdoors in the region, rather than to genetically elevated sensitivity to these
factors.

Causality has been demonstrated in the case of time outdoors through randomized clinical
trials in which increased time outdoors in schools has prevented the onset of myopia. In the
case of educational pressures, evidence of causality comes from the high prevalence of myopia
and high myopia in Jewish boys attending Orthodox schools in Israel compared to their sisters
attending religious schools, and boys and girls attending secular schools.

Combining increased time outdoors in schools, to slow the onset of myopia, with clinical
methods for slowing myopic progression, should lead to the control of this epidemic, which
would otherwise pose a major health challenge. Reforms to the organization of school systems
to reduce intense early competition for accelerated learning pathways may also be important.”

AAO also stated, “Too much time spent indoors increases a child’s risk for nearsightedness.
Studies show that more time outdoors in natural light reduces a child’s risk.” 19 Similarly, French
researchers described “outdoor activities” as one of the most promising treatments for myopia in
children.20

An alarming increase was further identified in myopia in children in 2020, when home
lockdowns occurred, keeping an already nature-starved population indoors even more. One
study found that home confinement due to the COVID-19 pandemic was associated with
worsening myopia in children. Myopia prevalence among children aged 6 to 8 years increased
1.4 to three times in 2020 compared to the five years prior. 21

Another study, published in the American Journal of Ophthalmology, described digital screen
time during the COVID-19 pandemic as a “risk for a further myopia boom.” “Increased digital
screen time, near work, and limited outdoor activities were found to be associated with the onset
and progression of myopia, and could potentially be aggravated during and beyond the COVID-
19 pandemic outbreak period,” they wrote in 2021.22

Moving Toward Myopia Control

With nearsightedness worsening in young children, treatments aimed at myopia control, or

Treatments include atropine eye drops, multifocal soft contact lenses and orthokeratology lenses
(OrthoK), which are worn overnight. OrthoK are contact lenses that reshape the eyeball’s clear,
front layer, changing the way light enters the eye and helping to improve vision. 24

No treatments are capable of curing myopia, however; they’re only able to slow down its
progression. Prevention is a better option, and spending more time outdoors — and far less time
on screens — is key for that, especially in young children.

Blue Light Exposure From Screens Also Dangerous

Technology is interfering with eyesight in multiple ways, not only because people are spending
so much time focused on close-up screens but also because they’re being exposed to blue light
in the process. Data presented at the 60th Annual European Society for Pediatric Endocrinology
Meeting further revealed that longer exposure to blue light was associated with earlier onset of
puberty in rats, along with reduced levels of melatonin, increased levels of certain reproductive
hormones and changes in the ovaries.25

LEDs found in many screens have virtually no beneficial infrared light and an excess of blue
light that generates reactive oxygen species (ROS), harming your vision and possibly leading to
age-related macular degeneration (AMD), 26 which is the leading cause of blindness among the
elderly in the U.S. LED lights may also exacerbate mitochondrial dysfunction leading to chronic
conditions ranging from metabolic disorders to cancer.

“Although not conclusive, we would advise that the use of blue light emitting devices should be
minimized in prepubertal children, especially in the evening when exposure may have the most
hormone-altering effects,” Dr. Aylin Kilinç Uğurlu said in a news release.

If you view screens at night, it’s therefore essential to block your exposure to blue light while
doing so. In the case of your computer, you can install a program to automatically lower the
color temperature of your screen. In addition, when watching TV or other screens, be sure to
wear blue-blocking glasses after sundown. Better yet, eliminate the use of screens entirely after
sunset, particularly in young children who are most susceptible to their deleterious effects.

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