The upshot is that dopamine regulates eye lengthening, and more light stimulates more dopamine.
Based on recent studies in Australia and Asia they recommend two hours of daily time outdoors for children to prevent myopia.
So it isn’t caused by looking at things close up, the confound was that people who spend a lot of time looking at things close up tend to do so under artificial light.
Three years ago at age 25 I booked an eye exam due after getting some new floaters. After imaging my eye doc came in and asked if I was comfortable driving while dilated, because he would be dilating and numbing my eyes before sending me off to the retina specialist for an urgent exam. The ophthalmologist immediately diagnosed me with lattice degeneration and saw a horseshoe tear. That same afternoon he sat me in a chair and used a laser to create a barrier of scar tissue around the tear to prevent it from progressing. Three years later I have had two rounds of prophylactic treatment of those weak spots in each eye. I most likely will never experience a retinal detachment, but annual dilated eye exams are in my future.
I don't even have very bad myopia (-2.75/-3.25), but I kick myself for not spending as much time outside during my childhood as some of my friends did.
I had the exact same situation happen, except my optometrist was visibly concerned. I usually explain it as spot welding my retina in place there. That was the weirdest sensation/discomfort ever. Last month or so I got a scan done and was able to see a really high res image of it.
Glad you got yours taken care of! They were definitely concerned about the tear, they're apparently common but when asymptomatic they're hardly noted (or even noticed if in the peripheral retinal areas).
The laser is definitely uncomfortable, hard to say if it's even pain when your ocular globe is injected with so much anesthetic. Brain freeze, but extremely acute and right behind your eyeball might be accurate. During one of the prophylactic treatments he did some 'spot welds' near my optic nerve. I couldn't tell if I was even looking at his ear like he told me to, every burst of green triggered my reflexes. It was impossible to keep my other eye open. At least the discomfort is so temporary, I forget about it until someone asks if it was painful.
Do you (/anyone?) know of any treatment that gets rid of floaters? I've seen a reference to some laser treatment, but not enough to seem trustworthy. If you don't mind me asking, did the laser-to-the-retina treatment generate any new floaters?
The treatment itself didn't generate any new floaters, but in the past year I did start experiencing a set of new floaters which correlates with the new atrophic hole my doc found. It's taken a few months but I can finally just ignore them or not even see them if I'm inside.
Isn't the main problem that myopia is genetically aggressive, and natural evolution stopped working because we correct for myopia through prescription glasses and contact lenses etc.?
The article talks about that a bit, there have been a number of 'causes' of myopia that are 'common knowledge' but end up not holding water. Genetics and close-up work being the two major scapegoats. Modern studies are showing a lack of dopamine in the eyeball to be the most likely factor, without a strong link to genetics.
Is this a rigorous study with control group and large selection?
Otherwise it looks like an option not considered seriously. I'm not going to medicate daily for the rest of my life to "decrease or slow by about a half". The promised result is wimpy - you still need to wear the same glasses till the end of your life, but hey, they have different numbers.
This is a category problem, really. It’s up to private industry (for capitalists) or the government (for socialists) to actually take research results and do something eith them.
According to TA, most cases of myopia are caused by being inside all day. There might be a genetic component, but it doesn't seem to be that relevant (yet).
You do realize that "natural evolution" doesn't happen within time scales of less than a single generation, right? The environment can change faster than that.
This is like saying “well I’m 70 years old and perfectly healthy after smoking my whole life”.
We’re talking about probabilities and statistics over large populations. Not every child who plays outside will avoid myopia, like yourself. But looking at the population, the expectation is that children who get more sunlight tend to have a lower incidence of myopia and weaker myopia.
Full midday sunlight is about 100,000 lux. Recommended illumination levels for office buildings are 300-500 lux. Domestic rooms will often be lit at less than 100 lux.
My workbench is illuminated to 10,000 lux, which compares to common daylight conditions. Just lighting that small area requires 120 watts of high-efficiency LEDs. Lighting the whole room to that level would require nearly two kilowatts of LEDs. Most "super strong indoor lighting" is in fact very dim compared to sunlight. We don't realise it, because our visual system is incredibly adaptable to changing illumination conditions.
I feel like it's not directly comparable because light gets reflected around indoors. I imagine having full sunlight indoors would turn everything white.
Illuminance (lux) is a measure of the amount of light falling on a surface, not the amount of light being emitted. Any reflected light will count towards the measured illuminance.
Sunlight is just incredibly bright. There's a reason why film crews often need to use huge metal halide lamps powered by a generator truck - it takes an immense amount of power to compete with daylight.
You can just use a light meter to measure directly.
Normal indoor lighting is a few hundred lux and with the right setup, I was able to increase it to 1000 lux at where my head is generally physically located.
Wouldn't the indoor light have to be strong enough to make you want to wear sunglasses indoors?
You would probably have to put stage lighting in your house to get the same affect as being outside. My eyes behave pretty different and seem to get a "workout" when I am outside in sunny weather.
I imagine you'd be able to wear the same thing you do outdoors. Which is to say, i don't wear sunglasses outdoors.
But regarding the lighting itself, yes i do think it is similar to stage lighting (brighter, i assume). Thermal and power is a significant concern with the lighting iirc, but i'm not too familiar. If i recall correctly the post that advocated these as a video and had an explanation on the difficulties. It heated up the room significantly.
