Body Electric Part 3: Why Our Eyes Are Elongating

0:00This message comes from AT &T. Staying connected matters. That's why AT &T has connectivity you can count on or they'll proactively make it right. That's the AT &T &T guarantee. Terms and conditions apply. Visit AT &T.com. Guarante for details. Hi, it's Manoush. All right, and let's get you a line to read. Can you read down this line for me? And I want to introduce you to 12-year-old Harmony. E-S-T-L. I don't think I can see the last one. This is her getting her regular eye checkup at a clinic in Berkeley, California. O-P-L-O-T. All right, and then I'm really pushing you here. How about this one?

0:44So Harmony has myopia. That means she's nearsighted. She and her mom, Ching Tai, can't quite remember exactly when she first got diagnosed. I was in first grade. I think I was second. Okay, second grade. How old was I? Second grade is. Six or seven, I think. So Harmony wore glasses for a while. Her parents also made her take very regular breaks from looking at a book or a screen, which Harmony hated. So she cried a lot. She had to use alarm clock every 20 minutes. And she needs to take a rest for 5 or 10 minutes. And she just gets really upset. But her parents knew that they needed to deal with Harmony's nearsightedness because, as they learned, myopia, especially early-onset myopia, can cause dangerous vision problems later in life.

1:40When she was diagnosed with myopia, actually we didn't tell her. My husband and I both, like, went through a sleepless night because she was so little. And we knew how bad it can get. It can lead to a lot of complications, including loss of vision, if it gets bad enough. The World Health Organization warns that by 2030, 40 % of the world's population will likely be nearsighted. And rates of myopia in kids are soaring around the world. In China, where they specifically track early-onset myopia, 80 % of teens and young adults are now nearsighted. There's been a debate over why so many kids are going nearsighted earlier and earlier.

2:33Because bad eyesight used to just be chalked up to genetics. But now experts agree that something else is going on. What though? Too much screen time? Too much time inside? Clearly, our habits are at odds with what it takes to maintain healthy vision. I'm Manoush Zomorodi, and this is Episode 3 of NPR's Body Electric Series, an investigation into the relationship between our technology and our bodies. This week, why our eyeballs are elongating. causing so many of us to go nearsighted and what we can do about it, especially for kids.

3:26So how has your vision been since the last time we saw you? I know it's been about three or so months. Pretty good. So Harmony doesn't need to wear glasses anymore because for the last two and a half years, she's been wearing special lenses while she sleeps. And were you able to wear your contact lenses last night, Harmony? Yes. How many hours would you say? Um, 10 hours. By gently reshaping her eyeballs back to the spherical shape they should be, these special lenses are correcting her eyesight. Do you ever forget to put your contacts in? No. And it seems like, so far, the treatment is working.

4:06My vision started getting better after, like, a week, which was pretty fast. So I think my vision went from pretty blurry, couldn't see distant objects, to really sharp. And color was clearer, especially in farther areas. So I can actually see things without having to spend too much effort or having really thick glasses on my nose. Harmony and her mother say they have a woman named Maria Lu to thank. The majority of the patients we're seeing here on Saturday are myopia-controlled patients. A decade ago, Maria founded the Myopia Control Clinic at Berkeley, the first of its kind in the U.S., where she began offering a wide variety of treatment options beyond just glasses.

4:58We're prescribing them treatments not only just to correct their vision, but also to help slow down the progression of myopia. In a minute, how some of these treatments work, and why Maria's colleagues at UC Berkeley originally scoffed at her plan to offer them. Correct. Actually, it's worse than that. They didn't even believe myopia control is a thing. And so I actually volunteered my Sunday time to get the clinic going. We'll be right back.

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6:56Okay, we're back. So my name is Maria Liu. I'm a professor at UC Berkeley School of Optometry. Dr. Maria Liu was born and raised in Beijing, and she has so much to say about what's happening to our eyesight. Her obsession, specifically with nearsightedness, started as a child. So I'm the only nearsighted person in my family. I started noticing my distance vision, it started to be too blurry for anything on the blackboard, roughly when I was 9 or 10 years old. I started reading very early on and I had experienced a very, very intense academic program. Wait, what kind of school did you go to? I went to an accelerated program, so I skipped one year in primary school, one year in middle school, two years in high school.

