Updated: Mar 11, 2019
I have a young daughter and two young nieces. These three little girls are some of the biggest joys of my life. I want to do everything I can to make sure they have a great life and that includes good eye health.
My husband and I are both nearsighted. So is my sister and her husband. So the kids are pretty much doomed right? Not necessarily. Thankfully, research has shown that genes are not the whole story. In the words of Dr. Neil Barnard, some genes are like dictators. You WILL have blue eyes. Others are more like committees. Meaning, there will be some "discussion" on the matter. You MAY get myopia (nearsightedness) or maybe not. Turns out many factors influence why a person becomes myopic. This is an area of hot debate right now because nearsightedness has increased at striking rates. So can these girls escape the family trend of nearsightedness? I'm going to do everything I can to try. I've been extensively researching the topic and I've come up with a few strategies I'll share.
1. Minimize activities that are close-up
Yes, reading is important. Every pediatrician would agree. But too much close-work is one of the biggest risk factors for myopia. In China, almost 90 percent of teenagers and young adults are nearsighted. It’s no coincidence that the average 15 year old in Shanghai spends 14 hours per week doing homework. Additionally, students who attended more years in school had a much higher rate of myopia than did their less academic peers. Which careers have the highest population of nearsighted folks? Engineers. Doctors. Lawyers. Also, a study was done on workers at a textile factory in Norway. The workers were given the task of finding weaving errors in slowly moving textiles and repair them. Every single one of the workers became nearsighted, even the ones who had been farsighted prior to starting the job. So on one hand, reading is important, but on the other hand too much close-work is detrimental to vision. Therefore, it goes without saying that near-work that is NOT reading (I'm talking about phones, tablets, and other screens), should be minimized, if not eliminated completely.
2. Spend 3 hours per day outdoors
Admittedly, the reason behind this is not well understood. But the trend is undeniable. Those who spend at least three hours per day in daylight are MUCH less likely to become nearsighted than those who don't. Take in this graph for a minute:
This study controlled for both parental myopia and ethnicity. So what's going on? It seems to have to do with the amount of natural light we get. Natural light is a lot brighter than indoor light (measured in a unit called lux). To give you some perspective, natural outdoor light can be as bright as 100,000 lux. With sunglasses on, its more like 10,000 lux. A well lit indoor classroom is no more than 500 lux. What is the amount needed to effectively prevent myopia? Around 10,000. So DO wear the sunglasses.
Keep in mind this important distinction: Outdoor time doesn't seem to SLOW myopia once it's already started. But it does PREVENT a child from becoming myopic in the first place. So this is most important for a child who isn't showing signs of myopia yet.
3. Delay the age it starts
One of the biggest risk factors for myopia progressing quickly is the age that it starts. If myopia starts at age 9 or earlier, it is more likely to get bad quickly. If it starts at age 10 or later, it is less likely to get bad quickly. So maybe my kid will get nearsighted despite all my efforts. But if I can delay the inevitable, her prognosis will be much better. Needless to say, implementing these strategies as young as possible is key.
4. Make annual exams a priority
Here's why: It's important to know exactly how quickly the nearsightedness developed. I'll give you two scenarios.
1- Julie is in fifth grade and comes home one day and says the board looks blurry. So her parents take her for an eye exam. Julie has had eye exams every single year and the doctor notices a pattern: When she was in second grade, there was -0.25 dioptors of nearsightedness (that's practically nothing) and glasses weren't prescribed. When she was in third grade there was -0.50 dioptors. Fourth grade -0.75. Finally in fifth grade, -1.00 dioptor of nearsightedness is enough to cause difficulty in school so glasses are prescribed. Since she's had annual exams, we know exactly the rate at which this came on: -0.25 dioptors per year. This is pretty slow. Since the progression has been slow overall, we know that it is likely to continue moving slowly. The concern level here is low.
2-Olivia is in fifth grade and comes home one day and says the board looks blurry. At her annual eye exam, the doctor finds there is -1.00 dioptor of nearsightedness. At her exam just a year ago, there was NO nearsightedness at all. It progressed a whole dioptor in just a year. At this rate, she's likely to continue progressing quickly. In this case, the optometrist and the parents will want to consider different forms of myopia control- alternatives to glasses which may slow things down (SEE: Orthokeratology).
Both scenarios happen all the time. A huge risk factor for figuring out whether myopia will progress quickly is how fast its already been progressing. But if the first time the student gets an eye exam is during fifth grade when the blurriness became significant, how do we know if she is a Julie or an Olivia? Bottom line is take your child in for eye exams even if she isn't complaining yet. Even if the myopia is so low that action won't be taken, it's still important to know if it's starting.
Make it a new year's resolution to start protecting your children against myopia now. A few small action steps now can have a huge payoff later.