By Dr Cesar Chelala/New York
Shortsightedness or myopia, a condition where distant objects appear blurry while close objects appear normal, is an eye problem that is becoming increasingly serious among Chinese children. It is estimated that in China the myopia rate is 31%. However, among children and teenagers it can be as high as 90%. Because when it is uncorrected it can have health-damaging consequences, it must be dealt with more effectively by both parents and health authorities in the country.
Myopia is a global issue. According to researchers, rates of myopia have doubled, or even tripled, in most East Asian countries over the last 40 years. Although Singapore is considered to have the highest rate in the world, with about 80% of the population being affected by it, the prevalence of myopia in India in the general population is only 6.9%.
Rates of myopia have been rising in Western nations like Germany and the US In this last country, as well as in some European countries, the rate has almost doubled in the last 50 years. According to some estimates, one third of the world’s population - 2.5bn people - could be affected by short-sightedness by 2020. Some experts say we are close to having a myopia epidemic.
A combination of both genetic and environmental factors seems to be responsible for myopia. Risk factors for this problem are doing work that focuses on close objects, spending a lot of time indoors and a family history for this condition. Although for many years genetic factors were considered responsible for this condition, it was proven that other environmental factors were also important.
One of the factors considered important was the amount of time spent studying and doing close-reading home work. It was shown that children who spent more hours reading and doing home-work inside their homes or at school had a higher probability of developing myopia. This theory, however, didn’t hold up. Close work, although it had an effect, was not, apparently, the factor most responsible for this condition.
Researchers at the University of Cambridge in England have found that a lack of outdoor play has been linked to myopia. There seems to be a protective effect of sunlight during children’s critical years of development, while their eyeballs are still growing. The reasons for this effect, however, are not yet known.
Ian Morgan, a myopia researcher at Australian National University, said that if children get outside enough it doesn’t matter how much study they do, since they don’t become myopic as frequently as children who spend much of their time inside their homes. Based on his studies, Morgan estimates that children need to spend around three hours per day under good light levels to be protected against myopia.
The problem with this approach, however, is that in many places and in different seasons children cannot get enough outside light. There are some experiments now carried out to allow more children to play and study in better artificial lighting conditions. No clear-cut results, however, have been achieved yet.
Some researchers suggest that children should spend more time playing outside which has the additional benefits of improving mood, increasing their level of physical activity and decreasing the likelihood of obesity, another significant problem among children.
More research should be carried out as to why in India myopia is less frequent than in other Asian countries.
Although eye exercises are frequently done in China, there is no clear-cut evidence that they have been effective in lowering the rate of myopia among children. To be able to detect early any problem, all children should have a comprehensive eye examination by age three. Parents should be aware of any change in their children’s sight and take them for an eye examination since they are born. At the same time, children’s eyesight would probably benefit from less homework, less use of electronic gadgets and more activities carried out outdoors, an approach difficult to implement in today’s competitive societies. As with any other health problem, regarding children’s eyesight, prevention is more effective and less costly than a cure.
* Dr Cesar Chelala is an international public health consultant.
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