7:53Holy moly. So you were studying all the time. Yes. Maria ended up going to medical school in Beijing, too, and specializing in ophthalmology, where she learned how our vision works. Yes, so our visual system, but more specifically for the eyeballs, they are extremely complicated. For one thing, our eyeballs go through a very precise, coordinated growth soon after birth. As soon as we're born, our eyeballs start growing faster than the rest of our body. And the retina, that section at the back of the eyeball that's sensitive to light, quickly matures so it can focus on images that are far away.

8:41The retina, just an aside here, I mean, it is amazing. It's what turns those images into electric signals that it sends to the brain to interpret. it. Anyway, at around four months old, our eyeballs finally grow into a healthy spherical shape that makes it possible for us to see images close up too. But myopia causes our eyeballs to morph, to elongate. Instead of maintaining a relatively global or round shape, a spherical shape, it actually turns into a more sitting egg shape where the axial dimension is longer than the horizontal dimension. This elongated shape helps the eye do a great job focusing on things right in front of us.

9:31But it refracts light in a way that makes it harder to focus on things far away. So we become nearsighted. But why does this happen? For decades, optometry schools have taught that myopia is genetic. It gets passed down through your parents. But that didn't totally make sense to Maria. And so that certainly really interested me in understanding why I'm the only near-sighted person in my family. I have been told that near-sightedness is a pure genetic problem. It tends to run in the family, but this is certainly not the case for me. She wondered if it had to do with the long hours she'd spent studying, because a lot of her classmates had also ended up nearsighted.

10:16Then around 1996, during her residency, she noticed that for some patients, a certain kind of contact lens slowed down their myopia. Yeah, they were wearing them just as an alternative to glasses or soft contact lenses. And I happened to notice the progression is not nearly as fast in those patients. So Maria started using them on her younger patients. I started feeding my patients a special type of lenses called orthokeratology. It's a type of rigid contact lenses for overnight wear during overnight sleep. So it's just like wearing a retainer for your teeth at night. Exactly. But she still wanted to understand what triggers nearsightedness.

11:00So in 2000, she went to UC Berkeley to do some research. I was mostly working with chicks and guinea pigs, as well as monkeys or even primate, rhesus monkeys, as close as to human visual system. And she found that what mammals, including us humans, do early in life can make us go nearsighted. It's not just in our genes. So there are multiple factors. Number one, early introduction of electronic devices. Number two, drastically reduced outdoor time. If we indulge our vision into a very closed-up world, spending too much time doing reading or using electronic devices, spending too little time outdoor, the visual system will think, okay, now the ideal endpoint is not to be able to see things clearly at far.

12:02I mean, it's kind of impressive, right, that our eyes have evolved over millions of years to grow to the right length. And yet, if we use them in certain ways, they will quickly, quickly adapt to what we're asking of them within the span of a couple years. Yeah, so this is a very interesting thing. Um, millions of years ago, you know, animals or human beings rely on having clear vision, either as a prey or as a predator. And nowadays, being able to work comfortably in front of a computer becomes advantageous vision-wise. So this is actually our visual system's adaptive response to the drastically changing lifestyle.

12:49When you say kids are getting, or you're seeing this in kids younger and younger, What are you talking about? We're talking about age four or five years old becoming myopic. Oh, wow. And it used to be? It used to be like early teens, but it's really not uncommon, especially in areas with a higher educational level, to see kids becoming myopic in toddlers, but definitely kindergartners. Oh, those little eyeballs. They're elongating in ways they shouldn't be. Correct. So because the eyes are so plastic in like a younger age, a small stress, visual stress will cause a bigger change or a bigger axial elongation in younger children compared to older children of the same visual stress.

