hckrnws

> Fortunately, just a few minutes a day with glasses or contact lenses that correct for blur stops the progression of myopia [link], which is why early vision testing and vision correction are important to limit the development of myopia.

That’s the first time I’ve heard of that, so I clicked the link. It’s a fascinating, and rather distressing, study in chickens, that does not say what the article claims at all.

There is an actual, properly tested (in humans!) childhood intervention that is effective, though: low dose atropine. I’m surprised it wasn’t mentioned. https://www.aao.org/eyenet/article/how-to-use-low-dose-atrop...

In opposition to the other comments, I have worn glasses since an early age and my vision got progressively worse even after wearing glasses. I know many people in a similar situation. As far as I know that claim is not supported at all

Same here. And my ophthalmologist explained to me that the moment you start wearing glasses, your eyes stop making an effort to correct the blur (because the glasses are doing that for them) so the muscles involved in correcting vision become weaker overtime. According to him, the best course of action once myopia begins is to not wear glasses and try to correct it with other techniques.

It's interesting how we scientifically know that sarcopenia occurs after age 50-60 or so, but we assume that somehow the eye-related muscles get weaker rapidly at a very young age itself.

Did he give any hints on what the other techniques are?

Mainly stopping whatever is worsening myopia (pauses from screens and looking at something far away, more daylight) and also incorporating orthoptic rehabilitation.

Except you don't know what your vision would be if you didn't have correction, so I'm not sure how that actually says anything

> I have worn glasses since an early age and my vision got progressively worse even after wearing glasses. I know many people in a similar situation.

That is normal and expected. I have never heard anyone claim that glasses prevent the progression of myopia. They obviously do not.

There is a theory going around that myopia is caused by insufficient exposure to sunlight, which seems highly plausible to me.

>I have never heard anyone claim that glasses prevent the progression of myopia.

The article seems to claim that:

>Fortunately, just a few minutes a day with glasses or contact lenses that correct for blur stops the progression of myopia, which is why early vision testing and vision correction are important to limit the development of myopia. Eye checks for children are mandatory in some countries, such as the U.K. and now China, as well as most U.S. states.

> Eye checks for children are mandatory in some countries, such as the U.K.

That is nonsense. Tests are free for children, but my daughter only gets a test if I book one.

What about people who live north of the Arctic Circle?

I have fairly mild nearsightedness and can corroborate, I've been wearing glasses for about 13 years or so and my sight has very slowly but certainly degraded in spite.

Corrective lenses definitely slow the degradation and improve daily quality of life, but unfortunately the rate of degradation does not reach zero.

> Corrective lenses definitely slow the degradation

And how do we know that? I mean, that an eye doctor would rather prescribe glasses than not, it's not surprising. The fact that they'd back up their choice by some "scientific" explanation, is only natural.

Let me offer the opposing view in the form of an example: I have been diagnosed with mild miopia (-0.5), and prescribed glasses. I did wear the glasses for a few months but at some point I lost them, and didn't go back for a replacement. Now about 20 years later, I have never again wear glasses or any other correction and I don't need them (I can read the small leters on the vision tests. I would not say that my vision is 100%, but I never need glasses to see the things in the distance). If anything, my vision improved without wearing correction!

>And how do we know that?

Because my sight is getting slowly but progressively worse each time I go in for eye exams to check if my glasses are still sufficient, but not as quickly as when I first had to get glasses in the first place.

Same. Exactly as my optometrists predicted, too.

NIH seems to say it doesn't work:

https://www.nih.gov/news-events/news-releases/low-dose-atrop...

What is the recommended method for correcting myopia? Is laser corrective surgery still popular?

Correcting yes, eye laser, however you still have risks about retinal detachment because your eye is too long.

The thing is everyone looking for is prevention now, because you don't want to have the retinal detachment risk.

Huh, interesting. Although I feel obligated to object:

> After the treatment period, and 6 months after treatment stopped, there were no significant differences between the groups in terms of changes in degree of myopia compared with baseline. Nor were there significant differences in axial length within the two groups when compared with baseline measurements.

This implies essentially nothing about the efficacy of atropine — it actually means “if there was an effect, then the study was underpowered for the size of the effect or otherwise failed to detect it.” One could quantify the degree to which the study actually suggests that the treatment didn’t work, but the authors did not do that.

I, too, can fail to detect a benefit to low-dose atropine. Hey, look, I just enrolled 0 subjects and didn’t confirm the effect. So it wasn’t “significant!” But I obviously showed nothing at all.

Looking at the actual summary in the linked paper’s results section, and doing no real math, it does look like it genuinely contradicts the idea that low-dose atropine is as effective as previous studies seem to suggest, which is interesting. But that’s not what the authors, or the NIH summary, wrote!

My 7 y/o is taking low dose atropine every night. It’s slowed the myopia progression for about a year now and she’s really great about taking the drops. I’m looking forward to when she’s old and responsible enough for the special contacts that that will also correct the issue.

I remember making some comments along these lines to my optometrist in my teenage years when I still had the spicy zest of youth and boundless curiosity for pursuit of knowledge. He grunted. That was the first time I realized what burn out was and I felt doomed. Also , my eye sight got worse from first diagnosis in my early preteen years to early adulthood so I concur with your point (aside: Chickens with contacts. God bless you chicken ladies. What will we think of next ? neuralink? Bomb guiding?)

> Bomb guiding?

That's pretty old-school considering that after WWII, seeding industrial areas in Germany with nuclear mines was being considered, and the plan had chickens supplying body heat to prevent the detonators from freezing over in winter.

https://en.wikipedia.org/wiki/Blue_Peacock#Chicken-powered_n...

Try out RGP lens. These are the sort of contact lenses that you wear before sleep and take off the morning. It maintains the shape of your eye, providing sharper vision in the morning with just the naked eye. I wear it since I'm 11 years old and it has effectively stopped the progression of myopia.

Do you have other eye-wear for the day? My daughter had started with regular glasses for near-sightedness which we got quickly when we realized she had trouble seeing in school. This year we did a checkup and the optician recommended specialist glasses (MiyoSamrt) as my daughter had no experience with contacts. I am now wondering if she should try something like RGP at night, and then use her glasses for short-sightedness. I know some treatments can be additive and some other combinations are not recommended (like drops + glasses).

