Researchers Concerned, Studying Nearsightedness in Children

Prior to the advent of remote schooling on electronic devices ushered in by COVID-19, doctors and researchers at the Children’s Vision Lab in the Back Bay’s New England College of Optometry (NECO) were concerned about how those devices might be contributing to nearsightedness (known as myopia) in young people.

Now, with vastly greater amounts of time spent looking at a device without breaks, the concern has grown even greater, and the researchers are conducting informational sessions around the city – including one at the Hurley School in the South End recently – and also looking for volunteers to help them further study the issue.

“Myopia is caused by the eyeball getting too long,” said Dr. Fuensanta Vera-Diaz, of NECO. “It causes you to see blurry but it’s because the eye is too long. When it’s too long, you can’t change that. At the moment, the only treatment is to slow it down from growing longer. Once it starts, we cannot reverse it. The majority of myopia is caused by the environment. There is a genetic component, but that accounts for only about 10 percent…Our ultimate goal is to prevent myopia and to do that we need to find out more.”

That’s exactly what Dr. Vera-Diaz, Cecilia Idman-Rait and Kristin Kerber have been doing at the Children’s Vision Lab, as well as in presentations to local schools and parent groups in Boston.

One of the keys is that they know myopia is caused by environmental concerns – particularly spending more time inside and more time looking closely at things like computers for long periods of time. They believe if that can be slowed down or changed, the growing numbers of young people with myopia can also be slowed down.

“It’s a fact we’re using our eyes to look closely long periods of time,” said Dr. Vera-Diaz. “It has the effect of bringing on myopia for younger people. We know that. We have to reduce the time spent looking up close. That’s very important. If we reduce the overall time we spend looking up close, it’s very positive. What’s also very important is taking breaks when we are looking up close.”

That was difficult before COVID-19 as children and young people were more and more drawn to video games, phones and other devices that are used up close – and much less likely to go outside to play or exercise. Now, with COVID-19 in play, the situation has gotten much more concerning much faster. Prior to COVID, kids could go outside, they could have recess and they took breaks at certain times of the day. Now, with remote schooling all or part of the week, it’s much harder to find that kind of schedule.

Dr. Vera-Diaz and her researchers recommend for children and adults to take a device break every 20 minutes. That can be a challenge, but even looking out the window for a bit into the distance can change things if done regularly.

“Taking these breaks is hard to do, especially with electronic devices because you get immersed in them and lose track of time,” she said. “That is especially true with games and developers are good at keeping you from getting up.”

In addition, she said there are numerous studies and evidence they’ve uncovered that spending at least two hours outdoors every day reduces the ability to develop myopia.

“Sunlight is important,” she said. “We don’t know why for sure. We do know there is a benefit of having sunlight…We just know light plays a role and sunlight is very different than indoor lighting, but we don’t know exactly the mechanism.”

The problem with myopia, she said, is a modern problem that developed over the last 150 years as people started spending more time indoors and less time outside. Myopia started to show up in young people 150 to 200 years ago when children started to go to school and started having to look close up at books. That has gotten worse with electric lighting and now, with technology. As more time is spent inside, and less time outside – as well as the demand of having to spend long periods of time looking closely – the numbers have only increased.

Over the last 25 years, she said, there has been a 50 percent increase, and now 43 percent of older kids and adults have it.

“The numbers are rising rapidly and that one reason it’s so important to us,” she said.

Additionally, they are concerned because myopia is associated with a number of other eye problems, including retinal detachment and glaucoma.

Dr. Vera-Diaz and Idman-Rait and Kerber said they have great concerns about what the last 18 months has done for kids in relation to myopia. She said the studies are not done yet, and they are just now starting to see some early studies, but her gut feeling is that it’s not going to be good news.

“Looking up close is detrimental,” she said. “Looking up close at the screen all day for school is a problem.”

For those in remote schooling, and even adults working online remotely, she said it’s important to make sure free time is spent doing things that don’t involve a screen or looking up closely.

“It will be very important that when screen time is over for school, kids don’t spend their free time on a device as well,” she said.

The reason they have gone on a virtual tour to the various schools is to educate teachers and parents about the threat myopia is causing and will cause. Education is a primary purpose of the visits, to sound the alarm and let everyone know this is a growing problem they may not have heard a lot about.

“Our main purpose is to educate,” she said. “Education is being in the know about what’s good and not good for kids’ eyes.”

The other part of the visits are to recruit kids to study treatments within their PICNIC study at the Children’s Vision Lab. That study is founded by the National Institutes of Health (NIH) to do a long-term study with kids on myopia. For three years, the kids visit the clinic and the researchers measure their eyesight for the study. That all falls within the purpose of slowing down the advance of myopia in kids – and thus more severe sight issues as an adult.

For more information on the study or on myopia in kids, go to the study’s website at www.neco.edu/PICNIC.

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