With that said i want to stress that this was some post i saw several years ago, and i can't seem to find the video anymore. Iirc the lights were insanely bright, though.
I briefly took up a hobby of trying to raise some tomato plants indoors. The lights that claim to emit the full spectrum of non-visible light to match sunlight are insanely expensive (thermally and otherwise). There's probably more to the sunlight's effects on dopamine production than lux.
Possibly unrelated, but a specific frequency of infrared light has been found to have a protective and possibly even regenerative effect on aging eyes.
"Upon transcranial delivery, NIR light has been shown to significantly increase cytochrome oxidase and superoxide dismutase activities which suggests its role in inducing metabolic and antioxidant beneficial effects. Furthermore, NIR light may also boost cerebral blood flow and cognitive functions in humans without adverse effects. In this review, we highlight the value of NIR therapy as a novel paradigm for treatment of visual and neurological conditions, and provide scientific evidence to support the use of NIR therapy with emphasis on molecular and cellular mechanisms in eye diseases." [1]
NIR = near infrared light, 670 nm wavelength. This wavelength is present in sunlight, but not found in basically any indoor lighting with the possible exception of full spectrum LEDs and IR bulbs. Another study found improvement from NIR exposure, but only from exposure in the morning (for three minutes, once a week, at 670nm wavelength), and only in individuals older than 38. The study proposes that the effects they found from NIR exposure is due to improved mitochondrial function in the retina. [2]
The human retina ages faster than other organs, with a 70% decline in functional ATP production by mitochondria over a lifetime. The aging mitochondria, in addition to not producing as much ATP, also spit out junk amino acids that can cause chronic inflammation in the area (and signal cell death where none is called for?). As an aside, improved mitochondrial function is also proposed to be responsible for the significant health benefits of fasting and prolonged calorie restriction.
Another study also theorizes this mechanism:
"Our data suggest, 670 nm light can significantly improve aged retinal function, perhaps by providing additional adenosine triphosphate production for photoreceptor ion pumps or reduced aged inflammation." [3]
More study is clearly called for the better understand what is going on here and why. It seems like it could potentially have implications for age-related degeneration throughout the entire body, not just in the retina.
NIR has been known to be useful for a while. Closer to 1000nm, penetrates deeper, but isn't as 'potent'
670nm is great, but you can notice it when it's on, ESPECIALLY if it's the only light in your room, which can be annoying.
It's true that NIR stuff is healthy for your eyes, but HOW much so, is up to debate.
I've bought 10 30 W NIR bulbs to no effect (range from 650nm-950nm), but on the other hand blue light bulbs have been helpful with increasing visual accuity (shorter wavelengths appear to your eyes as fuzzy, so your eyes push themselves to refocus more often, though at the downside of low dopamine levels and no will to do anything {maybe this goes away with time? But I've spent a few days doing nothing due to blue light and I like to be productive}, while red light has no effect on motivation, but worsens my eyesight (light appears in focus, no need to refocus, eyes get "lazy")
All of this anecdotal, but I really do like reading/learning about this stuff and NIR seems to be more fad than not in real world situations
They have so many different recommendations they could do a "bullshit recommendation of the day".
Tell you to do something every day for the rest of your life. If it does not work, scold you for slacking off. If your vision does not degrade, praise it all on the topical bullshit therapy.
Floaters have many causes. An early sign of retinal detachment will be floaters until it progresses closer to the macular hole, at which point the symptoms will be more of a curtain being drawn across your vision.
I was able to catch a retinal tear that had a very high chance of proceeding to a retinal detachment (horsehoe tear with sub-retinal fluid) by getting some new floaters checked out.
Floaters are commonly caused by a (mostly) benign aging phenomenon called posterior vitreous detachment, where the vitriol gel liquefies as a person ages.
I've got one floater that tied itself into a knot several years ago. I was looking into a microscope, and I saw it cross my vision with this perfectly tied knot that wasn't quite pulled tight. Now it's worked itself into a tangled mess, and when I see it it's more like a hairball.
Floaters are black spots. The translucent spots you can see in the sky are sometimes called blue sky sprites, and are actually white blood cells distorting the light
Nah, floaters can be kinda clear. Mine look like circles with stuff in them (they look kinda like diagrams of a cell, or maybe a simple diagram of an atom—they have kinda a dot in the middle) and some of those same circles connected in long, curly strings with tube-like (?) structures.
They do indeed “float”. If I move my eyes they move with them, then have momentum when I stop moving my eyes. They’re way more visible against static, bright backgrounds (like blue sky) but I can see them in indoor lighting, too.
I’ve had them since I was very young. The white flashes you’re referring to I’ve only noticed recently, and are very different things. They do require a bright blue sky for me to see them.
In response to top of thread, retinal detachment does usually start with new floaters.
My first floater came with an unusually timed cluster headache ( like a migraine but usually with predictable timing ) so I had accompanying visual auras. Because I didn’t recognize it as a cluster I described it to the on call eye doc as new floaters and sparkles. That got me an emergency trip to optical ER and a slightly disappointed surgeon.
Ditto. I remember my first and only floater which manifested in a somewhat dark library. I found myself batting away at what appeared to be a rather large and persistent butterfly. Took awhile to calm down! I still haven't become accustomed to it despite my opthalmologist's assurances that my "eyes will accomodate" to it" (BS I think).
