America's Future Vision

Vision is paramount in this day and age; 80% of our sensory perception to the world is through our eyes. There are a hundred times as many nerve fibers devoted to vision than to hearing. In fact 40% of the brain is devoted to what we must see and perceive around us.

 We’re experiencing an explosion in refractive errors, especially in nearsightedness. It all starts with children who perform hours of close work without taking a break; they Tweet, spend hours on the computer and smart phones and on other social media. Then as adults they continue the same practices while trying to fit too many activities into a day. Researchers, Dr.Susan Vitale and colleagues from the National Eye Institute reported the incidence of myopia has jumped from 25% to 42% in American adults in the last 30 years. This compared the 1971 to 1972 National Health and Examination Survey to the latest one from 1999 to 2004. The American study shows the highest rate of change in females and Caucasians, although Asians were not specifically evaluated. All levels of myopia increased being greatest in those with moderate and high myopia.

Increases in nearsightedness have been noted around the world especially in Asian countries. Over the past 30 years myopia in Singapore has jumped from 25 to 75% of school children; 80% of male Army recruits are myopic. Men living in rural India have only a 10% chance of becoming nearsighted, whereas, 70% of those living in Singapore are myopic. Taiwan has gone from 80 to 90% myopia of young adults. Sweden, which has always kept excellent statistics, finds that children age 12 have a 50% chance of being myopic increasing to 70% by age 18. Rural societies are largely farsighted which changes dramatically when people move to the cities. For instance, Eskimo children jumped from 0% to 44% when they became urbanized; that was in 1970, so it must be much higher by now.

The big jump is due to increasing hours of accommodative stress. All ocular movements are parallel with the exception of the convergence of the eyes with near activities. Children and young adults are overusing their convergence and it’s not compensated with a suitable number of hours of focusing at distances beyond 20 feet. The usage of Smart phones, computers and applications like Twitter, Facebook, etc, are all contributors that stimulate this undue amount of accommodation, which appears to increase nearsightedness. We won’t have to wait 30 more years to detect a change in these numbers since this pattern is environmental and not genetic.

19.2 billion dollars were spent on vision correction in 2002 which did not include sunglasses. Consider that the cost of glasses, contact lenses, myopia and poor vision from not being examined at all will continue to increase in a geometric fashion. Increasing myopia will reduce children’s academic performance if unrecognized, require continuing expenditure and, more alarmingly, is associated with more ocular disease. Identifying modifiable risk factors can lead to the development of cost effective interventional strategies. For instance, greater time spent outdoors will increase both Vitamin D and Dopamine, both of which may modify the elongation of the eyes.
This increase is further amazing when you recognize that most small children are actually farsighted and adults become less nearsighted after cataract surgery. 

On top of this we’re witnessing the fact that America is aging; within the next 10 years there will be 54 million people 65 and over. With age comes a decreasing focus power (presbyopia) and an increase in ocular conditions such as dry eye, cataracts, glaucoma and macular degeneration. Although there are many new technical innovations for diagnosing and treating eye disease, it is still best to avoid them in the first place.
Night driving has become increasingly stressful for the following reasons: unregulated headlight illumination, the small cone of light from the driver’s vehicle markedly reduces peripheral clarity; narrowing of the pupil at night; increased glare from cataracts; speed of vehicles; and the decrease in reaction time with age. Many of the elderly may not be able to pass a new driving test which is currently being evaluated.

Good eye health begins with very basic preventive steps such as the following:

• Taking breaks every 30 minutes from the computer and portable devices. A recent article has demonstrated that bifocals with prisms reduce the rate of nearsightedness in Asian American children but it’s a lot easier just to take those periodic breaks for 30 seconds at 30 minute intervals.
• Sunglasses protect against ultraviolet light that can damage the crystalline lens and the retina. This would reduce the risk for developing cataracts and macular degeneration.
• Maintaining ideal weight through diet, supplementation and exercise will lessen the chances of developing diabetes.
• Moderate alcohol intake and not smoking, eliminate additional toxicity to the eyes.
• Learning to relax through rhythmic breathing, meditation, exercise or socializing also reduces the creation of free radicals.
• Taking appropriate multivitamins and vitamins such as Omega3 fatty acids, vitamins C, D, E and Lutein protect the eyes.
• Having regular eye exams, especially if you have symptoms. Be certain you are wearing the appropriate glasses or contact lenses.

In order to explore extending these messages, I have written books in different genres, which people can access in the comfort of their home instead of their doctors office or the Internet. In my mystery thriller, “Lethal Hindsight”, Lauren Chandler, M.D., uncovers a diabolical plot that revolves around manipulating vision. One of the subplots in the book is the fact that nutrition and supplementation will be very protective for the future vision of Americans.
On a lighter note, my children’s book, ”Lumi’s Book of Eyes”, advocates children’s health through the character Lumi, who is the narrator for a series of health books. My website, www.eyeadvisory.com, has attracted international attention.

In summary, we recognize the need to take care of our eyes and prevent progression of both refractive errors and eye disease. Lifestyle modification including proper choices and good advice will benefit all of us personally and as a society throughout the years. We are living longer so we must be able to continue to see the world around us.

Robert Abel Jr., M.D. is an internationally renowned ophthalmologist who combines traditional and complimentary medicine.  He attended Wesleyan University, Thomas Jefferson College of Medicine and the Mount Sinai Hospital. He has written six books including The Eye Care Revolution, The DHA Story and Lumi’s Book of Eyes.  He has been featured on the Discovery Channel with Dr. Oz, PBS, Biography Magazine and has written many scientific papers and periodicals.  He lives and practices in Wilmington, Delaware, performs Tai Chi and works with organizations that foster wellness.