[HN Gopher] Eye exercises for myopia prevention and control: com...
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Eye exercises for myopia prevention and control: comprehensive
systematic review
Author : gnabgib
Score : 138 points
Date : 2024-05-31 16:34 UTC (6 hours ago)
(HTM) web link (www.nature.com)
(TXT) w3m dump (www.nature.com)
| billconan wrote:
| As someone who grew up in China, we were forced to do this
| exercises everyday at school. And yet, China has the highest
| myopia rate.
| onemoresoop wrote:
| Maybe these exercises help some people but myopia is largely
| hereditary. It's worth trying though, it's free.
| xpe wrote:
| > It's worth trying though, it's free.
|
| The above claim strays far from the way of logic. Follow that
| pattern of thinking, and you'll never run out of things to
| try.
| daveguy wrote:
| It's only free if you don't value your own time.
| powersnail wrote:
| > Maybe these exercises help some people
|
| Similar studies have been conducted in China for multiple
| times, no clinically significant results were ever found. It
| probably doesn't help anybody, other than encouraging a short
| while of not using your eyes.
|
| The guy who first invented the exercise basically just made
| it up from thin air, trying to fix his own myopia, which was
| a reasonable effort that didn't work out. But for some
| reason, it caught on in schools nevertheless.
| hosh wrote:
| Turns out, myopia isn't hereditary. It has to do with
| dopamine interactions and the retina receiving outdoor
| lighting. When there is insufficient outdoor lighting, the
| retina starts growing in a different shape, leading to
| myopia. Just let the kids play outside.
|
| I don't know if going outside more often will reverse it.
|
| Astigmatism, on the other hand, may be hereditary.
| lucb1e wrote:
| > Just let
|
| I don't know about you, but in my case that would have been
| "just push". RCT1+2 was a lot more fun and even if I would
| play with the (often mean) village kids, they too were more
| into video games than ball games, albeit more something
| like Postal (rated for mature audiences, like ten years
| older than we were). There was some voluntary playing
| outside as well as inverse curfews imposed to make sure we
| don't only game and watch Pokemon inside at some age, but
| this notion of "just let them do what they enjoy" is so
| contradictory to my personal experience
| hosh wrote:
| In China and Taiwan, where many kids are pushed to study
| more, outside play would be a treat. Although I don't
| know about video games.
|
| In the US, the complicating factor is that parents get in
| trouble for letting kids play unsupervised outside. Both
| custom and legislation discourages this kind of
| parenting. There is an advocacy group in the US trying to
| lobby for legislative protections for parents, so "just
| let them play outside" means something a bit different.
| yorwba wrote:
| Anything that is even slightly hereditary looks "largely
| hereditary" in the absence of environmental factors. That
| doesn't mean that large changes in environmental conditions
| cannot have a large effect on hereditary traits.
|
| Body height is largely hereditary if you can avoid
| malnutrition. But improved nutrition has led to an increase
| in average height over time.
|
| It's not improbable that spending ten hours a day indoors to
| study could have an effect on myopia in children, even if the
| variation among children who all study for approximately the
| same duration appears to be explainable by hereditary
| factors.
| colinb wrote:
| from the conclusion:
|
| "Overall, the results suggest that eye exercises have limited
| to no efficacy in preventing or controlling myopia progression.
| Until robust evidence supports their efficacy, available
| evidence suggests retiring the eye-exercise policy."
| rahimnathwani wrote:
| ISTR reading that lack of time outdoors is one of the culprits.
|
| This study wasn't conclusive:
| https://iovs.arvojournals.org/article.aspx?articleid=2360831
| hosh wrote:
| Taiwan had something similar, found it it has to do with
| outdoor lighting (because many kids in both China and Taiwan
| stay indoors to study), and started a program to let kids play
| outside. Along with an early childhood intervention, myopia
| rates have been dropping.
| xpe wrote:
| Given that the Nature research (above) shows that eye exercises
| don't seem to work, we should focus [1] on what does. Research
| shows more outdoor time can help with myopia. See
| https://onlinelibrary.wiley.com/doi/full/10.1111/aos.13403
|
| [1] See [1] what I did there?
| tremon wrote:
| Why is spending time outdoors not considered an eye exercise?
| powersnail wrote:
| The study is about a specific type of eye exercise. The
| translated English title makes it sounds more general than it
| is.
| jspash wrote:
| It's probably similar to the difference between doing
| "proper" squats in a squat rack vs. using a cheater frame.
| The muscle movement is more varied and not as linear as doing
| a single left/right up/down exercise. But that's just a
| guess.
| 0cf8612b2e1e wrote:
| Is there any hard data on how much a machine impacts muscle
| growth/flexibility/whatever vs free weights?