A friend of mine saw a floater for the first time and was freaking out. This confused me since, by then (and we're the same age), I was used to seeing the world through an aquarium of floaters. 8D
I've also had floaters and sometimes flashes (pin pricks) of light since childhood. Still have 20/20 vision, and every time I've gotten an eye exam they've said the retina looks healthy. From what I understand it'll be more of a "blizzard" of floaters when detachment is happening. At least for me the number of floaters seems to be highly correlated with my sleep quality. The flashes seem correlated with my blood pressure.
I've had them since my late teens. Mine haven't really progressed at all, but I have noticed that they seem to fluctuate a bit depending upon my hydration level. I see more if I'm dehydrated and they seem to decrease drastically if I really focus on hydration for a few days (1 gallon or more per day of water).
Same here (until I started getting new ones)! The best thing to do is to get a dilated fundus exam by someone who really knows retinas to rule out anything major if you start noticing them more.
> Floaters are commonly caused by a (mostly) benign aging phenomenon called posterior vitreous detachment, where the vitriol gel liquefies as a person ages.
And, the longer your eye is (the higher your myopia is), the earlier this happens.
Retinal detachment is rare though, even with tons of floaters and high myopia.
Very true, if it were very common you'd see retinal surgery centers in every hospital or more blind folks in rural communities. Thankfully it's not so rare that we don't have decent treatment for it. Like the article pointed out, rising myope rates are concerning for the implication on how many people will experience retinal issues. Sight is the last sense I want to give up, maybe the warning signs of RD should be as common as knowing the warning signs of strokes.
That might not be the case, given what the others have already mentioned about lifestyle --- I imagine most rural people will be outside a lot more and looking farther than city people.
and yet whenever I leave the city to go out to a rural area it seems like the people there are in much worse shape than the city dwellers. The obesity rate seems markedly higher. I think you would be right 50 or 100 years ago but not now.
> Floaters are commonly caused by a (mostly) benign aging phenomenon called posterior vitreous detachment, where the vitriol gel liquefies as a person ages.
I've had floaters since I was 18. A couple of years ago at 59 all of the sudden I had a huge increase in floaters accompanied by flashes in the left eye. I was sure I was having a retinal detachment. Got into an eye doc right away and she said told me it was the vitreous detachment and is something that happens normally at my age. It went on for several months with the flashing and floaters. The right eye followed suit about 6 months later. I had no idea that this was something that happens to pretty much everyone around age 60. Apparently, though, a lot of people don't notice it happening.
I remember as a kid I used to peek through this semi-transparent hole in a blanket to look at floaters. I saw dozens and dozens of them. I thought they looked beautiful. At that time I wasn't sure exactly what caused them if it was related to my eyes or the blanket or perhaps dust or something. Nothing happened to my eyesight then or since, and I don't even have myopia.
I started to see floaters this year. First, it scared the shit out of me, because I only have one healthy eye and starting to see this flying dots and strings was a really scary experience. It also was just really annoying.
After the ophthalmologist checked my eye, she said what I'm seeing is called "mouches volantes" and it's something that happens when people get older. I'm "only" 37 and don't have any problems with my eyesight, which makes me wonder what caused these floaters in my case.
Anyway, it's something I have to get used to. It only really is annoying on sunny days because then I can see them clearly floating around.
Build schools outside, more hybrid spaces/semi-indoor, spend more time doing activities outside, teach your kids sailing,mountain climbing, astronomy... Etc, engage with more nature. Learning happens in the real natural world as much as it happens in books. Take the books and apply it's lessons to reality. Step out of Plato's cave and discover the world. I grew up with myopia since I was 12. I always wondered why it exists evolutionarily it seems like a huge problem for survival. It's another modern disease. I know what to do to change things for my kids in the future.
Actually the followup to the initial paper it turns out it's shifting focus from near to far and back. I spent hours outside, maybe school caught up with me I was myopic by 2nd grade. I heard about that focus shift far, short, far is a big part. I taught my kid to focus up on tall buildings we can see. I'm between Murray hill and Gramercy in Manhattan, we have some views out our window and my now 15 year old has perfect vision. Eye Doctor assumes his eye is mostly if not full grown and he escaped the last couple of generations on both sides of the family. His success is more the focus changes than lots of daylight. Daylight surely helps with mood so I did teach him to get 20 even 30 minutes of daylight into his retina but not hours.
I completely agree that it’s the near-far-near focusing while outdoors. I read this on HN years ago right after getting my first indication that one eye was just barely no longer 20/20. I was always proud of my perfect vision and was quite worried. Since then I have tried to do several of those near-far-near transitions outdoors every morning and my vision is back to perfect in both eyes and has stayed there.
We know how myopia works now. Low dose atropine and glasses with fogged edges reliably slow or stop myopia progression. Myopia is not reversible by natural means. Sunlight is maybe related but it is more likely the proven mechanism of near work, specifically keeping peripheral vision in focus which tells the eye to grow longer (there is no brain involvement, the eye does this alone). Myopia discussions are terrible, they are filled with people offering advice and guesses on something they don’t know anything about, and people claiming it’s curable.
This article includes interviews from multiple experts, citing data from both retrospective and case control studies, plus the pandemic which effectively provided an even broader, country-wide study that again matched their data.
I’d love to understand why you would post such a dogmatic dismissal without so much as a citation. Are you an ophthalmology researcher yourself who is familiar with contrary and well-vetted research? Are you someone with a strong personal experience that you have a hard time squaring with the data? Or are you someone who forms strong beliefs, firmly held, regardless of whatever new information life offers?
