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The Nearsighted Epidemic – How the Digital Device Addiction is Changing our World

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Randall Fuerst O.D., F.A.A.O.

Being nearsighted—otherwise known as myopia, is a growing concern in the eye health industry. It's effects are lifelong, and it's rates of occurrence are increasing drastically. Further, suggested links to digital device use have us looking to the future as more and more kids find focusing up close on a phone or laptop a significant part of daily life.

Earlier this month, the American Academy of Ophthalmology issued a statement regarding a global initiative to address the myopia epidemic. EYEcenter joins the eye health community in heightened concern that the coronavirus pandemic may worsen the epidemic of children at risk of nearsightedness. EYEcenter’s Dr. Randall Fuerst weighs in on the subject below, including suggestions to help your children avoid increased risk.

Last year, the CDC issued a report that stated the average US adult is using digital devices approximately eleven hours per day.  I ask my adult patients how many hours they are using a computer, smartphone, or tablet—and these numbers are certainly borne out. Research is starting to show a strong causative impact between screen time and eye and vision changes for the worse. Newer research is now showing strong links to sight-threatening diseases—macular degeneration, cataracts, glaucoma, and retinal detachments—all of which can lead to blindness.

A recent 2020 report out of South Korea, where military service is compulsory, stated that 95.1% of 19-year-old males in South Korea measured as nearsighted (myopic). On November 11, 2020, the Academy of Ophthalmology in a joint statement with the American Academy of Optometry noted that in the US the number of nearsighted Americans has doubled in the past 50 years—to about 41.6% of our population. In Asia, the numbers are now at between 80-90% nearsighted.

So Why is This a Problem?

The trends suggest that by 2050, half the world’s population will be nearsighted. The bigger problem is not more people needing glasses or contact lenses. It is that those who genetically are destined to be myopic are starting earlier—and ending up significantly more myopic—a condition called high myopia, or pathologic myopia.

“Myopia needs our focus now”, states Richard Abbott, MD, leader of the Academy of Ophthalmology’s Myopia Task Force. “Kids who develop myopia early in life and progress to high myopia face an uncertain future. They have 50% greater risk of glaucoma, they are 17% more likely to need cataract surgery, and have 6 times greater risk of retinal detachment and retinal tears.”

In a study out of Finland that followed myopic progression for 22 years, researchers found that ‘over 80% of those getting their first myopic spectacles at age 9 become highly myopic.’

“Right now, the world’s myopia rates are expected to be closer to Asia’s by 2050. It’s possible—but not inevitable,” said Donald Tan, MD, a director of the Myopia Task Force. “ Public health officials need to recognize that high myopia is a disease and promote interventions to reduce its overall incidence and slow progression. Action now can change the future.”

The challenge with myopia is that in the early years, you don’t need to wear your glasses all the time due to your vision only being minimally challenged. In fact, it is called nearsighted for a very descriptive reason—you can see well at near—possibly better than with glasses. But, as the months slip into years, and the vision loss progresses, we miss an important window for intervention. Like the age-old adage states, the earlier, the better. There have been hundreds of millions of dollars spent researching how we can slow and possibly even stop the progression of myopia. “There are a number of treatments available, which slow myopia progression. They include drops, special contact lenses, and glasses.  Many of these treatments have been around for decades, and some have undergone rigorous clinical trials.  The future for newer and better methods is bright with some newer methods already approved in Europe,” states Jeffrey Cooper, OD, MS, FAAO, professor emeritus, SUNY College of Optometry, and one of the foremost myopia treatment experts.

The key, however, is early intervention – a time when most kids and parents look at nearsightedness as a minor irritation.

There are several common-sense recommendations that we make to parents.

What Has Shown to Be Effective
  1. Limit screen time.
  2. Read and work in good lighting. Lower light levels are adapted to visually by increasing your pupil size. Larger pupils, like camera lenses with larger aperture settings, decrease depth of focus. This, in turn, increases the load on the patient’s focusing system, called accommodation.
  3. Maintain a good working distance from the eyes to the digital device. This should be at least 12”, and preferably, 14-16” away.
  4. 20/20 Rule – it is easy to spend hours working on near tasks. For hours then, the accommodative system is engaged and active. This ‘rule’ suggests that whenever possible, every twenty minutes, take a 20-second break, look at least 20 feet away to relax your eyes focusing muscles, and blink 10-20 times (extended computer use has been shown to decrease blinking).
  5. Go outdoors! There are a number of good studies that show that by being outside in the sunlight, there is a decrease in the progression of myopia.
  6. MiSight Soft Contact lenses—These FDA approved soft contact lenses have been demonstrated to slow the rate of myopic progression by nearly 50%.
  7. Orthokeratology gas permeable contacts. These FDA approved contact lenses are worn during sleep, flattening the corneal and slowing the increase in axial length- the factors that change in myopia.
  8. Low dose atropine—an eye drop that has been shown to be surprisingly effective with slowing nearsighted progression. Atropine is one of the world’s oldest drugs known to man. Eye doctors don’t argue as to whether or not atropine works or not, rather, the argument is on what strength is most effective.