|
| I agree that free weights are probably better overall, but
| would love if that were quantified somehow.
| adrianmonk wrote:
| I don't think they know for sure what it is about being
| outdoors that helps prevent myopia. But it's thought that it
| might be the bright light. To me, passively taking in bright
| light wouldn't qualify as an exercise.
| calebm wrote:
| I recently was required to renew my glasses prescription
| because the other one was 2 years old (so considered expired).
| When I got my new prescription, my optometrist said "your
| vision improved". I have been spending more time outside. I
| have found that time on the water seems to make my vision
| improve. I also suspect that walking through forests and
| experiencing the parallax effect might function as something
| like a depth perception calibration. It's also worth noting
| that I do wear glasses, but not all the time - intentionally so
| I can exercise my eyes.
| hosh wrote:
| It's the dopamine interaction of the retina receiving outdoor
| lighting which changes things.
|
| I don't think this works on astigmatism though.
| LorenPechtel wrote:
| While I can see this altering your prescription why should it
| improve your vision?
| napoleoncomplex wrote:
| How does wearing sunglasses affect time outside effectiveness?
| Any research on that?
|
| (Just something I've wondered since sunglasses are super
| prevalent)
| happyopossum wrote:
| My understanding is that the benefit of being outdoors is the
| ability and opportunity to regularly focus on things at a
| distance that helps, so sunglasses wouldn't factor in.
| hinkley wrote:
| Isn't that eye exercises?
| JumpCrisscross wrote:
| It's also exposure to natural light. Myopia jumps when kids
| are exposed to artificial lighting [1]. It seems some
| constant is hard coded into our genes to calibrate our eyes
| to the Sun's light. (Artificial natural light, despite
| sounding like an oxymoron, can help.)
|
| [1] https://pubmed.ncbi.nlm.nih.gov/38766340/
| kyriakos wrote:
| Sunglasses are not just a fashion item they also protect your
| eye lens from gradual damage from UV. It may be a good
| compromise in the end.
| drjasonharrison wrote:
| The issue isn't brightness, it's distance to what you are
| looking at and focus on the retina. When your eyes can still
| bring far objects into focus, they produce a signal that
| causes your eyes to grow longer.
| https://newsroom.uw.edu/news-releases/glasses-stop-myopia-
| ar...
| hinkley wrote:
| I wonder if this is something VR headsets can eventually
| fix by putting things at a longer focal length?
|
| Maybe instead of a 50" screen 24" away, a 500' screen 240'
| away.
| incognito124 wrote:
| Rarely do the jokes on HN get a chuckle out of me, but you did
| it!
| medstrom wrote:
| This is why we hackers need to install Emacs/Vim on an e-reader
| and use that as our dev environment... outdoors with Bluetooth
| keyboard every day.
| sieste wrote:
| This, or you could switch to an outdoors-themed wallpaper.
| xpe wrote:
| You belong in a basement-level late-night comedy club. No
| sunlight for you.
| steve_adams_86 wrote:
| This is why myopia wasn't as much of a problem back in the
| Windows XP days.
|
| https://d7hftxdivxxvm.cloudfront.net/?quality=80&resize_to=
| w...
| initplus wrote:
| I assumed outdoor time helps because your eyes spend time
| focusing at a greater distance. Going outside, but only to
| use a phone/ereader/book is likely not effective.
| abeppu wrote:
| I think this assumption, though perhaps reasonable, is
| incorrect, for at least two reasons:
|
| - There are animal model studies which vary environment
| brightness and show a causal relationship between darker
| environments and myopia. The animals in the darker
| experimental groups aren't reading etc, and the animals in
| the brighter experimental groups aren't in larger cages.
|
| - There are studies on myopia that varied indoor lighting
| brightness and showed brighter lighting later/decreased
| myopia onset. Classroom sizes (or distances from desk to
| blackboard, etc) did not change. These studies also found a
| bunch of other variables were important including longer
| sleep time, and less screen time.
|
| https://onlinelibrary.wiley.com/doi/abs/10.1111/opo.12207
| matthewdgreen wrote:
| 23 of 25 studies were in children, and also it didn't seem to
| have any effect in people who already have the problem :(
| amelius wrote:
| If VR goggles have the image focal point at infinity, does that
| count too?
|
| Also, what if you wear glasses that move points close by (e.g.
| your screen) to infinity?
| jeremiahbuckley wrote:
| I've heard this is important for young kids when eyes are
| developing. Once the weakness is built in, there's not much t
| that can be done.
|
| But I definitely recommend this to people I know with new
| babies. We do a bad job consciously recognizing the difference
| between indoor and outdoor light, but they're orders of
| magnitude different in actual brightness.
| dsego wrote:
| I only started understanding the difference after getting
| into photography.