My optometrist said that this is only proven way to stop the progression of myopia. Sadly, I cannot wear these as I have cylinder

Hmmm interesting. I have an anecdote to share:

I've been suffering from presbyopia for some years (I'm 41 now, and it seemed to start getting pretty bad around 38 or so). My eyes also often feel dry, itchy, and half-closed. I have floaters in my left eye. If I open both of my eyes very wide, and cover only my left eye with my hand, the problem becomes much less severe.

When I went to an eye doctor, they used a drug, placed in eye drops, to force my pupils to dilate, which I gather is typical.

Not only did these drops provide fast-acting relief from the feelings of dryness and itchiness, but my vision also improved markedly for about a day and a half afterward.

I reported this to the doctor via a phone call, but they either didn't seem to believe me, or didn't seem to care.

I haven't found a solution yet, but I do wish that those drops were commercially available for me to use for experimentation.

There are a lot of different drops without needing the doc, have you tried them? I have similar problems and was told to use the off the shelf stuff and it has worked pretty good. The thicker the fluid, the better the results were. I use "HYLO-gel".

The doctor also warned to stay away from eye drops that has any sort of preservatives, it reacts with the tear fluid and gets almost like sand corns in the eyes.

Also, find a real eye doctor...

Atropine! From nightshade (belladonna) or mandrake. Coool. I’m waiting for eye dilation for cosmetic purposes to be cool again.

Wonder how they figured out it helped with myopia in kids…

It's based on understanding the (theorized) disease process and trying to prevent it. If the problem is that you're looking at nearby stuff too much (e.g. phone screens held less than a foot away from the eyes), then that means your eye muscles are contracting too much. Atropine paralyzed the eye muscles and forces them to look further away because nearby stuff would be blurry.

That's kinda putting the cart before the horse.

My kid's in a Steiner preschool and they start the day with two hours or so in outdoor play. That oughta do the trick. Plenty of far focus.

Can somewhat confirm. I always wore glasses. My brother on the other hand would often not wear them. His vision became worse. Mine improved (because I wore them at a slight distance from my eyes right on the tip of my nose).

Anecdotal but I’ve had the same -1.5 prescription since I was diagnosed with nearsightedness at 12. I’m 37 now, so 25 years of the same rx, I’d say that’s pretty consistent.

My myopia began at onset of puberty and got worse as I grew then stabilized late teens. I was told it was just an eyeball size thing.

I was diagnosed at like 6. In that time it's gone from -2 to -10, though it's mostly stabilised from my mid-20s.

In fact the time where it slowed down getting worse was coincidentally the time where my daily near work went from 2-3 hours to 8+ hours as I was doing it professionally and not just in my free time.

I was diagnosed around age 11, and my eyes have never had a stable prescription for more than two years.

I've given up hope on getting LASIK or similar surgery, and am now just starting to get age related farsighted as well. A few more years and I'll be needing bifocals :/

Just a tip: If you use computers much, don't just get one pair of bifocals, get a special pair specifically made for the distance you use the computer screen. Meassure the distance before ordering the glasses.

It's horrible to use bifocals on a computer screen, you can only see sharp on a small horizontal band. You have to tilt the head to see the rest.

I have the opposite of Myopia. Near-perfect distance vision, but increasingly struggle with reading things that are close. Never had this problem as a child but it's become gradually worse as an adult, since my mid 30s or so.

Now I have glasses with +1 ADD power that help greatly, and can comfortably read tiny fonts on my phone screen again.

Isn’t this to be expected?

https://en.wikipedia.org/wiki/Presbyopia

Sounds about right. The "Progressively worsening" part is worrying as I feel like it started affected me relatively young.

Mid-30s is maybe a tad earlier than average, but by the age of 40 you’d expect noticeable changes.

Counter-anecdote, my prescription has slid double digits since I was first diagnosed at about 7.

So you are sayind I should put chemicql compound in my children eyes for a decade, and when it does not work, you will lash at me for not doing that rigorously enough?

That isn't a great proposition. Think better.

Ask yourself, how much brighter is it outside than inside (assuming a sunny day vs a brightly lit office)? Before looking into this, I would have guessed 2X or 3X, but would you believe it's actually over 100X!

I bet most people's guess would also be off by 1 or 2 orders of magnitude.

Even outdoors in the shade, it is over 50X brighter than indoors.

(For specific numbers and comparisons, see: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6656201/ )

Apparently, our eyes adjust so quickly to the difference that we have a very poor sense of the magnitude of light change between indoors and outdoors.

I bring this up because one of the largest factors in myopia development appears to be outdoor light exposure in childhood.

Genetics are likely a factor too, but light exposure seems to have a huge effect: "The prevalence of myopia in 6- and 7-year-old children of Chinese ethnicity was significantly lower in Sydney (3.3%) than in Singapore (29.1%), while patterns of daily outdoor light exposure showed that children living in Singapore were exposed to significantly less daily outdoor light than Australian children." (from the same study linked above)

The obvious takeaway for parents, schools, and governments: ensure your children have plenty of outdoor playtime. It will greatly reduce instances of myopia (not to mention the benefits from higher Vitamin D levels, exercise, etc).

(This is a repost of my comment from 3 years ago on the same topic: https://news.ycombinator.com/item?id=25909557 )

So if you're living in a multi-storey apartment block in a place where there are periods of rain, cold and darkness, naturally your routine will not be conductive of spending lots of time outdoors. What's the plan B?

Sure, if you live in Australia with a tiny population living in own houses (while they can still afford those), they risk UV-burns more than myopia. But that doesn't scale that great.

Nothing can replace full spectrum natural light, so face a window or go outside, when possible, https://endmyopia.org/why-vision-is-worse-at-night-and-on-cl...

Indoor, try Sylvania TruWave LED (2700K, high CRI, low flicker, high lumens), https://gembared.com/blogs/musings/the-best-daytime-white-li...

