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Leaders | What to do about myopia

Short-sightedness has become an epidemic

To fight it, schools should send their students outside

2ENJMFP A Chinese doctor examines the eyesight of a young myopic kid
at an ophthalmologic hospital in Handan City, north China's Hebei
Province on August 28th, 2019. China rolled out a scheme in 2018 to
curb the rise in myopia among children and teenagers. The scheme aims
to keep the myopia rate among six-year-olds at around three percent
by 2030, and the rate among junior and senior high school students
below 60 percent and 70 percent, respectively. A report on the
physique of Chinese students published in 2018 estimated that over
100 million primary, junior and senior high school students suffer
fro2ENJMFP A Chinese doctor examines the eyesight of a young myopic
kid at an ophthalmologic hospital in Handan City, north China's Hebei
Province on August 28th, 2019. China rolled out a scheme in 2018 to
curb the rise in myopia among children and teenagers. The scheme aims
to keep the myopia rate among six-year-olds at around three percent
by 2030, and the rate among junior and senior high school students
below 60 percent and 70 percent, respectively. A report on the
physique of Chinese students published in 2018 estimated that over
100 million primary, junior and senior high school students suffer
fro
Jun 9th 2022
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Few things come with no downsides at all. Rich countries have almost
completely banished infectious diseases such as tuberculosis, cholera
and malaria. Instead, their health ministries spend much of their
time worrying about illnesses caused by wealth. Cheap, calorie-dense
food has abolished starvation in the rich world, but it also
encourages diabetes. Sedentary, white-collar jobs are less arduous
(and less lethal) than manual work. They also promote obesity and
heart disease.

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Even education is not always an unalloyed good. Over the past few
decades, East Asia has seen a stunning rise in the rate of
short-sightedness. And a growing pile of evidence suggests that the
main underlying reason for this is education--specifically, the fact
that children spend large parts of the day in comparatively dimly lit
classrooms.

Before the long economic booms that began in the 1960s, myopia was
uncommon in East Asia. These days, among the young, it is almost
ubiquitous. In Hong Kong, Singapore and Taipei more than 80% of
school-leavers are short-sighted. In Seoul over nine in ten young men
are. China, which began its economic rise later, is catching up. Data
from as far afield as Guangzhou in the south and Inner Mongolia in
the north show myopia rates among young people of about 80%.

If East Asia is the centre of the epidemic, the West is not immune.
Good data are harder to come by. But studies suggest rates of between
20% and 40% in Europe, an order of magnitude higher than the natural
state of affairs. One study in California found a rate of 59% among
17- to 19-year-olds.

There are, admittedly, worse things to suffer from. But
short-sightedness is not always benign. Glasses and contact lenses
are an expensive, lifelong hassle. In parts of rural China, where
some families cannot afford either, children struggle in the very
schools that are causing the problem. And severe myopia predisposes
those enduring it to other eye diseases in middle age, some of which
can cause untreatable loss of vision. Governments in Asia are
increasingly worried about the public-health implications of entire
generations growing up short-sighted. Those in other parts of the
world should start worrying, too.

The evidence suggests that regular exposure to bright daylight is
vital in properly controlling the growth of children's eyes. Too
little light leads to elongated, short-sighted eyes. Researchers
think that this explains why rates are so high in Asia, where a
strong cultural emphasis on the value of education leads to long
school days and, often, private tutoring in the afternoon and
evening. That leaves little time for sunshine. Western children,
whose parents are increasingly worried by a hyper-competitive jobs
market that threatens much less secure employment than they enjoyed,
are beginning to go the same way.

Special eyedrops, as well as clever glasses and contact lenses, may
be able to slow the progression of myopia once it has started. But
prevention is better than mitigation, and the science suggests a
cheap, straightforward measure. A series of encouraging trials, many
conducted in Taiwan, show that giving schoolchildren--and especially
those in primary education--more time outside can cut the number who
go on to develop myopia. An island-wide policy of doing just that
seems to have begun reversing the decades-long rise in myopia rates.
Similar attempts in Singapore relied on parents, who proved more
reluctant to change their behaviour, perhaps worried that other
parents might not follow suit, leaving their children at a
disadvantage in the classroom.

Governments are well placed to solve such collective-action problems,
while reassuring anxious parents that a bit less classroom time is
unlikely to be catastrophic. After all, countries such as Finland and
Sweden do well in global education rankings with a less intense
approach to education. Giving more outdoor time to young children
would still leave room for them to cram for exams in their teenage
years. And longer breaks in the playground may also make a dent in
other rich-world problems such as childhood obesity. Far-sighted
governments should send the kids outdoors. #

This article appeared in the Leaders section of the print edition
under the headline "Protecting the pupils"

Leaders June 11th 2022

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