| jurassicfoxy wrote:
| Does anyone here suffer from double vision? Do exercises help
| with that?
| 4gotunameagain wrote:
| The 20-20-20 rule[1] can help with diplopia from computer
| vision syndrome.
|
| Although I would advise to reduce screen time rather than treat
| just the symptoms that arise because of it. [1]
| https://wiki.endmyopia.org/wiki/20-20-20_rule [2]
| https://en.wikipedia.org/wiki/Computer_vision_syndrome
| Eugr wrote:
| What helps me is:
|
| 1. Taking breaks more often. 2. Using bigger monitor with
| bigger fonts, so I could sit further away. 3. Using Apple
| Vision Pro as a monitor replacement as it gives you 4-5 feet
| focal distance.
|
| The last one lets me work at my computer all day without
| getting double vision, but it's not very comfortable and you
| start to feel the weight after 2 hours or less. Plus the
| friction on putting it on, connecting, etc.
| hi-v-rocknroll wrote:
| I have monofixation syndrome without amblyopia, discovered only
| after age 40 when an ophthalmologist who actually knew what
| they were doing did their job. My understanding is there no
| durable or neuroplastic adaptation to double vision, amblyopia,
| or monofixation syndrome after youth because it is permanently
| wired that way in the ocular-vestibular systems. Corrective
| eyewear, eye surgery, and/or weaker eye training at early ages
| may help, but show no evidence of correction in later years.
| Monofixation syndrome is a neurological adaptation of the brain
| to minimize the experience of double vision.
| humanfromearth9 wrote:
| Double vision ? Is this when one sees with both eyes
| simultaneously ? =)
| dbcurtis wrote:
| I have double vision from strabismus. There are quite a number
| of eye therapy exercises that you can do to improve the
| condition. The older you get, the more of it that it takes. I
| have made improvements, but before I made this discovery and
| started the therapy I was too far gone and too old to fully
| cure. But... I can get decent life improvements if I put in the
| effort.
|
| If you look hard enough you may find an optometrist that
| specializes in eye therapy for strabismus and similar vision
| issues. Expect to be the only adult in the waiting room that is
| not a parent, most patients will be early-grade-school-age
| kids.
| lucb1e wrote:
| I only ever heard about seeing double after some sort of
| accident. Do you know what causes yours? The sibling comments
| seem to assume it is from looking at screens for too long, is
| that it or does that make it worse?
| arijo wrote:
| As a teenager, my myopia led me to a book promising clear vision
| through eye exercises alone. My doctor quickly dismissed it as
| nonsense, insisting only "science" could help.
|
| Fast forward 30 years, and this post reminds me how valuable it
| is to approach even expert opinions with a healthy dose of
| skepticism.
|
| It's a funny twist, highlighting that while expertise is
| valuable, it's crucial to maintain a discerning mind and not
| blindly accept any claim as absolute truth.
| tarentel wrote:
| Did you even read it? It clearly says they're ineffective. Your
| doctor was correct to dismiss it as nonsense.
| s1artibartfast wrote:
| If the parent poster successfully treated their myopia, they
| have a n=1 to the contrary and it is the only n that matters
| for them.
| pessimizer wrote:
| They didn't say they did, they said that they once saw a
| book that their doctor dismissed as quackery. Reading the
| title of this study that also dismisses it as quackery has
| convinced them that it wasn't quackery.
| IncreasePosts wrote:
| Ironically, OP saw a random thing that seemed like a claim
| and blindly believed it.
| aatd86 wrote:
| I don't know wvy you're being downvoted. From various
| experiences, I have had that realization as well.
| francisofascii wrote:
| Had a conversation yesterday with an optometrist about this. My
| daughter's myopia jumped from -.75 to -2.0 in a year. Asked about
| the atropine drops, special contacts, etc. He said the number one
| thing was to make sure my daughter was outdoors in sunlight. You
| can read or be on screens, just outdoors. His opinion was mixed
| on the drops and special contacts. The tricky part is you don't
| know how bad the myopia would be without interventions. So my
| child's myopia might be progressing, but maybe would have been
| even worse if we didn't do the drops or whatever. He also said
| growth spurts correlate with myopia progression.
| avery17 wrote:
| Theres a brand of glasses for kids that stops the progression
| of myopia. Posted on HN the other day, cant remember the name.
| Look it up!
| drjasonharrison wrote:
| https://newsroom.uw.edu/news-releases/glasses-stop-myopia-
| ar...
| Nicholas_C wrote:
| Look into ortho-k contact lenses. My siblings all have terrible
| eyesight but mine is ok around -1.5 and I was the only one who
| used ortho-k contacts.
| abdullahkhalids wrote:
| So, what is important is what sort of exercises are being used.