As someone with an education in healthcare, nothing goes off the rails, and I mean really off the rails like a health related thread on HN.
You get some of the most ardent believers in some of the wildest hypotheses who are quick to dismiss a century or more of actual data.
That’s not to say that some early hypotheses won’t turn out to be correct, but there is a big difference between “I read this interesting paper with an interesting hypothesis” and “Hey guys, all of current medicine is 100% wrong and your doctor is conspiring to keep the truth from you (or so inept they probably can’t tie their own shoe).”
Emmitropization is a fact. Peripheral over focus causing myopia is well documented and peripheral defocus is also well studied. Peripheral defocus lenses and low dose atropine are well studied. The mechanism is understood, and proved by multiple different ways to interfere with the mechanism.
Optometrists are clothing salespeople. Only some ophthalmologists even know about atropine as an option.
Yup. If you spend time all day at a computer but never wear glasses, I can magically guess that your prescription is around -2. That's not a coincidence, just calculate the focal length and it comes out to exactly the computer screen distance.
And when you wear your full prescription without correcting for target distance, you just restart the process all over again. For some lucky people the axial length seems to be fixed after some point, but for most people that sets them on the path of increasing power.
So far our best guess is to make sure kids get enough sunlight every day and spend time outside, because looking at things in the distance is what regulates eye lengthening during growth. Since things are typically further away outdoors, it helps normal eye development and slows down nearsightedness.
> Sunlight is maybe related but it is more likely the proven mechanism of near work
My impression was that near work was previously a leading hypothesis but that, in agreement with this article, sunlight exposure is now considered the most likely explanation. However, I don't think there's ironclad proof either way, and a scholarly consensus is lacking.
Do you have a link to a recent review article that adjudicates between these hypotheses?
Essentially when things in your peripheral vision are in focus, aka things close to your eye like screens, your eye thinks it’s over focusing, and it grows longer to defocus, causing myopia. Preventing focus in peripheral vision removes this signal. The eye is very dumb, it grows on response to light focus. The brain is not involved.
Aren't there ongoing debates about the cause? I recall a Chinese government project to add sunlight to primary school classrooms. So it seems there is controversy still about what the actual cause is.
My dad had a theory that "kids belong outside", though I think it was more of a theory that we lived in a small house and he wanted some peace and quiet to work on his thesis.
I guess he was more right than he knew :-)
Anyhow, a large part of my childhood was spent outside. I've worn glasses since I was 6, with farsighted astigmatism.
There’s a lot of comments here and in the article - and in previous (honestly better) articles by others - about the lack of sunlight, and it’s definitely a thing, but we ensured junior was outdoors for the majority of his waking life and he still needed glasses at age 9. Later than me (age 6) but we put him into MiyoSmart lenses as soon as we could and they have definitely arrested the progress of his myopia.
In fact, there’s been no change in his prescription in a year.
In fact, one side went down 0.25 as my brilliant UK Opthalmologist deduced that he was not in need of it, and many kids opt for a slightly higher power than they need during the tests. Not to be fooled, this doc. The previous tests, the first, were conducted in Germany on similar equipment, but without a master sleuth operating them.
In short - MiyoSmart lenses are fricking brilliant and kids should be put into them immediately if they need glasses. They are twice the price in Germany than in the UK, like most things, but at least we had the choice.
When I was a lad, they only had a chart of ever-shrinking letters and can-you-tell-the-difference-between-Mickey-Mouse-and-Goofy-in-this-comic before they bolted a stronger pair of goggles on, fast forward 44 years and I’m a -10, and could well have been worse had I not found my optician 31 years ago. Now we monitor my eyes for diseases and potential retinal detachment.
But yes, be outdoors AND have passionate experts looking out for your vision.
I'm 30, software engineer, and I have had glasses for most of my life. I have astigmatism from birth like a lot of people. Now, up until 25 years old, it was just that, and even hypermetropia. But suddenly from 25, it started to reverse, losing about 0.5 dioptric per year. It started super late, so I was concerned, but turns out there's no age to get myopia, it seems. Now I'm about -2.5 on each eyes. And it's irreversible. All the doctors told me to get up and look far, but they forgot to tell me to have as much sunlight as possible. Now it's my number 1 criteria for renting an apartment, because it seems to have a huge impact on limiting my myopia progress.
If someone has also an experience of late myopia, I would be curious to hear from it, e.g. I would like to know if it stops someday, and if there are good solutions for it.
I know it's nothing in itself, but the progress in a few year was significant, and my doctors told it to me. It was a huge dégradation in a matter of 5 years, while I was already old. I wondered what was the thing that started the bad progress. Maybe because I got a phone with unlimited internet and kept using it, maybe because of poor light in the offices (during my first job, despite being on the computer all the time, I had no sight loss, because the light was actually pretty good).
I think no matter what your correction is, you should take the steps to not make it worse, and I find that there's very little information about that. Even doctors just say "look far once in a while" which doesn't see so efficient.
hypermetropia and astigmatism stack on top of each other, with astigmatism it was always blurry, and then on top of this you get the hypermetropia or myopia. So, I never had a normal vision because of astigmatism, but if I didn't have it, I guess so ? But like anyone has a normal vision until they have myopia. What shocked me is that it developed so quick, after being grown up.