I think most people are capable of spending time outside every day, even if they live in an apartment.

I’m typing this from a cafe in Manhattan, I try to walk at least a few km every morning. I did the same thing when I lived in Seattle. My understanding is you don’t need direct Australia-level sun to get the benefits we’re talking about.

Maybe have your kids room as bright as outside with >200W of LED lightning?

[dead]

Show HN (Feb 2024) with browser plugin demo, https://news.ycombinator.com/item?id=39484590

> There is a small neural network on the retina that tries to detect if the eye is far-sighted (most people are born far-sighted), and it is producing dopamine to slow or increase eye growth rate. It is not very smart, and if you do a lot of near-work it can think you are still hyperopic, causing further myopia progression. So, based on the refractive properties of the eye the software calculates the signal that would convince the retinal neural network that the eye is long enough, so it would produce dopamine, a known signal to stop axial eye growth. (based on myopic defocus LCA from the papers[2][3])

  Refractify is the worlds first software to apply myopic defocus effect on the screen. Pre-clinical studies suggest that it may slow the progression of myopia or even prevent it. This makes the screen look on the retina naturally as if it was at a greater distance. This is possible because there are slight detectable differences in the statistical properties of the light depending on how far it is coming from due to Longitudinal Chromatic Aberration(LCA) and other effects. LCA simulation is being used in computer graphics since at least 2017 to enhance depth perception, but only recently has it gained research interest for its myopia prevention properties.

[3] https://www.sciencedirect.com/science/article/abs/pii/S00144...

> if you do a lot of near-work it can think you are still hyperopic, causing further myopia progression.

Does this mean we should let our eyes see blurred images so our eyes would feel like they are seeing far away stuff and stop axial eye growth to stop myopia. This is in direct contrast to the claim in the post

> a few minutes a day with glasses or contact lenses that correct for blur stops the progression of myopia

which believes corrective lenses that correct for blur would stop the progression of myopia.

Note the references to color in the 2022 Nature paper:

> Here we show that, even though filtered movies looked similar, eyes became significantly shorter when the movie was sharp in the red plane but became longer when it was presented sharp in the blue plane. Strikingly, the eyes of young subjects who were already myopic did not respond at all—showing that their retina could no longer decode the sign of defocus based on LCA. Our findings resolve a long-standing question as to how the human retina detects the sign of defocus. It also suggests a new non-invasive strategy to inhibit early myopia development: keeping the red image plane on a computer screen sharp but low pass filtering the blue.

Okay that's great, except children get their myopia before they become casual laptop users.

I wonder if doing the same to TVs and tablets will do anything.

From the Show HN submission above:

> Some myopia control techniques work similarly, like MiSight and Hoya lenses.

MiSight is a contact lens used to slow myopia progression in children, aged 8-12 at the initiation of treatment.

What I don't like in this is the defeatist attitude of "slowing myopia progression".

If you have myopia, your life experience is already ruined, and it's not very much relevant whether it's -2 or -6. You're stuck with glasses either way so why bother "slowing it". Yes you can get retinal detachment but on average you won't.

I'm not even sure I can be bothered to spend effort on "slowing myopia progression" in my children by annoying treatments such as contact lenses or applying topical chicken guano, unless there are serious concerns. If you already have myopia just live with it. I would love for them to not have any myopia at all and perfect vision, though. Just very unlikely provided that basically everybody in my family wears glasses.

> defeatist attitude of "slowing myopia progression"

The global optical business is on the order of $100B in annual revenue.

Reversing or preventing myopia has less economic support, but research continues.

> it's not very much relevant whether it's -2 or -6

Smaller corrections can use CR-39 or even glass, with high optical quality. Lenses for larger myopia corrections become too thick with CR-39 material, requiring "high index" plastics. These have more cost and optical distortion. Smaller corrections are also more amenable to contact lenses.

I think this wired article is an excellent dive into the issue. Focuses on Taiwan, which has seen an insane rise in myopia.

https://archive.is/ybLnZ

This article was a great read. Much better than the featured article.

There was a paper around 15 years ago comparing kids in Singapore and expat kids of same ethnic group in Australia. Much lower myopia in the expat community's kids, whom spend more time outside. When I mentioned it to a physician I knew from my kid's school he said the trick is shifting focus from farther away back to close. I live in NYC I got my kid looking at the features on buildings near us, we are lucky to have good views from a small walk up. So the trick is to excersize focus, looking further down the road or street and then back to something real close. Me and my wife have myopia, kid is 20/20 and has exited the risk age now.

> the trick is shifting focus from farther away back to close

Hence the 20:20:20 guideline that says after 20 mins of near work, one should spend at least 20 seconds looking at an object 20 feet away. The same principle applies to extended contraction of your arm, core, eye or other muscles.

https://en.wikipedia.org/wiki/Spasm_of_accommodation

Cool trick for knowing when to use whom: if it can be replaced by he/she/they, it should be who. If it can be replaced by him/her/them, it should be whom. In this case, "whom spend more time outside", could not be written "them spend more time outside" but could be written "they spend more time outside" thus it should be "who spend more time outside".

The high levels of light outside almost certainly helps too.

The reason for this seems to be

1) extended depth of field with a smaller pupil in bright sunlight (smaller aperture) that keeps objects at a wider range in focus

2) biochemical cascade responding to certain wavelengths in sunlight that produce a “stop growth” signal in the retina

We've known for all of history that sitting inside for extended periods, allowing yourself to atrophy, not socializing with others, self-indulgence, and neglecting your spiritual and mental health are bad for you.

I get why people study this sort of thing and why it's useful. The thing that I don't understand is why people need studies to tell them they should skip desert, leave the phone on the counter, go outside, and ask your neighbor how they're doing.

As an aside, I was born nearsighted as well. /shrug

First of all, I predict that approximately zero people will change their behaviors because of this study. So saying "people need studies to tell them" is a bit much.

> We've known for all of history that...

I don't want to go too far into the epistemological weeds here, but we've also known that the earth was the center of the solar system and that many health problems are caused by an imbalance of the humors.