13:40So the earlier the age of onset, the harder it has to control and the later it stabilizes. So what does that mean? What could the long-term consequences be if you develop nearsightedness earlier in life? So the longer the eyes become, the higher the risk of complications such as retinal detachment, retinal tear, and myopia is also a very high risk factor for glaucoma as well. So all of these are actually happening much earlier than any other priority eye disease defined by WHO. So certainly more and more parents and even industry partners are aware that myopia is a controllable condition. And by intervening as early as possible, we're able to actually change the course of the development of this condition and eventually reduce the risk of those bad complications that may eventually lead to irreversible vision loss.

14:46Maria was changing the way people thought about myopia, and she was determined to change the way it was treated at Berkeley. So in 2013, she opened a myopia control clinic. But her colleagues were super skeptical. Correct. Actually, it's worse than that. They were not even interested. They didn't even believe myopia control is a thing. And so I actually volunteered my Sunday time to get the clinic going. You worked for free? Yes, for multiple years. So 10 years ago, how did you get the word out? And who were your first patients? We actually didn't do any marketing or advertisement. Obviously, in the Bay Area, we have a very high percentage of the Asian population.

15:39and myopia control has always been like a top priority for a lot of Asian parents. So as soon as they heard about having a myopia control clinic, we started getting more than enough patients I can handle by myself. So the clinic at that moment realized the potential and they started assigning me with residents and interns. So as of February this year, our clinic has over 1 ,700 recurring patients just for myopia control. So where are we now then in terms of parents generally in the United States thinking about myopia, thinking about control treatments? I think in general, comparing to 10 years ago, the disease awareness of myopia is getting much, much better.

16:37But they are quite expensive. The annual cost to cover both the services as well as the material is around$2 ,000 per year. Wow. I mean, you came across these lenses over 20 years ago, but they're still pretty expensive. And I guess people still aren't that familiar with them. Yeah, so this is still considered a concierge service by many practitioners. Okay, this is going to sound like a strange question, Maria, but if there is an ophthalmologist's fantasy, like just like go crazy here. A baby is born and you want them to have the highest chance of having healthy, rightly sized eyeballs, shaped eyeballs as they grow older.

17:27What would be the optimal lifestyle for that kid? so that they don't need you. Play with the real toys, stay outdoor, and just live like a normal kid instead of giving them the iPad, free up the mom's or dad's labor, and just take away those electronic devices from infants during their early visual development. They need to see the real toys, and they need to play with the real toys. they need to engage in the real outdoor life. I mean, my fantasy, I have a 13-year-old and a 16-year-old. I'm now thinking when they're doing their homework that I need to, every half hour, go grab them and make them walk around the block in the sunlight, looking around to see if they can spot birds.

18:18Will that help them with their eyesight? Absolutely. So to count for a good visual break, there are several conditions we have to consider. Number one, it has to be the whole vision looking at far. So popping the, you know, the head outside of a window just looking at far may not be good enough. I oftentimes have parents telling me, oh, I have a huge living room. And even inside this living room, they're actually looking at far. But keep in mind, the ceiling, the wall, the furnitures, everything is still crowding the peripheral vision. This is still telling the eyes that you're sitting or you're, you know, basically in a very up-close environment.

19:02And so get them a dog, walk the dog, you know, like multiple times a day, just, you know, anything to push them outside and play outdoor. All right. So we're like, kid, you need to go sit in a field around four o 'clock and scan the horizon for about five minutes. That's the ideal. Correct. And the break is actually most effective right after a sustained amount of near work. Oh. And another very, very important point, parents are their models. You can't ask your children to do better if you yourself, you know, spend the majority of your time texting or surfing on the cell phone. So we also need to tell parents to make sure you're setting up good examples.

19:49It just is fascinating to me how our habits can change our bodies. Absolutely. We do see this, you know, really, really consistent trend of the whole, like a global children population becoming nearsighted. And I actually don't know if we have a solution to tackle this natural evolution or the body adapting to the changing lifestyle. But I'm hoping we have better treatments available that can actually reduce the blinding effect of those complications. Just FYI, the Chinese government has been trying out various strategies to bring down myopia rates in kids, including encouraging them to get outside more.