I don’t have time to go down a YouTube rabbit hole but in my experience it’s quite simple - you just have to do near-far-near focusing while outdoors. I read this on HN years ago right after getting my first indication that one eye was just barely no longer 20/20. I was always proud of my perfect vision and was quite worried. Since then I have tried to do several of those near-far-near transitions outdoors every morning and my vision is back to perfect in both eyes and has stayed there. Look at a finger, look at a tree far away, back to my finger. I would highly encourage anyone to start doing this regardless of current vision.
A July 2023 report from NIH (the US government's biomedical and public health research body) is titled "Low-dose atropine eyedrops no better than placebo for slowing myopia progression".
It infers a possible significant racial or genetic divide in the effectiveness of the atropine treatment, also given that some other atropine studies, which show success, tend (as far as I've seen) to involve Asian demographics.
In any case, I am a total layperson, only here to note that fairly authoritative sources (e.g. in this case, a co-author being a professor of ophthalmology at Johns Hopkins University) appear to still be at odds about the application and demographic effectiveness of the atropine treatment, about which several general claims are made elsewhere in these HN comments.
This seems like it can be proven or nullified by long at geographic data. Do people living closer to the north pole where it's colder, at the very least for winter where people would be inside more, have a greater occurrence of myopia than those living around the equator where it's a comfortable temperature all year round and people are more likely to be outside more often?
Taiwan's successful strategy is a two hours outside per day policy in schools. Being outside two hours in total per day is bearable even in cooler climates. And nowadays, also life for people in tropical countries tends to move inside buildings where jobs and air conditioners are. There might be a signal when comparing with agrarian countries, even though it is possible that myopia is not accurately tracked by statistics there.
For those with kids: https://www.aao.org/eye-health/news/low-dose-atropine-kids-w... - this is what my eye doc and his colleagues do for their kids. I’m blind in one eye with retinal detachment and myopic macular degeneration in the “good” eye. My kids will be on this when old enough.
2. Short intense exposure delivers the same results as long, weak exposure *
Then logically, looking at the sun or other bright object with eyes closed for a few seconds would provide the optimal therapeutic benefits by triggering dopamine production in the least time necessary.
> The children most at risk of developing myopia are prescribed atropine alongside their time outdoors, and the results have been spectacular.
When I was a kid I got sometimes atropine drops, so my myopia could be measured precisely. I just hated it. I was forbidden to read while my pupils were stretched wide.
I wonder do Taiwanese medics forbid children to read when they prescribe atropine to them.
"(In 1989, an American ophthalmologist named Richard Stone found that he could induce myopia in chickens by manipulating light levels, and that there was less dopamine in the retinas of the myopic chickens.)"
And yet it took so many years to draw the conclusions for human myopia. I'm wondering how many insights are still hidden in scholar articles waiting to be put together. Would an LLM trained on scholar data be able to answer a well-posed question with new insights?
> For instance, orthokeratology contact lenses improve vision by temporarily squishing the cornea into a different shape, reminiscent of how ancient Chinese soldiers are said to have slept with sandbags over their eyes for the same effect.
This is a fascinating historical tidbit and I'm curious to learn more, but Google fails me. Did ancient Chinese soldiers do this specifically to improve their vision? Was myopia a big problem among those soldiers?
Meh. I have retinopathy of prematurity and -9.25 and -11.23 single vision lenses. My ROP was scored at level 3 of 5 generally speaking (I am a twin, my twin does not have ROP), my rop is considered stable. I get retina checkups every 6mo.
I've also had 2 retinal holes and 1 horse shoe tear across both eyes in the last 3-4 years... And cataract surgery in my worst eye last year implanting a mono-vision IOL. I am 43 years old now.
Everyone in this thread worrying about your -2 and -3 myopia can just go sit down ... Lol.
My biggest concern at the moment is the slow moving cataract in my "good" eye, I'd rather not get surgery for ~10 years if it can be avoided.... I write code for a living ...
Everyone's eyes age and deteriorate as we get older. My eyes are simply more prone to complications due to the ROP as they never fully developed correctly due to the incubator I was placed in at birth (born 2mo early)...
Heh I feel you on this one - it’s not a fun contest to “win” but I also find the “I have bad eyes” complaints funny when I have had 5 retinal detachment surgeries, leaving one eye completely blind. My good eye has had one RD surgery, glaucoma caused by surgery, cataract surgery, and is now facing macular degeneration. I get monthly eye injections to halt new blood vessels from growing. I basically live at the retinal specialist.
I hope your eye troubles keep at bay for many moons to come!
Hi thanks so much. I also hope your issues are manageable!
I don't mean to pry, are the shots for macular degeneration or do you have retinopathy of diabetes? My mom has macular degeneration and has had some shots already (she is stable at the moment)... And the doctor says the MD could be hereditary.... Oh joy, but there's essentially little I can do about that. So (I figure) take an over the counter eye vitamin and basically try to stay away from more surgeries if possible ... Rarely are surgeries a better result (for anything) than yourself prior to the surgery; there are always tradeoffs to lens implants, replacement knees etc.
No worries - the shots are indeed for MD. I actually don’t have the retinopathy you have, but am unlucky in the eye department in other ways. Retinal detachment was passed to me from my mom, but not sure exact genes in play here.
Something that I've noticed is how far more young people use glasses today compared to the 80's.
It could be the result of people getting richer and having more access to medical care, but then, I don't remember rich young people using glasses too much.