> We've known for all of history that sitting inside for extended periods, allowing yourself to atrophy, not socializing with others, self-indulgence, and neglecting your spiritual and mental health are bad for you.

That doesn't really capture the risk-carrying lifestyle they're highlighting in the article, though.

Spending your days contributing to your community in a safely sheltered school, office, etc as part of a social community and then your home time further learning and socializing indoors, with others, doesn't really look anything like what you described but seems to carry the similar risk here.

While some have an intuition that's already skeptical of that life, many people wouldn't give it a second thought. You're being productive, social, healthy, and maybe even physically active. Doesn't sound too bad! But you're not getting much sunlight, you're not seeing a lot of distant focal points, and you're specifically probably doing a lot of reading and watching -- that's where the increased risk of myopia quietly slips in.

I wish my parents would have known that sending me outside would prevent my needing glasses. Or that schools would have offered some sort of treatment to help prevent it.

I feel like society generally accepts myopia as something you just get, instead addressing it like a disease that can be prevented. Sure, it's manageable with corrective lenses or surgery, but prevention is so simple. Better education, through articles like this might catalyze some of the changes we need to make to allow a lot of children grow up being able to see things naturally.

it's like diabetes, sure, some people are born with it, but others develop it through lifestyle choices. Except in this case, this effects children, who have very little control over their lives. It's up to adults to help them grow up to be healthy.

We do science because sometimes common sense turns out to be wrong.

Most of the time "common sense" is actually just stuff that was drummed in to us as kids because it's what the research of the time said. So yeah, you do need these studies, and then they become common sense later.

> I get why people study this sort of thing and why it's useful. The thing that I don't understand is why people need studies to tell them they should skip desert, leave the phone on the counter, go outside, and ask your neighbor how they're doing.

People have all kinds of weird beliefs, and there are entire industries selling quack remedies and therapies that people, willingly and unwillingly, buy into.

Sure it won't reach everyone, but it might reach some people who genuinely thought their previous beliefs and behaviors were "correct".

The west has shifted into believing subjective experience is useless compared to objective knowledge.

This is like a BackEnd engineer saying that he doesn't believe the FrontEnd exists.

We've been studying the FrontEnd for the majority of human history, and while many things we've found are just plain wrong in an objective sense, they still have subjective value.

Case and point: look at how meditation has been receiving continuous affirmation from the scientific community.

> Case and point: look at how meditation has been receiving continuous affirmation from the scientific community

Has it?

Most of traditional medicine is quackery, as useful and correct as a broken clock.

The placebo is effect is nearly the strongest, and completely opaque as to its operation.

Yes. All my therapists have referred me to meditation and explained to me that Cognitive Behavioral Therapy takes some influence from it.

There are tons of articles published in journals on it.

As for the quackery, that comes from attempts to discern objective truths. Traditional medicine is terrible for objective truths. But it shines in subjective experience.

I once told a CBT therapist that it sounded very similar to religious ideas an quoted something from the Bible that matched it. He agreed. Really the follow up to that is another Biblical quote: "there is nothing new under the sun".

> As for the quackery, that comes from attempts to discern objective truths. Traditional medicine is terrible for objective truths. But it shines in subjective experience.

If it works it should be testable. A lot of traditional medicine does work, but then it can be incorporated in to medicine. If alternative medicine (traditional or otherwise) works we call it "medicine". If it shines in subjective experience but is not testable, it just sounds like it provides a temporary feel good experience.

>it just sounds like it provides a temporary feel good experience.

I think you're missing the point of optimizing for subjective experience over objective knowledge. The feel good experience is the point. Subjectively, life is like playing a video game; you do what _works_ to have good mental health. Sure it's fun to wonder what the video game's code looks like, but that's not the point of playing the game.

You will never experience the BackEnd of your brain. We can affect it of course, with medication and surgery etc. I take medication for anxiety myself, but I also meditate, and it's the union of FrontEnd behaviors and BackEnd modification that gives you wellbeing.

Also, subjective experience is testable, it's just not testable by anyone but YOU. You try things out and you see how your subjective experience changes.

There are tests we've done (MRIs on meditators) that show the neural correlates of meditation etc, but again that's not the point: You are going to die and all your knowledge will be annihilated, so play the game to have the best life by optimizing your subjective experience of every moment of life.

I don't know, it seems everyone has different idea of what meditation is and if it doesn't work for me I will be told I am doing it wrong in some way. At least CBT seems to have a clear enough definition and instructions.

Yeah, it's these "different ideas" of contemplative studies that gives it a bad name. There are especially a lot of grifters in the west selling snakeoil "eastern medicine."

Ultimately, you have to try things out and see what affects your subjective experience. You will know by direct experience what is transforming your experience.

If something doesn't work, throw it out.

There are a lot of different ways of meditating, because the brain is complex enough that every person has different predispositions. But ultimately meditation begins by watching your mind so that you can know how it behaves and then testing different things to see how the behavior changes.

But I do like CBT and agree is has the strength you're talking about; it has the rigorousness of scientific research behind it, so its solutions tend to be applicable for larger categories of people.

Science usually throws out anomalies where something only works or doesn't work for a few individuals.

Yeah, meditation as a practice seems kind of this "holier than thou" thing that I seem to not get. I get annoyed, impatient, frustrated trying to follow the guidelines. I have tried different things such as Mindspace, guided meditation, random YouTube videos and other things. They all just feel so boring and frustrating. Is it a flaw with me that I find them so boring? That I can't handle it?

However what I think has helped me is actually observing my negative thoughts or someone questioning those thoughts - in the "so what?" sense. I am worried or having negative thoughts - and there's this idea of "so what?" and reframing it.

I'm scared of failing at something or saying the wrong thing. So what if I fail? This will continue in to further ideas of how the failure might impact my life and "so what's" after that until I can't complain anymore. At certain point I am forced to find my negative thoughts ridiculous.

*Case in point

What is wrong with dessert? Last night I cut strawberries with my kids and placed them over some banana ice-cream I made in the morning. Not everybody needs to avoid sugars, especially if the diet is balanced and varied.