| From the paper, the types are
|
| 1. 3D visual training combined with ciliary muscle exercise
| training
|
| 2. Massage (point, eye muscle, head and neck, facial massage
| roller, automated eye massager)
|
| 3. Dazhui vibration (looks like acupuncture)
|
| 4. Auricular plaster therapy (some sort of acupuncture using
| magnetic seeds applied to ear)
|
| 5. Badminton training
|
| 6. Yoga eye therapy
|
| 7. Eyesight gymnastics with physical exercise for health
| maintenance
|
| First of all, it would be reasonable to concentrate on the
| interventions where there is a plausible causal model. Should 1
| and 7, and maybe 6 (depending on what exercises are being done)
| be looked at more carefully?
|
| Be being a mere physicist cannot read the forest plots in Fig 2,
| to determine which of the studies had some positive effect. Can
| someone else do that?
| inanutshellus wrote:
| Since the Nature.com link just basically says "myopia exercises
| don't work"...
|
| NPR just had a piece talking about a 2-yr study in Sydney that
| found that spending time outdoors reduces myopia in children and
| a 15-year-old program in Taiwan to ensure primary school children
| are sent outdoors more, which has reduced their % of myopia.
|
| Theory is that we change our focus distance regularly when we're
| outside. ("hey look, a bird!" "i think i'll stare blankly at that
| tree while I ponder that document" etc)
|
| https://www.npr.org/sections/health-shots/2024/05/13/1250555...
|
| Notably -- I guess -- the study was about children. Maybe adults
| are screwed. It certainly is easier to get kids outside more if
| the govt is backing the changes.
| molave wrote:
| Anecdotally, this worked on for me. It's not a great
| improvement, but it was noticeable.
| gdevenyi wrote:
| The theory is not focus distance changes, but high angle high
| brightness overhead lighting (sun) and sufficient blue light.
| lucb1e wrote:
| I've also heard the high brightness during the daytime helps
| with getting into a good sleep cycle by setting the
| biological clock to "ok now it is definitely day". Even when
| sitting close to a window, the light level is typically still
| something like 1/10th (or less) of what it is outside.
|
| Not that I do any of this; I enjoy reading long articles and
| writing code until 5am
| outdoorsun wrote:
| what is the best time for outdoor activities w.r.t myopia?
| morning? noon? evening? night? dusk?
| brigandish wrote:
| According to Dr Goldberg, who I heard on Huberman's podcast[1],
| morning sunlight so you can get red light. Dusk/twilight also
| has red light, but I've heard that it's helpful to combat the
| effect of bright light before sleep, like that from screens,
| for some reason I forget. Now I make sure to get a bit of both.
|
| [1] https://www.hubermanlab.com/episode/dr-jeffrey-goldberg-
| how-...
| outdoorsun wrote:
| if your doctor put new prescription, do not throw away your old
| glasses
|
| try these instead. it's free and reproducible.
|
| test on variations: on bright day with sun light (outdoor) focus
| on a fixed distance, say 4 meter. wear old glasses of -.5, -1, -2
| ... and your new prescription keep note which if those glasses
| give clear vision
|
| then vary the distance to 15cm, 30cm, 1m, 2m ... very far
|
| then vary the brightness level, next go to building with low
| light intensity, like underground parking
|
| then do the variation on distances and glasses' power
|
| keep notes of all your experiments
|
| the idea borrows from design of experiment of 2^3 factorial
| design: high and low brightness short and long distances old and
| new glasses
|
| the conclusion would be use the least power for different
| situations and best if you dont use any glasses (well, there's
| plus lens therapy which is the next step)
|
| say if you can see clearly thing on your phone (15 cm, light
| emiting screen -- i always use max brightness) without glasses,
| the don't use glasses
|
| if your -1 glasses are sufficient for desktop work, don't use
| higher power although no glasses wont hurt (i increase the font
| size till legible)
|
| anyway, if you're determined to do the experiments, please let us
| know
|
| thank you in advance
| komodus wrote:
| I remember my eyesight was 20/20 all my life until I started
| playing more and more with phones and tablets, now I can barely
| see any font in a regular browser tab at 100% zoom so I set it to
| 150% by default.
|
| One thing that changed for good is using a 50" TV as monitor
| connected to my mac mini at 4' distance from my chair. Now my
| eyes don't cross anymore and my sight has improved a lot.
|
| So yes, I concur that looking at clouds and the horizon everyday
| may be a good way to recalibrate our eyes. Spend more time
| outdoors.
|
| [edit] Oh, and whenever I can, I cast my phone to my tv in the
| bedroom so I don't spend countless hours on tiktok forcing my
| eyes. I wish tiktok and instagram were available in landscape
| mode.
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