Who would have thought, twenty years ago or so, that we would be so incredibly involved with our digital devices? In the past month, I have had several patients reporting that they are on their devices 16-18 hours a day! Twelve to 14 hours daily is not uncommon. When I asked about sleep and eating and how that factors in, patients just shake their heads.

Optometrists and ophthalmologists are being encouraged to push for greater intervention earlier in children’s lives. The concern is that, by waiting and missing the window when a child has low levels of myopia, you allow the more devasting vision loss causing diseases to, in essence, take root. Noel Brennan, MScOptom, PhD, FAAO, and Clinical Research Fellow at Johnson and Johnson Vision Care wrote recently, Our ability to isolate those myopic children who will not become highly myopic later in life is poor.  And suppose you did identify a child who has progressed by, say, a diopter or a diopter and a half a year—that’s progression you now cannot take back. And every diopter reduction in progression lessens the risk of myopic macular degeneration (MMD) by about 40%. The risks associated with, say, increasing outdoor time and use of daily disposable myopia control contact lenses are minimal compared to those risks associated with myopia-related complications later in life. 

Be sure and ask your EYEcenter doctor about your child’s risks regarding nearsightedness (myopia) and screen time. Our dedication to keeping you and your family seeing and enjoying the world around us to the fullest is our absolute drive and motivation!

COVID-19: Protect Your Eyes From Too Much Screen Time

You and your children are likely spending more time on mobile devices and computer screens than ever before. Too much time spent staring at screens can cause computer vision syndrome, or digital eye strain, in certain people. While not serious, this condition can be very uncomfortable, potentially causing:

  • Headaches
  • Eyestrain
  • Blurred vision
  • Dry eyes
  • Insomnia
  • Tiredness

Below are some useful tips to help you and your children avoid computer vision syndrome:

Blink more!

Staring at a screen strains the eyes more than reading printed material because people tend to blink 30-50% less. This can also cause your eyes to dry out. Be mindful of blinking and make it a habit when focusing on a screen, as it will keep your eyes healthy and lubricated.

Follow the 20-20-20 Rule

Give your eyes a break every 20 minutes by looking at an object located 20 feet away for 20 seconds. Doing so will allow your eyes to relax and will give both you and your eyes some rest.

Keep your distance

Your eyes work harder to see close up than at a distance. Try keeping your monitor or screen at arm’s length, or about 25 inches away.

Lighting matters

Make sure that your surrounding light is similar in strength to the light emanating from your screen. Contrasting levels of light, such as looking at a bright screen in a dark room, can strain the eyes.

Take breaks from the screen

You may want to stipulate ‘screen free’ time for yourself and/or your children, such as during meal times or for several hours throughout the day. Engage in hobbies that don’t require a screen, such as drawing, reading books, doing puzzles, playing an instrument or cooking (among many others).

Don’t use devices before bed

Studies show that blue light may affect your body’s circadian rhythm, also known as the natural wake and sleep cycle. Stop using screens one to two hours before bedtime or use nighttime settings to minimize blue light exposure.

Although it may require a bit of planning to protect your family’s eyes during this stressful time, ultimately, it’s all about balance — and what works for you and your family may differ from others.

From all of us at EYEcenter Optometric at Citrus Heights, we wish you good health and please stay safe.

How Much (Blue Light) is Too Much?

The American Academy of Pediatrics periodically makes recommendations or formulates guidelines for parents to follow in their child-rearing. They recommend certain ages for starting infants on solid foods, how much sleep growing children should try to get as they age and how much media time or exposure to devices that emit blue they should have.

While there is a fair amount of discussion regarding what is or is not appropriate media for children to be exposed to, one thing that is fairly agreed upon is that the average amount of time children spend watching television or using a computer or mobile device exceeds AAP recommendations, according to survey data published in JAMA Pediatrics. There are ages, particularly when children are very young when the AAP suggests zero exposure to digital devices and gradually increase exposure as children grow older. The AAP recommends avoiding digital media exposure for children aged younger than 18 months, introducing children aged 18 to 24 months to screen media slowly, and limiting screen time to an hour a day for children aged 2 to 5 years.

shutterstock 504325807Digital media limitations are important and meaningful ways to keep eyes healthy even as we age. Dr. Palmer Lee, O.D. has stated that “device use should be limited, especially in children. The blue light emitted from devices like TVs and computers has been shown to contribute to retinal complications and the earlier this exposure starts, the more severe it can be.” The AAP guidelines and our own instructions are becoming more and more difficult to follow.

The exposure to blue light digital media is ever-expanding. How we get our entertainment, how our children submit assignments for school, how we work in the modern business world, how we communicate are all examples of how intractable digital use is. From young ages, kids are watching television, playing video games, using iPads, using computers etc.