In the US, two thirds of adults are overweight or obese by BMI, and this is roughly the case across most of the developed world. That proportion is likely even higher by body fat percentage, since BMI tends to incorrectly label unhealthy body compositions as healthy. 11% of the population are diabetic and 38% are prediabetic.

I like dessert, have a normal BMI, and don't have diabetes. That being said, desserts like stewed fruit and yoghurt are not representative of what the average person is eating, and any unnecessary food is going to make problems with excess weight worse.

Born to move, payed to sit.

I prefer not knowing my neighbors

People are perfectly capable of being self indulgent, asocial and neglect their health outside and develop perfect eyesight. I really don't see how the moral judgement is relevant here.

Because it allows for oh so convenient victim blaming of course!

The economy expects us all to be guild navigators - doesn't matter how your body is transformed if you're producing some economic value in the near term.

Except that thats how progress is made. If people like Hooke, Newton and perhaps every other genius who made monumental contributions spent their life outside socializing with others and acting all spiritual we wouldnt have calculus or know about atoms.

Hooke and Newton did spend a considerable amount of time outside and socializing with others lol

> The thing that I don't understand is why people need studies to tell them they should skip desert, leave the phone on the counter, go outside, and ask your neighbor how they're doing.

I don't want to. I want them to find a different solution.

And eventually they do. The solution isn't skipping dessert, but rather Ozempic.

Doesn't Ozempic suppress appetite so you skip desserts with it, just involuntarily?

> We've known for all of history that sitting inside for extended periods, allowing yourself to atrophy, not socializing with others, self-indulgence, and neglecting your spiritual and mental health are bad for you.

This, IMO, is why WFH is a bad thing and should be avoided.

> This, IMO, is why WFH is a bad thing and should be avoided.

yes WFH bad. Drive 3 hours to sit in a cube instead with 1/6th the space of your room at home.

I agree, but only because the office is a 25 minute walk away. If I was driving an hour I’d feel different.

Because you have common sense; so many of these commenters seem to think that it’s somehow everyone else’s fault they chose to live in a place where everything is a 3 hour drive away.

Yeah, that works at best only as long as you're single; once you live together with a partner, it's highly likely one of you will be getting a long commute.

In a proper metro area, where jobs and housing are concentrated, this isn't such an issue, as there’s a high probability both your and your partner’s jobs would be quickly commutable.

Sadly, America’s backwards zoning policies have led to a situation where nothing is typically near anything else. But hey, at least people can have huge front yards that they never ever, use for anything! That’s something!

There's another problem, that's hitting Europe right now: approximately no one can actually afford to move to "a proper metro area", at least not when it comes to larger cities. Even on a dev salary, when you move to a place you can afford that offers basic comforts to family (i.e. not renting out single rooms shared with others), your commute is now back to ~1h each way. But at least you and your partner are traveling in the same direction, so there's that.

It's much easier for people who already own a place in the city.

I have no real opinion on whether or not WFH is better, but I feel compelled to point out that only a very small minority of people are working that far away from home.

In LA where I live, it’s the opposite. There are 14 million people in metro LA area. A 2h daily commute is on the average side. Some of my colleagues would drive north of 3h. Per day. 5 days a week. About 660 hours per year. Spent in a car, constantly endangered, paying for gas, polluting their own biosphere to the point of guaranteed impact on lifespan.

No thank you.

It would blow my mind to see people in Bentleys on my commute. Hard for me to imagine having enough money for such a car and not deciding to avoid the inhumane agony of forced commute.

Ok, 3 is not typical. There is a behavioral reason for this. Like in most economic considerations, there's a tradeoff, where humans will tolerate a certain amount of time travel, for the money. So this tends to be stretched out to the maxima, over time.

Given driving time and train time, it's easily 2 hours of a commute in any of the top 20 metros for the majority of the population. From personal experience: Seattle, San Francisco, San Jose, Los Angeles, Orange County (just Santa Ana to Irvine!), or the rest of the inland empire was all 1.5 or more, each way. Ofc there will be less general cases around the nation, where you might characterize a "very small minority" opposed to what I would believe was 1/3 of the nation doing 2 hours total before WFH was popularized. Some people (including people we each know) still make these commutes.

Also very few people are so lucky as to have a cubicle at work. Most work in open space halls of horrors.

I chose to live next to a lovely forest and get to enjoy a walk when ever I like during my workday. When working from an office I was stuck 2 hours each way in an underground tunnel, and then in a tiny box office, preconceptions are a funny thing.

Maybe if it becomes normalized for companies to have several small, localized offices that enable employees to live in lower cost areas while still being within a short drive (or preferably, walk/bike) of home rather than demand that everybody comes into the mothership without paying well enough across the board (not just devs) to make it not prohibitively expensive to live reasonably close by.

In short, as long as hour+ driving commutes are commonplace, WFH shouldn’t be going anywhere.

Extremely unlikely.

The main reason most companies used to have offices in large metros is not because they were expensive, but because they offer great access to workers. This became even more important as women's labor participation went up, as moving for one job is stressful, but moving when you have two earners is a real problem.

The main advantage for a company of WFH is opening up the pool of workers even more: I've worked at teams that might as well been UN sumits if you look at just nationalities and locations.

Small, localized offices in lower cost areas do not provide any significant social advantage over home if you don't find at least a handful of people you work with in said office. But if the company is very distributed, this isn't going to happen. So then you have to try to hire people living hear those, lower cost of living offices, which shrinks the available pool again. And if those places had a lot of highly paid workers, they stop being low cost of living anyway.

The only road to shorter commutes (once having an office is taken as mandatory) is massive density and public transport. It doesn't guarantee it, but then there are more people that are technically close enough to the office so that if they worked there, they'd have a short commute. Compare, say, LA and Madrid. LA is bigger, but the number of people that can get to a random point in downtown LA in 30 minutes is far lower than in Madrid.

I always thought that as women's labour force participation went up, working hours should have fallen. If you have double the workforce, surely people can reduce their hours?

My main reason is that it is better for families, and it would be kids spend more time with their parents (in the UK it is now common for kids to have breakfast at school, and be picked from after school childcare every day).

