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The rise in childhood myopia or nearsightedness has become more than just a matter of glasses—it’s a global public health concern. With the surge over decades, experts are raising alarms about this issue becoming a major public health challenge. A recent report from the National Academies of Sciences, Engineering, and Medicine (NASEM) urges the federal government to take action. By categorizing myopia as a disease, there's potential for more focused research and accessible treatment. But, can simply spending more time outdoors really help curb this problem?
While many of us associate myopia with the inconvenience of wearing glasses, in severe cases, it can lead to significant visual impairment due to refractive errors. Dr. Neil Bressler of Johns Hopkins highlights that even if only 10% of the predicted about, 5 billion people could be myopic by mid-century. As pediatric myopic cases rise, there are mounting socioeconomic barriers to treatment, with marginalized communities especially struggling to access care.
Myopia should already be recognized as a public health issue.
Dr. Machelle Pardue, Research Professor in Ophthalmology at Emory University
The theory? Natural light stimulates eye muscles and provides varied lighting that doesn’t happen indoors, supporting healthy eye growth. The report encourages the Centers for Disease Control (CDC) and Prevention (CDC) to create guidelines for children’s outdoor time, hoping schools and parents will promote more outdoor activity.
Children spending 1 to 2 hours outdoors daily may help slow myopia onset.
National Academies of Sciences, Engineering, and Medicine (NASEM)
Recent studies suggest that the "visual diet" of children what and how they view throughout the day has a major impact on eye health. Increased screen time and the demands of near work (like reading or using electronic devices) put a strain on the eye, especially in urban areas where outdoor access is limited.
In healthy eyes, light focuses on the retina, but myopia causes the eye to elongate, leading to light focusing in front of the retina, resulting in blurred distance vision. Myopia onset usually occurs between ages 8 and 13, stabilizing in late adolescence to early adulthood.
"Progression of myopia is faster in younger children, who may require frequent prescription adjustments. If myopia exceeds -6 diopters, it becomes pathologic, raising risks for severe complications like retinal detachment and myopic maculopathy, which may result in blindness," says Dr. Donald Mutti, The Ohio State University and coauthor of the NASEM report.
The sharp increase in myopia cases, especially in densely populated Asian countries, points to environmental factors as significant contributors.
Dr. Machelle Pardue of Emory University
A meta-analysis in the British Journal of Ophthalmology showed rising myopia rates among children, particularly in urban and high-literacy environments, with prevalence escalating from 24% (1990-2000) to 36% (2020-2023). In Scandinavia, however, cultural practices like spending time outdoors from an early age could be key to lower myopia rates. Parents there often leave babies outside in strollers, a norm researchers believe could positively impact visual development. But as Dr. Donald Mutti of Ohio State University points out, children worldwide are drawn indoors by the appeal of screens, depriving them of the outdoor exposure they need for eye health.
Despite the recommendations, there are obstacles. In some communities, outdoor spaces are scarce or unsafe, and educational pressures often prioritize indoor learning. For families in low-income neighborhoods, finding safe, accessible outdoor spaces is challenging, making it difficult to meet the recommended outdoor exposure.
Though treatments for myopia have grown over the last 20 years, including low-dose atropine eye drops and multifocal lenses, results remain limited. These treatments slow eye growth but don’t stop or reverse myopia, highlighting the need for more effective solutions. This urgency is echoed by the NASEM report, which calls on the National Institutes of Health (NIH) to fund research for innovative treatments. Additionally, reclassifying myopia as a disease could make eye exams more accessible and increase pediatricians’ roles in identifying and managing early cases.
Vision health isn’t just about seeing clearly. Children’s self-esteem, educational outcomes, and psychological well-being can all be impacted by untreated myopia. “Every child remembers the day they first got their pair of glasses,” Mutti observes, stressing the psychological weight myopia carries. By making outdoor time part of the school day and prioritizing eye care, experts believe we can address the rising epidemic more proactively.
Liang J, Pu Y, Chen J, Liu M, Ouyang B, Jin Z, Ge W, Wu Z, Yang X, Qin C, Wang C. Global prevalence, trend and projection of myopia in children and adolescents from 1990 to 2050: a comprehensive systematic review and meta-analysis. British Journal of Ophthalmology. 2024 Aug 14.
(Input from various sources)
(Rehash/Josna Lewis/MSM)
