If you don’t wear glasses now, you probably will soon
I have been four-eyed since I was 19. My prescription for nearsightedness was so mild, however, that I could manage without glasses if I wanted to.
Over the years, my myopia needle moved only slightly, generally hovering around -1.0. A slight reading prescription was added in middle age, introducing me to the joys of varifocal lenses and a new chance to shop for frames.
Now my eyes don’t know what has hit them. After more than a year of working from home and being glued to a laptop, desktop, mobile phone or large TV screen for the majority of my waking hours, my vision changed. A lot. The on-again, off-again eyelid twitch (doctors call it myokymia) was an early sign I wasn’t giving them enough rest or needed to lay off the caffeine. Then I noticed my glasses no longer brought everything into crisp relief.
But I wasn’t prepared to learn that my prescription would need to more than double in strength to -2.50 in both eyes — and that my reading sight had also considerably worsened. The optometrist said that kind of deterioration in under two years was highly unusual.
Kiran Vyas, the local optician I visited for new frames, tells me he’s seeing this more and more. It’s not just adults of a certain age complaining about their eyesight either; far more kids than before are coming in needing glasses, he says. After that visit, I noticed my husband (who has never worn prescription glasses and insists his eyes are fine) holding his reading material out as if it was a selfie stick. I booked a second appointment.
The more time children are inside reading, studying and using their electronic device(s), the less natural light the eye is receiving to develop properly.William Reynolds
It turns out that myopia has been a growing concern during the pandemic, especially among children. A study published early in 2021 in JAMA Opthamology, using data from Feincheng, China, reported that myopia in children aged six-13 years old increased by up to three times in 2020 from the period between 2015 and 2019. On average, children were more shortsighted by -0.3 dioptres (the unit used to measure the corrective power of the lens the eye requires).
The authors analysed nearly 195,000 test results from school vision screenings collected over six years. They found that not only does myopia appear to be worsening, it seems to be more prevalent too: only 5.7% of children were found to have myopia in 2015-2019; in 2020, that jumped to 21.5%. In 2018, 15.2% of seven-year-olds and 27.7% of eight-year-olds had myopia. Those figures jumped to 26.2% and 37.2%, respectively, in 2020.
Interestingly, the largest decrease in spherical equivalent refraction or SER, used to measure myopia, was found in the six-year-olds. Since older children were exposed to longer hours of screen time, this suggests younger eyes are more sensitive.
The authors cited their results as the first evidence that home confinement during Covid-19 and reduced outdoor activity is associated with worsening eyesight. They urged caution in interpreting their results, however, since the data didn’t provide the exact amount of screen time or close-up work, or the hours of outdoor activity for individual children. Still, the change in 2020 from previous years is striking.
The College of Optometrists in the UK reported last week that its research found nearly a third of Brits (31%) say their eyesight had worsened during the pandemic — a jump from the 22% who reported the same in June 2020.
Myopia is the most common ocular disorder and a leading cause of visual impairment in children. The World Health Organization (WHO) has warned that prevalence is on the rise — it is estimated to affect 52% of the world population by 2050. If you don’t have glasses now, you probably will soon.
The pandemic will almost certainly exacerbate this trend. William T Reynolds, president of the American Optometric Association (AOA), notes that the increased use of digital devices is likely to result in a surge in eye strain or other ocular complications. In March, the AOA held an emergency summit to raise the alarm over children’s eye health.
This has significant implications for poorer regions and the developing world too, since myopia increases the risk of serious (and costly) eye disorders such as retinal detachment, glaucoma and cataracts. High myopia (an SER of -5.00 in either eye) can cause serious retinal damage that can lead to blindness.
For policymakers and educators weighing hybrid and remote learning, the effect on eyesight has to be considered. “Increasing screen time is usually accompanied with a lack of outdoor time and more sedentary lifestyle. The more time children are inside reading, studying and using their electronic device(s), the less natural light the eye is receiving to develop properly,” Reynolds said. (The WHO says there is evidence that spending time outdoors can reduce myopia or delay its onset.)
The global eyewear market was estimated at $147bn in 2020 and is expected to grow at a compounded annual rate of 8.5% for most of this decade. Though pandemic store closures hurt eyewear sales, more people now needing glasses or changing prescriptions in the wake of Covid-19 should reverse that.
I realised with, um, hindsight, that my worsening vision might be tied to all the things I haven’t seen this last year. I no longer stare down a long train platform or spy a colleague from across the office. I don’t take in a kaleidoscope of moving colours and shapes during a commute. Such sights provided a workout for my eyes that I haven’t had in some time.
For those hoping to stay lens-free (or keep their myopia from worsening), optometrists are fond of the 20-20-20 rule: every 20 minutes, take a 20-second break to view something 6m away. Had I been doing that for the past year, I might have been spared the deterioration, as well as the cost of my new frames.
Bloomberg opinion. More stories like this are available on bloomberg.com/opinion.
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