With regard to this problem, it would also make commuting a lot easier. The biggest problem I have found with commuting is the crowding at peak times: it makes things slower and less comfortable, and means you cannot get work done on a train, etc. If you had shorter and more flexible working hours people could avoid peak times.

versus being stuck in a car alone during that time instead? then go to work and don't have friends because I can't say anything that can get me fired

The variety in vocal distances in my home office are much greater. I have a nice sunny window to look out into the distance, and the outdoors are 10 steps away which I indulge in at least every couple hours.

Only for those who depend on the workplace for their social life. Which might even be most people, but I don’t think it’s healthy.

But here we go again with a rehashed debate.

The bigger issue is why should we be forced to subject our biology to the pathogens in the office. Why should I have to sacrifice my health?

Ongoing, low-key exposure to pathogens is usually good for you, as it helps you keep immunity. Conversely, quarantining yourself is not a healthy way to live.

I have exposure to people through my family and other close friends, why do I need to swap germs with my coworkers and their kids and their classmates?

So everyone is exposed to broader variety of germs.

The take away should probably be that while indoors for long periods, you should sit with a window nearby and within view, so you can focus on far away objects periodically. (I've heard 15 second every fifteen minutes or 20 every 20 as rules of thumb.) And maybe take walks outside more often.

Do you have less opportunity to sit next to a window you can look out of periodically, when working from home? I'd think not. Less time to take walks outdoors? Nope. For many people, offices are going to be more of a detriment than a help.

When I must have been very very young, I remember, nobody was coming and I was alone in my crib, looking up at some carrot toy that was floating, but too far away to reach. then I noticed the rainbow, when the light breaks at the eye lashes. I probably looked a lot at them, they're pretty, still do sometimes.

But that behaviour must have driven the myopia, because I later learned that they'd leave me on purpose, so I'd not cry so much.

Then I was bullied a lot, so security was always on the paper in front of me, good reason to not look up, lol.

The childhood treatment for myopia is borderline abuse. Imagine treating childhood obesity with motor scooters. It’s basically that bad.

Obviously the eye, like every other body part, is subject to Selye adaptation. The correct treatment is clearly a training stimulus that reverses the myopia, not one that reinforces it.

Personally, my myopia stopped progressing when I stopped letting the eye doctor update my prescription. The reason, again obviously, is because my eyes are trained with constant close up work, but vision exams assume I spend my time looking at objects 20 feet away.

It would be nice to find an optometrist willing to work with me on reversing my myopia with a prescription suitable for my daily activities, but the ones I’ve talked to all have thoroughly calcified on the subject.

> optometrist willing to work with me on reversing my myopia with a prescription

High-quality and affordable glasses can be purchased online without a prescription.

EyeBuyDirect (US) and Clearly.ca (Canada) are owned by EssilorLuxottica, global optical behemoth.

> Just like in humans, if visual input is distorted, a chick’s eyes grow too large, resulting in myopia. And it’s progressive. Blur leads to eye growth, which causes more blur, which makes the eye grow even larger, and so on.

So, all the disney/cartoon characters with BIG eyes are myopic?

I guess Alita: Battle Angel and actresses Cristin Milioti and Ella Purnell are also myopic!

(Joking aside, is there any correlation between large eyes and myopia?)

It's more about aspect ratio: Overly long/deep eyes are more myopic, so cartoon/anime eyes are likely hyperopic instead!

I'm getting confused. I thought most of my teenage and adult life that it's been settled that "sitting close to the TV causes myopia" and "reading a lot of things causes myopia" and generally "looking a lot at things close to you causes myopia" was total bullshit, up there with "looking at microwave oven while it's active causes myopia".

Have there been any controlled studies on whether the use of fresnel lenses on books / screens to move the focal distance to infinity helps reduce / prevent myopia?

what if, and hear me out, glasses "cause" myopia?

To my memory, I played outside as a kid and had perfect vision. I didn't have access to a television growing up. I grew, my skull changed, my eye size changed, so my vision got blurry in 1st grade. I was (suddenly) very nearsighted. The teacher noticed, so they put glasses on me. The controversial claim: it is normal for eyesight to change during childhood and in adolescence and glasses may lock in a child's myopia.

Now I'm sure genes and environment, television and computer use, food quality, etc play a big role (my father also wears (weaker) glasses, and we were always low-income / made poor dietary decisions), but if it's the case that eyesight strength is malleable to some extent (with exercise, with playing outside in sunlight vs looking at television), and if it's the case that the epidemic outstrips genetic variance here over this timeline (surely?), I'd bet good money that slapping lenses on a kid during developmental years is as bad as giving a kid a tablet, moreso than one's genes.

I find it interesting that sometimes -my brain- can make out what faraway text reads as is but it is apparently -blurry- to my eyes. Like a blindsight phenomenon? Like the mechanics of sight, the muscle apparatus, etc is weak and underdeveloped (or developed to compensate for glasses), but the brain unhindered by developmental obstruction is doing the 'seeing'. Totally subjective, probably wrong.

Curious what folks might think in countries with traditional Hanzi / Kanji script might think. Are they really seeing what they read? How about their elders? How is it the case that after many years of reading such incredibly small script old folks retain their eyesight, but suddenly their children's children cannot (over a comparatively smaller span of time)? The answer is pretty obviously technology / environmental differences in each generation's developmental years. Why weren't those old folks also screwed? Well they didn't write / read at a young age -> no need for glasses for them early on.

This epidemic is occluded by the advent of the LCD screen, but not directly caused. What if glasses themselves and an increased effort to get kids glasses is playing a role in developing a myopia epidemic?

EDIT: haha, ok, one (unintended, misconstrued) reading of the actual article is "we put cute helmets and lenses on chickens at development and look how we messed up their eyeballs."

Related: https://endmyopia.org/

EndMyopia is an opinionated DIY/biohacking discussion of vision therapy. There's an open fork at https://reducedlens.org.

