Parents who want to promote good vision in their kids should unglue them from digital devices and shoo them outside. Here’s why: The thinking among eye care professionals is that excessive close work early in life, combined with a lack of time spent outdoors, is increasing the prevalence of child myopes, or nearsighted children.
Forty years ago, 25 percent of Americans had nearsightedness, or myopia; today, it’s likely well over 42 percent. The increase is even larger among African-Americans, from 13 percent to about 34 percent. And the trend is also global: In Asia, for example, the myopia rate is 50 percent. Eye care professionals are diagnosing myopia at earlier ages, and seeing more extreme cases of it, too.
“My kids are utilizing technology at a far earlier age than I did,” says Robin Kinnie, of Southfield, a mom blogger and creator of the internet-based radio network, Motor City Woman. “I love technology … but not at the expense of their health and well-being.”
Kinnie learned her daughter, Lynn, 5, is nearsighted after following up on a pre-kindergarten vision screening with an eye exam. The optometrist prescribed glasses for Lynn to use at school if she has trouble seeing the smartboard in the front of the room. Kinnie is also nearsighted, so there’s likely a genetic component to the myopia in their family.
After Lynn was diagnosed, Kinnie started implementing mandatory 15-minute breaks from screen time for her daughters — both have iPads. Lynn loves to use her device for games, drawing, and making music, as well as for her homework.
Dr. Michael Lipson, an optometrist at the University of Michigan’s clinic in Northville, explains the science behind what may be contributing to the rise in nearsightedness. He says modern children are engaging in near-visual tasks at a much earlier age and for longer durations than their predecessors, including reading, watching television, playing video games, and using smartphones and tablets. It’s not necessarily the screens’ blue light — already blamed for disturbing sleep and contributing to eye fatigue — that’s causing the myopia; Lipson says it’s also about distances and the amount of time the screen is being viewed.
“The eye is saying ‘OK, if we’re going to do this much close work, let’s adapt,’ ” he says. The adaptation includes lengthening of the eyeball, which distorts the mechanics of vision and causes nearsightedness.
That’s where the great outdoors plays a role: Since being outside shifts a child’s focus from close up to far away, it may help guard against becoming nearsighted. That’s according to Dr. Rajesh C. Rao, a staff ophthalmologist at Children’s Eye Care of Michigan.
“I don’t think we really know all of the factors behind it,” Rao says.
Distances aside, staying inside with a screen means exposure to a lot less sunlight, which compounds the problem. For all the damage it can do to skin and even the eyes, sunlight is necessary in some amount to stimulate normal eye development, Lipson explains. He, too, believes that spending time outdoors can delay the onset of nearsightedness in some people, even if they’re genetically predisposed to it.
“Once myopia develops, however, sunlight doesn’t seem to help slow the progression,” Lipson says.
Although sunlight doesn’t help someone once they have been diagnosed with myopia, there are other treatments to correct a child’s sight quickly — glasses and contact lenses. And there are longer-term measures that can keep nearsightedness from getting worse and reduce a child’s risk for related vision problems later in life. These can include myopic macular degeneration (deterioration of the retina), retinal detachment, and early-onset glaucoma and cataracts.
The longer-term measures include multifocal contacts; orthokeratology, which involves wearing contact lenses that reshape the front of the eyeball; and atropine eyedrops.
Low-concentration atropine drops are prescribed for children 5-12 years old who have a low-to-medium level of myopia that’s progressing. Atropine drops slow progression by about 50 percent, according to the American Academy of Ophthalmology. Rao’s office tracks these patients in a database that’s grown to include several hundred youth. For now, the therapy isn’t covered by insurance.
“I do think that as this gets recognized more and more, it should be a covered benefit of a vision plan,” Rao says. “Eventually, it probably will be.”
Dr. Sarah Muenk-Gold, also an ophthalmologist, is a parent, too. She thinks the atropine drops are worth the cost for her daughter Stella Gold, 11. Stella’s worn glasses for nearsightedness for three years and started on the drops about a year ago.
“We noticed that she was needing her glasses changed frequently and they needed to be stronger,” says Muenk-Gold, of Bloomfield Township. Since starting the drops, Stella’s vision hasn’t changed, her mom says.
Also thought to reduce myopia’s progression by about 40-60 percent, Lipson says, is orthokeratology. Commonly known as ortho-K, it involves wearing special contact lenses overnight to reshape the cornea, the transparent layer over the front of the eye. Users have normal vision as a result, but usually for only a day.
Alexis Ploutz-Snyder, a 17-year-old senior at Saline High School, switched from glasses to ortho-K in 2013 when her nearsightedness significantly accelerated.
“We think it’s stopped her myopia progression,” said Alexis’ father, Rob Ploutz-Snyder.
Alexis’ mother has severe myopia with fast progression, but even so, her parents didn’t choose ortho-K lightly. Rob Ploutz-Snyder is a biostatistician with the U-M School of Nursing, and his wife is dean of U-M’s School of Kinesiology, so both are familiar with research. They read published papers and pored over data on the therapy before
Like atropine and ortho-K, multifocal contact lenses slow myopia’s progression by about 50 percent, Lipson says. They’re like bifocals that have multiple prescriptions in each lens, for near and far vision. Even though child wearers don’t need help seeing close-up like older bifocal wearers do, the lenses slow the eyeball from
Amol, 14, a ninth-grader at Troy High School, has been wearing bifocal contacts for four years. His nearsightedness was also detected in a school screening, but his parents were already on the lookout for vision problems — both are nearsighted. (The family asked only their first names be used for privacy reasons.)
“We knew we had to be careful around this,” says Amol’s father, Vivek. Since wearing the bifocal lenses, Amol’s prescription has needed to be changed every 18 months instead of every six months, as it could have without the contacts.
Ways to reduce the prevalence of child myopes are clear: Parents who pay attention to getting their kids off-screen and outdoors periodically, and novel therapies, can help keep children’s eyes healthy and reduce severe vision problems later in life.
Tips to Give Your Child the Best Chance for Good Vision
1. A good time for a child’s first comprehensive eye exam is between the ages of 3 and 5. Fewer than 15 percent of preschool children get an eye exam, and fewer than 22 percent receive vision screening
2. Encourage children to spend time outdoors, especially school-aged children, since that’s when most myopia changes occur. Exposureto sunlight or using far vision, or both, may help slow the progression of nearsightedness.
3. When doing close-up work, take frequent breaks. The American Optometric Association recommends a 20-20-20 strategy: Look at something 20 feet away for 20 seconds every 20 minutes when using a digital device. But Dr. Michael Lipson, a University of Michigan optometrist, says that’s not long enough — he suggests increasing the break to 10 minutes, and taking it outdoors, if possible.
4. Keep your eyes healthy by eating a well-balanced diet. Eat different types of produce, especially leafy greens like spinach, kale, and collard greens. Fish like salmon, tuna, and halibut have been shown to help your eyes, too.
5. Protect your child’s eyesight with sunglasses as early in life as possible. You wear sunglasses, so why not your child, says an area optometrist.
6. Encourage safe play. Fireworks are a known hazard, as are BBs and paintball “bullets.” Even a Nerf dart or bullet made of foam can damage an eye.
7. When your child is old enough to participate in sports or take up a hobby like woodworking, provide the appropriate eye protection.