Europe might head in the same direction as East Asian countries like China, where more than 80% of young adults and teenagers have myopia, Sander Kneepkens told us.
The ophthalmologist-in-training and author of a recent study from the Erasmus University Medical Center in the Netherlands found that the number of Dutch people with nearsightedness has increased by 2.5 times in the past century. He says other European countries see a similar trend.
Shortsightedness develops when your eyeballs grow too long. Eyes grow until early adulthood, “but certain environmental factors and genes can make them grow longer than needed,” Kneepkens explained. As a result, distant objects appear blurry which, if not corrected, can cause headaches or eye strain. Glasses, contact lenses, or surgery can correct this.
The problems don't end there, as being nearsighted also means you're at a higher risk of developing more serious eye conditions such as glaucoma or cataracts at a later age. About one in three people with myopia become severely visually impaired by the age of 75, according to Kneepkens.
The longer the eye, the higher this risk is. And more serious cases are growing too: over 3% of Europeans now have a severe form of shortsightedness known as high myopia.
“The current situation in Europe should be viewed as a major public health concern,” Andrzej Grzybowski, professor of ophthalmology and head of the European Myopia Network, told us. The growing prevalence of shortsightedness in Europe means a loss of productivity and an increase in both cost and burden for healthcare systems, he said.
What is happening to our eyes?
Nearsightedness can be genetic, but a major reason for its rise in younger generations can be found in the name: we spend more time looking at things that are closer to us – often screens, but also books.
“If young people, whose eyes are still growing, look at things close to them for a prolonged time, this signals that the eyes need to grow longer. Looking at things close to you takes more effort for your eyes, so your body is trying to adjust for that,” Kneepkens said.
A second reason is that we're going outside less and are less exposed to daylight, which is a protective factor against myopia.
Both of these risk factors can be found where children spend most of their day: school. Studies consistently link higher school demands to higher rates of shortsightedness, as this involves more time doing homework or reading and less time outside. Kneepkens points out that higher education is related to more shortsightedness as well, as this too involves more indoor desk work.
Differences in all of these factors lead to varying myopia rates per country. According to one study, Finland only has a prevalance of 11.9%, while other European countries see numbers as high as nearly 50% in Sweden or 46% in Russia.
Who can afford to see well?
Besides declining eyesight, rising myopia rates are also exposing inequalities in access to eye care. While diagnosis and treatment of eye diseases tend to be covered by public healthcare systems, eye exams and glasses are often not (or only partially) reimbursed.
“This creates inequalities in visual health, educational opportunities, and quality of life,” Grzybowski said. A recent study in the Netherlands, for example, showed that about 16% of parents can't afford glasses for their children, which can cause conditions to worsen.
Only a few European countries have implemented myopia prevention strategies, and those focus mainly on screening instead of prevention. A coordinated European strategy is also lacking.
Grzybowski thinks helpful measures would be more (and earlier) monitoring, public education about myopia, and reimbursement for glasses or treatments that slow progression of the condition. Kneepkens adds that a major solution could be relatively simple: make sure that young people go outside more.