Slow and often expensive vision therapy for myopia helps some people, but not everyone, possibly due to genetic and neuroplasticity differences, https://hn.algolia.com/?dateRange=all&page=0&prefix=false&qu.... Nevertheless, many VT principles can help children whose eyes and brains are still developing. COVD, the professional association has existed for 40 years, https://www.covd.org/page/About_Us

  The College of Optometrists in Vision Development (COVD) is a non-profit, international membership association of eye care professionals including optometrists, optometry students, and vision therapists. Established in 1970, COVD provides board certification for optometrists and vision therapists who are prepared to offer state-of-the-art services in Behavioral and developmental vision care, Vision therapy, Neuro-optometric rehabilitation.

> There's an open fork at https://reducedlens.org.

Been a few years since I read endmyopia - didn’t realize there was so much drama going on.

Another attempt to summarize EndMyopia principles: https://losetheglasses.org

A fork was inevitable, it was always an effort to unbundle the data/analysis/science from the author.

They have a large number of testimonials from people who have significantly reduced their prescriptions, as well as with optometrists trying to do the same for their patients. I can't speak from experience, but it's something I want to investigate for myself.

Our bodies are much better at adapting to our environments than we realize. There are parallels with soft modern diets and jaws and teeth that don't receive enough stimulus to develop properly. We're only starting to understand the burden of man-made disease.

I didn't wear glasses as a child and only started doing so in my 30s, when I got my driver's license. At the eye exam the doctor fond out I need about -2 diopters and was rather amazed "did you always see like this and not use glasses?". I honestly don't know.

Anyhow it's about 15 years since and my diopters haven't changed. Also I never use the glasses when up close (ex: reading a book or watching something on my phone). I do use them when at my computer since the monitor is a bit too far to read comfortably. And outside, only if I drive and need to see very clear what's in front. Otherwise no glasses and they bother me: sure, things are a little blurry far away but I'm used to that.

Overall: my myopia is stable and don't know if it's genetic or by the habit of wearing glasses only when absolutely necessary and using the naked eye otherwise.

Which gets me thinking to ... dental care. I'm 46 and have all my teeth, sure some may have some incipient cavities. But some 20+ years ago I went to a dentist and he basically said "Your teeth are terrible, I basically need to puncture and put a filling in every one of them", to which I said "Thanks, I'll think about it" in loud voice and "Yeah, right" in mental one and left. Went to another dentist (a woman this time) and she said "I'll be honest. There are some incipient cavities but it'll do more harm than good breaking the tooth enamel and putting a filling at this point. Monitor them and when they progress, come back". They haven't progressed much in 20 years so again I don't know: would 17 fillings (a figure of style for "many, many fillings") would have helped more over the course of 20 years?

Optometrist legal liability for driving license exams are one contributor to incremental over-correction over a human lifetime. One can manage this risk by taking the eye exam first thing in the morning (vision deteriorates over the course of a day) and wearing weaker glasses when not driving, or during near work.

> They haven't progressed much in 20 years so again I don't know: would 17 fillings (a figure of style for "many, many fillings") would have helped more over the course of 20 years?

No. If they're not progressing, there is no problem to solve.

Dental sealant might be worthwhile.

From what I've read elsewhere on the topic of childhood myopia, the answer seems to be a combination of two factors:

1. spending a lot of times on screens means the eye only focusses at objects at a very close distance most of the time, this seems to cause eye strain which is why for adults working with screens the recommendation is to focus on objects in the distance every now and then

2. sunlight somehow (the exact mechanism seems to be unclear) contributes to the development of eye shape in children, in other words a lack of sunlight can cause the eye shape not to adjust as the body growth, impairing eyesight and causing myopia

The effect of 1 seems to be minute compared to 2 and the latter can be solved by literally just spending time outside. Putting your toddler outside to watch their iPad seems to be literally better for eye sight than taking the iPad away but keeping them inside. Of course the ideal solution would be having the kid outside without the iPad but if it's a choice between the two, getting them outside is the more important focus - and it's often the easier one too.

Lots of the comments are really far off.

The solution is more sunlight during childhood and early adult years. It seems that sunlight is an important signal when it comes to eye growth and shape development.

This has been confirmed for at least a decade.

No need for any particular supplement or food or anything. Literally just go outside for 30 min to 2 hours (can't remember the recommendation).

Kids need recess back.

> The solution is more sunlight during childhood and early adult years.

Kids can go out front and stand there. And that's what they can do.

In FL they can do that in ~100° + ~100% humidity. School is out all summer to allow that. During not-summer months, kids have schools to keep them safely away from any not-awful weather. Because crops or something.

Both my kids wore glasses. This year we learned about Ortho-K contact lenses. When worn overnight, these halt the progression of myopia and correct vision for the next day. The kids have responded really well to them, and I wish we'd known about them earlier.

Do these work on 20-year olds?

Screens are the disease. AR is the cure.

Not really, or at least not yet. In the future perhaps VR/AR devices can provide a flexible focal distance, for eye health.

I find it a relief that with the Vision Pro I don't need reading glasses. I can even "focus" closer than I could before I needed those darned things. Just a couple inches or so from my nose. Would be nice to also keep my eye's lenses focused at distance. The VR/AR separation of lens and stereoscopic focus is interesting.

My theory is that people who always use their eyes to look at short distance objects, like staying indoor and doing indoor activities only, makes the muscles used by eyes to focus -- shorter. People need to go out or at least make it a habit to look at long distance objects or horizon to increase the range of motions involved in focusing.

There’s lots of interesting myopia control techniques now for kids. Hard and soft contact lenses as well as extremely low dose dilation medications have all been shown to reduce myopia progression. Some really neat stuff that can definitely help along with getting outside more and staring at close things less.

I was surprised by the fact that people with slight myopia often need reading glasses (presbyopia) later in life compared to people without myopia. Myopia might not be that "pathological", more like early life adaptation for certain visual stimuli.

Asianometry had a great video on nearsightedness in China: https://www.youtube.com/watch?v=3YWbR8K0jT4

Reading glasses cost $20 on amazon, and make close objects appear far away.

In case any of you look at something close up all day, and want to make it appear further away.

Anyone wearing glasses for myopia should have dedicated (reduced) glasses for the exact focal plane of their monitor, placed as far away as practical for the desk.

