Younger generations facing myopia epidemic
Too much time indoors, addiction to technology have made more kids nearsighted, experts say
When Karen Kawawada learned both her young daughters were diagnosed with myopia, she feared they would grow to share her struggles with vision.
The Kitchener-based mom started wearing glasses at age seven to compensate for her nearsightedness. Now in her 40s, Kawawada says she “can’t see anything clearly beyond my hand in front of my face” without sight aids.
“I thought (my kids) were going to go the same way as me, and I was afraid of that,” she said.
But, despite her best efforts to limit screen time and encourage outdoor play, her children have been swept up in what experts call a myopia epidemic.
The vision disorder has risen dramatically in recent years, projected to impact half the world’s population by 2050 — and our youngest generations will bear the brunt of the burden, eye doctors tell the Star.
“The thing that’s heartbreaking is it’s actually a fairly easy correction,” said Dr. David Wong, ophthalmologist-in-chief at Unity Health Toronto.
Myopia, or nearsightedness, is a common condition that makes objects farther away appear blurry. It can occur when one’s eyeball is too long or the cornea too curved, leading to focusing issues inside the organ, Wong explained.
The disease currently affects around 30 per cent of the Canadian population, according to the Canadian Association of Optometrists. In the U.S., myopia rates nearly doubled in 50 years from 25 per cent in 1971 to 42 per cent in 2017. Across the pond, 80 to 90 per cent of Singaporean high school graduates are now myopic, and similar rates have been seen in China, Taiwan, South Korea and Japan.
If current trends continue, the world will have 4.76 billion people with myopia by 2050 — about half the projected global population that year, studies show.
Ten per cent of the total population, or nearly a billion people, will have high myopia by then. By definition, these people will have “far worse” unaided visual acuity than the threshold for blindness.
Although the majority of myopia cases can be managed through wearing glasses or contact lenses, the disorder may worsen to the point of threatening one’s eyesight. Anyone with myopia is at risk of developing retinal detachments, cataracts, glaucomas and myopic maculopathy — a leading cause of visual impairment worldwide — as the condition progresses, Wong said.
That’s concerning because children’s eyes are still growing, lending to faster-progressing myopia and more severe outcomes, said Dr. Deborah Jones, a clinical professor at the University of Waterloo’s School of Optometry and Vision Science.
It’s normal for our eyes to lengthen by about seven millimetres growing up. But, in kids with myopia, “we’re seeing this abnormal growth. It’s like this rapid elongation — so it gets to (seven millimetres) way before it should, and then it just continues to grow,” Jones explained.
As of 2018, nearly 30 per cent of Ontarian kids aged 11 to 13 had myopia. Jones expects this figure to have ballooned in recent years, especially after the pandemic — anecdotally, her clinic has been seeing a surge in young children with myopia.
The public health burden will be felt years from now when they grow up. What could be behind the surge?
For years, scientists thought genetics alone dictated whether one developed myopia. Now, the debate has been muddied — one’s environment clearly made an impact, given the rise in recent cases, but the exact factors weren’t clear, Wong explained.
The consensus now is that exposure to natural sunlight likely plays a big role, he said.
Studies suggest certain wavelengths of natural sunlight can stimulate dopamine release inside the organ, potentially protecting against nearsightedness as the eyes develop.
“As more and more people are becoming educated, their kids are (spending more time) indoors reading, and not being into outside play as much,” he said.
This was intensified during the pandemic lockdowns, when kids were kept away from sunlight at a time when they needed it most, Wong continued.
“The recommendation is kids really should be getting a certain amount of light, about 90 minutes to 120 minutes of light a day outdoors,” he continued.
Jones noted this issue is compounded by our collective screen addictions — bad enough for adult eyes, but far worse for those still growing.
“There’s this dependency on digital devices for entertainment. Kids have iPads, they have cellphones … and everything’s being watched up close,” she said.
“So our big recommendations are to limit non-academic screen time and to go spend more time outside.”
Kawawada said she felt “dismayed” when her daughter Penelope, now 14 (the Star is identifying both by their middle names for privacy reasons), was diagnosed as myopic near the start of the pandemic. Her youngest, Lillian, now 11, followed suit a couple of years later.
After their diagnosis, Kawawada got her daughters started on myopia control — a suite of treatments including eyeglasses or contact lenses, as well as ortho-k or atropine eye drops, intended to slow the disease’s progression. She felt consigned to her daughters’ fates as myopes.
But then something unexpected happened. Against the odds and contrary to doctors’ expectations, both her daughters’ visions began steadily improving.
“After a couple of years in both cases, their sight actually improved to the point where they no longer have a prescription,” she said.
“I’m so grateful for myopia control technology and how it’s helped my kids.”
They’re still on low-dose atropine, and likely will be until they turn 18, she said — but the turnaround has felt like “a miracle.”
Kawawada’s family are the exception, as myopic control very rarely leads to improvements in eyesight — but Jones urges parents to give it a try anyway, especially when kids are still growing.
The recommendation is kids really should be getting a certain amount of light, about 90 minutes to 120 minutes of light a day outdoors.
DR. DAVID WONG OPHTHALMOLOGIST-IN-CHIEF AT UNITY HEALTH TORONTO