20:39And they're starting to see results. One recent study reported that the rates of nearsightedness in 18-year-olds was down nearly 4%. When we come back, we'll hear from a work-from-home team that have been trying to get more movement into their workday. Stay with us.

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21:44Bring your vision to life with smart business buying tools and technology from Amazon Business. From fast, free shipping to in-depth buying insights and automated purchase approvals, they deliver everything you need to achieve your goals. It's not easy to stand out from the crowd. Simplify how you stock up to get ahead. Go to AmazonBusiness.com for support. Hello again. Okay, it's time to talk about our big project with Columbia Medical Center to try and get people off their screens and moving their bodies. We have had over 20 ,000 people sign up, which is amazing. And if you're part of the study, you'll be wrapping up your baseline data reporting soon and starting to incorporate those movement snacks into your life.

22:29and we wanted to give you a little preview of what the project might be like for you. A few months back, some folks at a startup called Fig agreed to give it a test run. They all work from home and were so psyched to do it together as a team. We asked them to record voice memos to document their progress. This is day two of the walking experiment. In the first few days, some, like Hans Weidler, felt pretty good. I definitely felt a lot better energy-wise, and my mood was better. And just overall, I was happier that I was going outside during the day and moving more. But after a short honeymoon period, Hans said he started losing steam.

23:17I'm on my five-minute walk right now, and it's starting to annoy me a little bit to have to get up. kind of in a flow of being productive and trying to get something done. I would come back from a walk and I feel like it takes me a few minutes to get my focus back up to where it was before. So overall, I really liked it, but I'm not sure that the 30 minutes will work for me long term. Meanwhile, his colleague Anurima Sharma was recruiting her pals to join her. Hello. Today, I got lots of friends on our five-minute walks. I think it's made us productive today. But she also started seeing a side effect.

23:59I found that on the first day when my focus was on the walking, I was like, oh, it's time for a break. What do I go do? And I grabbed a snack and I ended up snacking 10 or 11 times the first day. So I did it, but I don't think the point of doing it was to just go eat a bunch of snacks. Today, I had to time my outdoor walks in between the rain. I did a lot of work at my standing desk and then every 25, 30 minutes doing some lunges, walking in place a little bit, a little swing side to side, a little dance party. Others, like her colleague Jake Lynch, had to get a little creative due to extenuating circumstances.

24:39I was traveling a lot this week, so I was on a plane doing work and I would like take breaks and go to the bathroom. but one time I purposely kind of got stuck behind the food cart for a little bit so I had a little bit of a longer break but I was like kind of nervous that I was like annoying the people by me but I actually noticed the guy next to me got up and walked a bunch of the times too that was pretty funny I was like oh maybe maybe I'm encouraging other people to uh to do a little more walking that is pretty funny I love that maybe this behavior is contagious Whether you are signed up for the study or not, if you're trying to get more movement snacks into your life, we'd love to hear from you.

25:20Record a voice memo. Tell us how you're keeping yourself or your team going. We are at bodyelectricatnpr.org. And thank you. Also, come say hi online. I'm at Manoush Z on Instagram, and we're at TED Radio Hour on Facebook. Next week, our posture. We hunch over our devices for hours on end. But what is it really doing to us? Can we trust what we read? This story was so viral. I had, you know, I had multiple people in my life like, is this real? Can you believe this? And I was like, no, absolutely, I do not. I do not believe it. Body Electric was produced by Katie Monteleone and edited by Sana's Meshkinpour with production support from Rachel Faulkner-White.

26:09Special thanks this week to Kobe McDonald for his help with field production. Our original music was by David Herman. Our audio engineer was Valentina Rodriguez-Sanchez. Our fact checker was Chloe Weiner. Thanks also to Anya Grundman, Lauren Gonzalez, Lindsay McKenna, Yolanda Sanguene, Beth Donovan, Irene Noguchi, Julia Carney, and Fiona Guerin. I'm Manoush Zomorodi, and you've been listening to Body Electric from NPR.

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