As someone who is of East Asian descent, and with a mid -8 diopter, I fall into this category. I am extremely grateful that I can still get 20/20 vision with corrective lenses, but I assume that at some point, that will no longer be the case.
Oh hey for those who do have good distance vision, what would say the moon looks like to you? I would say it’s roughly the same apparent level of detail as a 30x30 bitmap. More or less. It’s too cloudy tonight for me to go look.
I have never enjoyed time outside even as a kid so I feel it is a good price (-4 diopters) to pay for the extra 1-2 hours/day I can spend indoors in all these years.
The article is a bit confusing imo. It mentions myopia and also retinal detachment, and sort of implies a link between the two but not does not explain that at all.
The eye elongating sufficiently will cause the retina to at least partially detach; its size cannot increase, but the surface area of the thing it is attached to is increasing.
this article is about a childhood developmental issue.
TLDR
High myopia is the medical term for extreme or severe nearsightedness. A person who needs a vision prescription of -6.00 diopters (D) or more has high myopia ... It's very important to manage myopia progression during childhood, before it becomes high myopia. Myopia typically begins during early childhood and progresses over time. The peak years of myopia progression are roughly between ages 7 and 15.5 ... For about 50% of people, myopia stabilizes by age 15, but it can progress until around age 24 for others. Low and moderate myopia fall between -0.25 D and -5.75 D.
High myopia causes
Nearsightedness primarily occurs as the result of a slightly elongated eyeball shape. When the eyeball is too long, light focuses too far in front of the retina. This causes distant objects to look blurry ... Inherited genes can play a role in the development of high myopia. Children have a greater risk of developing the condition when one or both parents have nearsightedness.
Severe myopia does not generally lead to vision loss on its own. Instead, the progressive lengthening of the eyeball stretches and thins the retina and other eye tissues. This makes them more vulnerable to damage and disease.
The TLDR is that a lot of people have very high myopia that causes severe eyeball elongation, which then causes retinal damage/detachment, which sadly could progress into blindness..
I myself was -5.75 and -6.25 with some non-negligible cylinders. I experienced discomfort when looking at my phone phone and reading book with my glasses on. I General check up said that my eyeball pressure and all were normal, but I know the discomfort is nothing good and can be quite serious. I read up online and found out that myopia could cause eyeball elongation, which could cause discomfort and ultimately could cause retinal damage/detachment. The discomfort I was experiencing was probably due to my elongated eyeball.
I prayed and began looking for way to work around my myopic eyes without having to get yet another thicker glasses... And I'm super thankful to have found out about this life-changing video by Todd Becker on how to reverse myopia: https://www.youtube.com/watch?v=x5Efg42-Qn0. The TLDR is that eyeball elongation (and hence myopic eyes) can be reversed in a way very similar to how strength training is conducted (hormesis). You simply need to keep wearing reduced prescription and do eye-focus exercises regularly.
It sounds too good to be true, doesn't it? I was scared too at first, and when I went to a glasses store to get a lower prescription glasses, the store attendant warned me too. But I went ahead anyway. My latest eyes exam before the attempt (back in August 2021) was -6.75 and -6.5 with -0.25 and -0.5 cyls. After 2 years of wearing lower prescription whenever possible and doing eye-focus exercise quite inconsistently (by reading on Kindle with lower prescription at a distance that causes hormesis, as explained by Todd Becker), I am happy to announce that I'm now wearing -4.5 on both eyes (without cyls) when I need almost-perfect vision, and wearing -3.5 for training purposes. I have seen people online who seem to be much more consistent reported even faster progress.
On top of those resources, I am happy to share more of my experience and the exercise I did as well. Feel free to email me at denny at nusantara-cloud dot com if you want to have a chat with me!
I was diagnosed with myopia at 4 years old, which prompted the simultaneous diagnosis of my sister, then just 2 years old. I've probably been myopic longer than I could read, and maybe even longer than I could walk on two feet.
I spent a lot of time reading as a kid. When I've heard other people, sometimes doctors, speak as though that somehow caused my high myopia, or my sister's, it has struck me as obviously laughable. The sunlight theory is interesting.
My sister and I also share an inherited retinal disease that causes photophobia (severe light sensitivity). Because the disease is progressive (degenerative) and we were only diagnosed as adults, we never had any ERGs taken as kids, so we don't know whether or how it was affecting us then. But from even pre-school, I remember walking around with not just my face pointed down, but my eyes closed, opening them only every couple seconds, in order to escape the extremely bright sun where we lived. So does she.
I wonder if to some extent, our early visual impairments and light sensitivity exacerbated our myopia by making outdoor times and outdoor activity less rewarding for us.
Aside: as someone with high myopia, content like this, seemingly fixated on preventing, curing or 'ending' myopia, reminds me a lot of some things I've seen on Reddit. Out of some personal interest, I sometimes browse r/myopia as well as r/blind. And it strikes me over and over how r/blind seems like a much more sane place to me. r/myopia is full of people absolutely panicking over myopia that is fully correctable! It's got post after post of people desperately trying to 'reverse' their myopia, people going to great lengths to try to shave one or two diopters. Many posters there describe feeling depressed and deflated by their first prescriptions, obtained in adolescence or young adulthood, and anxious about the future.