Dr. Randall Fuerst, O.D. commented, “with activities like video games and smartphone use intertwined into everyday routines, the amount of close work kids do is drastically increasing. Besides affecting a wide range of vision functions, like the use of peripherals, the long-term focusing on a stationary object can also hinder ocular motor function. These factors combine to make eyes less useful when driving, playing a sport, or even simpler activities like maintaining balance or reading.”shutterstock 93771490

Additionally, the time of the day that children are exposed to digital devices is important. Blue light in the evening hours can have a deleterious affect on the ease of falling asleep. The AAP recommends that families to come up with family media plans that can be applied effectively, which would include encouraging digital media use as a shared experience in the family and importantly determine when, where and how often screens are used; and supporting the need for sleep, physical activity and device-free interactions.

The content on this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.

Is School Work Causing Computer Vision Syndrome in Your Child?

Eye health tips for students from our Citrus Heights eye doctor

The start of fall means back-to-school for kids of all ages – and our team at EYEcenter Optometric wishes everyone a smooth and successful return to the classroom!

When your child enters school after a summer of outdoor fun, many of the summer’s vision hazards are left behind. Yet, that doesn’t mean all eye health risks are eliminated! Nowadays, the majority of learning is computer based – exposing students’ eyes to the pain and dangers of blue light and computer vision syndrome. Fortunately, a variety of helpful devices and smartphone apps are available to block blue light and keep your child’s vision safe and comfortable.

To help you safeguard your child’s vision for the upcoming semesters and the long term of life, our Citrus Heights optometrist explains all about computer vision syndrome and how to prevent it.

Symptoms of computer vision syndrome

It’s smart to familiarize yourself with the signs of computer vision syndrome. If your child complains about any of these common symptoms, you can help prevent any lasting vision damage by booking an eye exam with our Citrus Heights eye doctor near you:

  • Eye irritation and redness
  • Neck, shoulder and back pain
  • Blurry vision
  • Dry eyes, due to reduced blinking
  • Headaches

Basics of blue light

Students spend endless hours in front of digital screens, be it a computer monitor, tablet, or smartphone. There is homework to be done, research to be conducted, texting with friends, and movies and gaming during downtime. All of this screen time exposes your child’s eyes to blue light.

Many research studies have demonstrated that flickering blue light – the shortest, highest-energy wavelength of visible light – can lead to tired eyes, headaches, and blurry vision. Additionally, blue light can disrupt the sleep/wake cycle, causing sleep deprivation and all the physical and mental health problems associated with it. As for your child’s future eye health, blue light may also be linked to the later development of macular degeneration and retinal damage.

How to avoid computer vision syndrome

Our Citrus Heights eye doctor shares the following ways to block blue light and protect against computer vision syndrome:

  • Computer glasses, eyeglasses lenses treated with a blue-light blocking coating, and contact lenses with built-in blue light protection are all effective ways to optimize visual comfort when working in front of a screen. These optics reduce eye strain and prevent hazardous blue-light radiation from entering the eyes.
  • Practice the 20-20-20 rule; pause every 20 minutes to gaze at an object that’s 20 feet away for 20 seconds. This simple behavior gives eyes a chance to rest from the intensity of the computer or smartphone screen, preventing eye fatigue.
  • Prescription glasses can be helpful when using a computer for long periods – even for students who don’t generally need prescription eyewear. A weak prescription can take the stress off of your child’s eyes, decreasing fatigue and increasing their ability to concentrate. Our Citrus Heights optometrist will perform a personalized eye exam to determine the most suitable prescription.
  • Moisturize vision with eye drops. One of the most common symptoms of computer vision syndrome is dry eyes, namely because people forget to blink frequently enough. Equip your child with a bottle of preservative-free artificial tears eye drops (available over the counter) and remind them to blink!
  • Blue light filters can be installed on a computer, smartphone, and all digital screens to minimize exposure to blue. A range of helpful free apps are also available for download.
  • Limit screen time for your child each day, or encourage breaks at least once an hour. Typically, the degree of discomfort from computer vision syndrome is in direct proportion with the amount of time your child spends viewing digital screens.
  • Set the proper screen distance. Younger children (elementary school) should view their computer at a half-arm’s length away from their eyes, just below eye level. Kids in middle school and high school should sit about 20 – 28 inches from the screen, with the top of the screen at eye level.

For additional info, book a consultation and eye exam at EYEcenter Optometric

When you and your child meet with our Citrus Heights eye doctor, we’ll ask questions about your child’s school and study habits to provide customized recommendations on the most effective ways to stay safe from computer vision syndrome and blue light. Our optometrist stays up-to-date with the latest optic technologies and methods to prevent painful vision and eye health damage from using a computer, so you can depend on us for contemporary, progressive treatment.

At EYEcenter Optometric, we put your family’s needs first. Talk to us about how we can help you maintain healthy vision. Call us today: 916-727-6518 or book an appointment online to see one of our Citrus Heights eye doctors.

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At EYEcenter Optometric, we put your family’s needs first. Talk to us about how we can help you maintain healthy vision. Call us today: 916-727-6518 or book an appointment online to see one of our Citrus Heights eye doctors.

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