Has anyone ever studied how the War On Darkness (the elimination of dark nighttime) might be affecting our eyesight (or other facets of our health)?

I recently learned sleeping in a very, or nearly dark room is critical to not develop nearsightedness.

Actually, it seems there is little or no conclusive evidence for this.

[1] https://sleepopolis.com/news/children-night-lights-cause-myo...

[2] https://www.sciencedaily.com/releases/2000/03/000309074442.h...

[3] https://news.osu.edu/night-lights-dont-lead-to-nearsightedne...

Interesting, I haven't heard that. Can you link to some evidence?

> While having two myopic parents does mean you’re more likely to be nearsighted, there’s no single myopia gene. That means the causes of myopia are more behavioral than genetic.

This stinks of faulty logic.

Yeah it’s terrible. There is also no single height gene, but one wouldn’t say height is more behavioural than genetic.

I agree, but it’s worth pointing out that height is also quite strongly affected by environment (we’ve seen average height grow a lot due to improving diets since the Great Depression).

Everything is strongly affected by the environment. For example, if I butcher you, your height will go down. Also all of your organs will stop working.

But height is not affected by the environment in any meaningful way in a modern first-world context; everyone's diet is already maxed out.

[flagged]

In all seriousness: Can you provide proof of that? Because nothing I've read on the subject is definitive about methods that prevent it.

Gell Mann amnesia effect.

TL;DR: Myopia can be staved off by spending more time outside. Unfortunately, accelerating climate change will mean that fewer people will be able to thrive outdoors for extended periods. I hope things like full-spectrum indoor light sources paired with larger screens or projected images 10+ feet away can allow people to regain some of sunlight's benefits without having to contend with scorching temperatures.

I suffer from horrible myopia. I've been an indoorsy bookworm and techie for most of my life and had my first pair of glasses at age 9. Now that I'm almost 50, my eyes are atrocious.

People will blame literally anything on climate change

Hah. Climate change be damned -- if I had to do it all over, I'd still be inside constantly! :D Miss out on the best things in life (video games, coding) so my last few decades are better? That doesn't really make a whole lot of sense. You should accept you gotta go sometime, and you should have a good time until then!

"Spending time outdoors" is a pre-computers anachronism. You're better off hoping for cybernetic eye implants.

But once you have cybernetic eye implants, why stay indoors? You can lie on a grass in a forest and code.

We will stop fighting myopia and start fighting ticks and mosquitoes, I guess...

Modulo mosquitoes, ants, Lyme disease, temperature, dirt, and laziness, I'd totally code in a forest with AR cybereyes. B] The twin enemies of ergonomics and glare defeated at last!

The heck? My earliest memories before I was walking I couldn't see far away. I was born nearsighted and with a lazy eye that caused me to see double. There wasn't anything anyone could do to prevent this. This article is bringing up a whole lot of data but it's not passing the scrutability test. It almost sounds like it wants to blame people for having nearsightedness.

There wasn't anything anyone could do to prevent this.

Maybe they are not talking about you personally. There seems to be strong evidence for time outside being a contributing factor, as one example. That doesn't automatically discount your personal experience, but at the same time any HN reader is well aware the label placed on data from one's personal experience.

--

A guy who also has probably been near-sighted since birth

In early elementary-school I would memorize what color clothes my friends were wearing each morning, so that during outdoor recess I could find them without meandering between clusters of kids trying to get close enough to check faces.

Then with glasses: "You mean everybody sees like this!?"

So I was already nearsighted when I still cared about climbing trees and trampolines etc., the books and computers phase came later.

I have been nearsighted nearly my whole life. I started wearing glasses in 2nd grade, probably needed them before then but who knows. I played outside a lot -- we had recess 3x day in school and most days I played outside until dark when I got home. Had very little "screen time" as the only screen in the house was a 12" black and white television.

My suspicion is a lot of it is due to Winter, and shortening recess times, plus increasing reluctance of schools to send kids outside in anything but perfect weather.

Go to school just as the sun’s coming up -> inside recess because it’s too cold or it’s raining a little -> sunset around 5:00PM.

Schools get kids five days a week for most of the winter, so as parents it’s damn hard to get them outside much while the sun’s up on those days if the schools won’t do it consistently. And you need lots of time in very-bright light to cut your odds of myopia to something very low.

Yeah, I think there is a genetic component. I had glasses from the third grade, and I recall spending lots of time outdoors as a youngster. There wasn't much else to do.

> This article is bringing up a whole lot of data but it's not passing the scrutability test.

I disagree. The environmental causes of myopia are very well understood, and have been an area of research for decades and the treatments have been known for nearly as long. Exposure to sunlight at an early age will reduce prevalence of myopia.

They are not saying it's the only cause of myopia. There are people with congenital myopia, such as yourself. But the the bulk of myopia cases are not congenital, they are developed. This is why myopia prevalence increases as a country industrializes, and children spend more time indoors.

Most mammals are born with eyes that don't have a depth (and hence optical focus) set correctly for sharp focus on the retina.

The eyes need to use auto focus mechanisms to tune growth rates to correct for this. If something goes wrong you end up with vision problems.

The brain isn't born able to process visual images and needs training data. If the input from one eye is much inferior during learning image fusion it's input is just discarded and you end up with a lazy eye.

I read that vitamin d deficiency might be related to myopia. It seems controversial though.

Nothing controversial, but it is more likely a correlation, not causation.

If you're vitamin d deficient, that means you're not spending time outdoors (in the sun).

If you're not spending time outdoors, it probably means you're focusing your vision on short-distance objects, like screens and books. Which naturally leads to myopia for most people.

Obviously, vitamin D supplementation is highly unlikely to do anything to improve the condition, because vitamin D deficiency is just a symptom.

Similarly seasonal affective disorder is also very rarely improved by vitamin D supplementation alone.

.. what, how does that track? The article is inscrutable because you happen to have been visually impaired at an early age? What's the logic here?

people weight their anecdotal evidence higher than scientific evidence. shrugs

i.e. "proof by example"

If the article was about people who've lost arms in childhood and you were born missing an arm, would you still assume it were about you?

[dead]