I've never really known what it's like to have normal vision. In that sense, I know I'm inclined to underestimate the sense of loss that some people will naturally and rightly feel when their once-perfect vision degrades. But I can't help but look at r/myopia and think it all seems a bit unhinged. It's strange to watch people with highly correctable vision, whose vision will likely never seriously affect their mobility, independence, or work act like the sky is falling because they're nominally myopic while half of my immediate family is blind or slowly going blind.
In contrast to r/myopia, r/blind seems so much more grounded. There's grief and worry there also, but for the most part, people posting there are just figuring out how to live their lives. It's a place that feels much less depressing, much less despairing, to me.
To some extent, I think the OP and the shift in thinking it describes is aligned with r/myopia, while the older view that myopia is largely genetic and something more to be managed than to avoided, with r/blind. I think from a public health perspective, interventions like the OP describes are absolutely warranted. But when it comes to individuals, I think a lot of people would serve themselves better by taking up a looser posture. Even 'high' myopia is extremely manageable, if that's all you've got going on. It's not the end of the world to be myopic (or even to be blind, as a brief scroll through r/blind makes clear). By all means, let school systems and health departments and scientists keep working out how to address myopia at scale. But individuals with myopia, or children with myopia, should know that they're okay.
Sure, but as someone with myopia, I can easily see it the other way.
The more kids difficulty kids had seeing at distance, the less likely they were to spend outside.
Once I started wearing glasses, swimming / pool time was less fun cause I can't see. Other sports were fine with glasses, but sometimes they fly off and maybe get damaged which is a big deal and dampers enthusiasm. Some amusement parks are real strict about not wearing glasses and roller coasters are less fun when you can't see. Etc
I guess I'll just hang out inside with books and computers, thanks.
> The more kids difficulty kids had seeing at distance, the less likely they were to spend outside.
This is logical, but the evidence still points to something environmental causing a major shift in levels of myopia. In one generation the rate of myopia in some countries went from 20% to 80%[0]. This means that it isn't genetic, something environmental must have changed to cause this.
By the time I was...probably about 12, my myopia was bad enough that I could no longer read without glasses (or without holding the book uncomfortably close to my face). Similarly, attempting to interact with a screen would've been impractical, because it's all fine detail.
Outdoors, however, most things that I would need to care about were large enough that I could see them just fine. I wouldn't have had much trouble, for instance, playing soccer without my glasses on, because I didn't need to care which face was which or even the numbers on the backs of the shirts—I just needed to see the colors of the shirts, and the position of the ball, well enough to maneuver between them. (Well, I wouldn't have had trouble due to my myopia. The trouble I had playing soccer was from a different source.)
...I have literally never encountered an amusement park where I couldn't wear my glasses. It seems to me that if there's really a danger, they should provide some kind of protection for you.
There are amusement parks that don’t allow non-prescription sunglasses on rides. But sometimes the operators don’t ask if they’re prescription, and you need to tell them that your sunglasses are prescription.
For swimming, you can get prescription goggles. That makes snorkeling a completely different experience, you can actually _see_ things on the seafloor.
For other types of sports, you can wear contact lenses. Even if you're not comfortable wearing them all the time (I certainly am).
Last year I decided to get a laser eye surgery (PRK), and I'm now enjoying clear vision without glasses.
I don't know why western media always talks about myopia (in Asia) as if it's some sort of mystery. Where I'm from, everyone believes that myopia is caused by... the habit of looking at close objects for prolonged periods, such as electronic devices or books. Like how shocking (it should not if you know how muscles around your eyeballs work). I think it's even written so in the textbooks.
Yes, that's a common belief in the West as well, and used to be generally accepted. But there's a very strong correlation between looking at close objects for prolonged periods and being inside so it's easy to understand why it was misunderstood for so long.
you seem to think the real cause is "being inside" and not using your eyes in a particular way? (looking at close objects...). What is the exact mechanism by which being inside affects your eyes then?
I'll try to explain what I understood from the article: the natural sunlight makes your body release dopamine, dopamine causes the eye not to elongate, not elongation equals not having near-sightedness.
Probably I got that only half right.
Anyhow the article claims it's not looking at close things and the real cause is being inside.
> There is preliminary evidence that the protective effect of outdoor activities on the development of myopia is due, at least in part, to the effect of long hours of exposure to daylight on the production and the release of retinal dopamine.
yes, there is a theory on how the muscles of the eyes become "miscalibrated", so to speak, if you only look at close things. What is the exact mechanism of the "lower light" theory then?
the problem with playing indoor is that your "eye break" only goes so far as the walls of the space, still "close objects" in relative terms. In nature, humans use their eyes to gaze landscape, stars... really far things.
Well, the real problem is that children's eyes aren't getting enough sunlight exposure to trigger dopamine production, which regulates the lengthening of the eyeballs, while cooped up inside. Eye strain is muscle fatigue, unrelated to myopia.
My understanding is that 20 feet or so is optical infinity, so whether you're looking at an object 20 feet away or 20 light years away, your eye muscles are just as relaxed (hence the 20-20-20 recommendation: every 20 minutes, stare at an object 20 feet away for 20 seconds)
I don't know about you, but where I spent my childhood, most things indoors were much closer than 20 feet away.
That's a fairly large room, and we typically don't focus on the furthest point while indoors anyway. So with the 20ft requirement, it's a lot easier to fulfill while being outdoors.
Oh yeah definitely - I was purely commenting on the parent comment's "really far" claim, and noting that it's all the same to the eye muscles once you hit 20 feet - you don't have to (no pun intended) set your sights on the stars to relax your eye muscles.
The problem is everyone and their dog wants urbanization, and dense urbanization at that. Be it for environmental reasons (land use, reduction of individual car traffic), for financial reasons (easier to supply dense areas with infrastructure like water/electricity/public transit, at least up until a certain point) or for the benefit of employers (a large, concentrated talent pool).
The downsides however? We're completely ignoring them for whatever reason, and increasing myopia and rising child obesity rates are just one point on the giant list.
Personally, I want urbanization to fight against obesity - walkable cities produce a lot more natural and casual physical activity than living in suburbia and needing to drive three miles to pick up a can of coke.
Good urbanization also, I believe, would discourage myopia. I've spent the past few months living in Barcelona and nearly everything here happens outside in the sun - going for dinner, meeting friends, playing a board game... people tend not to do as much inside under florescent lights when usable, comfortable, and safe outdoor spaces are available.
As a child of the 1970s and a teen in the early 1980s I was outside more than in even in cold Canadian winters. I have bad astigmatism and I'm also near or far sighted (can never recall which).
I know just my own life doesn't nullify the statement but all my friends were the same I mean outside but I don't know of them who has glasses as adults.
> I'm also near or far sighted (can never recall which).
Take off your glasses and try to read a book at arm length, and close up. If you can easily read it at both distances, you might have good vision. If you can only read it when it's far, you are far sighted. If you can only read it when it's near, you're near sighted.
I know just my own life doesn't nullify the statement but all my friends were
the same I mean outside but I don't know of them who has glasses as adults.
This statement is confusing. And this is something I'm super keen to learn more about. So lets see if I understand this correctly.
You mean you _do not_ know of any friends who _do not_ wear eyeglasses as adults?
Let me rephrase that.
You played outside as a child. You now wear glasses.
All of your friends played outside as well. All your friends now wear glasses
as well.
My friends and I played outside as children. I began to wear eyeglasses at age 17. My friends at the time to the best of my knowledge did not wear eyeglasses (ages 0 to 18). I do not know any of the same people now so I cannot say if they as adults wear eyeglasses or not.
I have astigmatism and now presbyopia too so if I remove my glasses and try to see if they magnify or reduce thing I'm not able to see because I can't see without my glasses. lol
I’ve got better than 20/20 vision and I can focus just fine on the moon, and I haven’t got the slightest clue why my vision is good and other people have myopia. My parents didn’t let me have a lot of sugar as a child (we never ate fast food, no soda in the house), I don’t see that being studied much.. pure speculation on my part of course.
Didn’t read the article. But currently curing my own myopia with measureable improvement. Yes, I know it’s impossible whatever. It’s happening. I believe what I see with own eyes (pun fully intended). There’s a not-yet-scientific theory behind it. See https://m.youtube.com/watch?v=XPIGDSY_xBs
Myopia is not reversible with any known means except surgery. Your results are irrelevant and minor changes could simply be due to choroid thickness changes. There are comments like yours on every myopia post where people claim minor changes (1-2 diopters) then are never heard from again.
No, it doesn't. Vision therapy is reliably shown to be quackery in studies. Vision therapy doesn't make sense, as there is no known signal to cause ECM breakdown / eye reshaping to reduce axial elongation.
Myopia is a terrible thing to discuss, there are so many people guessing and making false claims about things.
The College of Optometrists in Vision Development (COVD) is a non-profit, international membership association of eye care professionals including optometrists, optometry students, and vision therapists. Established in 1970, COVD provides board certification for optometrists and vision therapists who are prepared to offer state-of-the-art services in Behavioral and developmental vision care, Vision therapy, Neuro-optometric rehabilitation.
A local search found 40 COVD-certified optometrists.
I'm sorry, simply no. I know myopia is supposed to be not reversible. No one knows how these methods work. But they work, and I'm so happy I'll be able to get rid of my glasses without laser surgery, I can't care less about what science or people currently say.
Furthermore there are contact lenses that temporarily reshape the surface of the eye as well as new glasses, both of which are now either FDA approved or in late-stage trials.
"A likely explanation of the inverse association between pregnancy and myopia progression is the higher exposure to outdoor activities in pregnant women during their maternal leaves. Time of outdoors physical activity of 6.9 vs 5.2 h per week (P=0.002) in pregnant woman compared to non-pregnant woman."
Outdoor activities - the same thing as in the Wired article that's noted to slow down myopia progression. I don't think this study supports what you think it supports.
Also myopia didn't reverse, the rate of increase merely slowed down in the pregnant women.
> Jake has a vast wealth of valuable writing about the subject and his blog posts go into a lot of useful detail. Unfortunately, Jake has some issues ... I thought I'd take a crack at summarizing the most important findings across all these thinkers on one page, including stuff from community members and my own experiences ... it's time to stop treating this like property and start treating it like a common resource.
Great resource (2nd link) I can confidently point people to, thanks! The only thing NottNott disagrees here based on experience (I don't have a precise opinion on it) is that avoidance of screens are not necessary whatsoever, as long as you are getting your daily ~2 hour active focus distance vision (walk).
Based on recent studies in Australia and Asia they recommend two hours of daily time outdoors for children to prevent myopia.
So it isn’t caused by looking at things close up, the confound was that people who spend a lot of time looking at things close up tend to do so under artificial light.