Welcome to The Bright Eyes Podcast: Advice for Healthy Vision for All Ages. Your hosts are Dr. Nate Bonilla-Warford & Dr. Beth Knighton, residency-trained optometrist that provide eye exams for glasses and contacts, and specialty services including vision therapy, myopia control, orthokeratology, and sports vision training. Their mission to empower patients by providing the best in friendly, professional, and individualized eye care.
In this episode, Dr. Nate talks with Dr. Beth about recent research that supports the idea that spending more time outside will reduce the likelihood of children becoming nearsighted.
Note: See these related episodes: #4 UV Protection and #6 Refractive Error (Myopia and others).
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Dr. Nate: 00:18 Hi, this is Dr Nate. This episode was actually recorded in the summer of 2017 before Dr. Knighton went on maternity leave and then we got so busy it took me this long to put the episode up. That’s why even though it’s cold and rainy in Florida right now, we are outside at a park where it’s sunny and kids are playing. Enjoy.
Intro: 00:49 Welcome to the bright eyes podcast, advice for healthy vision for all ages. Your hosts are Dr. Nate Bonilla- Warford and Dr Beth Knighton, residency trained optometrist providing eye care to all ages with exams for glasses and contacts and specialty services including vision therapy, Myopia control orthokeratology and sports vision training. Their mission is to empower patients by providing the best in friendly, professional, and individualized care
Dr. Nate: 01:19 From sunny Tampa Bay. It’s the bright eyes podcast. This is episode number seven and I’m Dr. Nate Bonilla- Warford.
Dr. Beth: 01:19 And I’m Dr Beth Knighton
Dr. Nate: 01:30 And today’s episode is all about going outside and why that’s important. So why do you think were outside?
Dr. Beth: 01:39 Well, today is about as lovely as the day as you get in the summertime in Florida. So we thought it’d be nice to just get out of the office. Occasionally we go for walks at lunch and what not just to get out.
Dr. Nate: 01:54 And that’s totally true, and that is completely important, and it is very nice even though it’s a little warm, but it’s still very nice out here. Um, but there’s also another reason why we’re outside. Now, we already talked about getting outside once in episode number four. Can you remind what our listeners, what that was all about?
Dr. Beth: 02:15 Well, we reminding you all about why it’s so important to have UV protection for your eyes when you’re outdoors.
Dr. Nate: 02:22 Absolutely. And I’m still blown away when I ask people about their sunglasses and they say like “No, I just don’t wear sunglasses, I just don’t really need them”. And in Florida, having sunglasses, prescription sunglasses, is a must, but that’s not what we’re talking about. That episode is all about some of the dangers of going outside if you don’t do it cautiously or carefully. This episode is about the benefits of going outside. And so what we’re talking about is specifically how going for children reduces the likelihood that those kids are going to be near-sighted. Now, for a long time it was thought by many people that nearsightedness, or myopia, or not being able to see far away clearly without glasses, was purely genetic. Are your parents nearsighted?
Dr. Beth: 02:22 Only one of them.
Dr. Nate: 02:22 Only one of them.
Dr. Beth: 02:22 And I am.
Dr. Nate: 03:31 Well, both of my parents are and almost everybody in my family is. And I thought that I was going to be and I am nearsighted and that’s why I have my prescription sunglasses on right now. But there has been a lot of research in the last ten years and even a lot of research just in the first half of this year, which shows that nearsightedness is not purely genetic. And as a matter of fact, what we know is the more time children spend out doors when they’re younger, the less likely they are to become nearsighted and need glasses to see far away. And that is one of the most interesting and exciting developments that somebody like me who is a pediatric optometrist is a reading about right now because this means that we can educate our patients and help them understand why going outside is so important and actually reduce people’s dependence on glasses in the future. But before we get to the details and the studies just kind of in general, do you think going outside is a good idea?
Dr. Beth: 04:52 Well absolutely. I mean we have to stay active, we need to enjoy nature as it is and both Nate and I, our families are outside all the time doing things. So we are very aware of both the dangers and the benefits of being outdoors with everything in moderation is key.
Dr. Nate: 05:13 Absolutely. And what’s so great about this particular subject, the beneficial thing which is going outside is free. It’s easy. It’s convenient because it’s everywhere and it is fun. I tell families probably every day or almost every day, one of the best things you can do is just go for a walk after dinner. If you have a dog, go walk the dog. If you don’t have a dog, just go outside with your family. Some of my best memories from when I was a kid was going for a walk with my family and seeing other people and finding out what’s going on in the community and seeing other people walking their dogs and so now we have lots of evidence that just something as simple as that is really important for children’s eyes and it’s also important for a reducing obesity and just general strength and exercise. There’s so many different reasons.
Dr. Nate: 06:10 So what I brought today were three different studies which have different results, which talk about this relationship between the more children go outside and how likely they are to become nearsighted. So, the first one that I have is from the British Journal of Ophthalmology earlier in 2017. What it says is that of the hundred and thirty seven children that they studied, all of the different factors that they looked at whether or not they became nearsighted was more dependent on environmental factors. Most of those children before the age of six is when you could start to see differences and so environmental factors include all kinds of lifestyle choices like going outside and like the types of different activities that people do, but it also has to do with education and socio economic status, so there’s lots of different factors that are that go into that, but one of them is just exercising going outside and so that’s just the type of study that we see on a very regular basis. When I read the new studies that have come out in, I care, I see studies like that all the time. Twenty or thirty years ago, that would’ve been really surprising. Do you think that that’s surprising now?
Dr. Beth: 07:31 I think that in general, people are paying more attention to what can we do to prevent problems in the future as opposed to reacting once we’ve already got problems and that’s across the board in healthcare. These are very simple, easy ways to help prevent our children from becoming more near sighted because not only does it cause them to have thicker glasses and harder time seeing, but it also can cause a higher risk for eye disease later on. They’re at higher risk for having glaucoma. They’re at higher risk for having retinal issues like a detachment or a hole in the retina. And so if we can prevent those things early on, much better outcome for them.
Dr. Nate: 08:17 And that’s actually a great lead into the next study which was from this year and Acta Ophthalmologica. And the gist of that study was a few different things. This was a review, a Meta analysis of twenty five other studies. What they found was that if children spent seventy six minutes outside each day, there were fifty percent less likely to become nearsighted. So that’s if they are not near-sighted, they’re not myopic at first. And then they spend roughly an hour and fifteen minutes outside each day, they’re fifty percent less likely to become nearsighted, and that corresponds with a lot of the individual studies that we’ve seen. But this is nice because this is twenty five studies all kind of pulled together that held up. What was very interesting though is there really wasn’t much benefit for children who are already near-sighted. So, this doesn’t mean that if you’re already near-sighted, all you got to do is go outside more and then you’re nearsightedness won’t progress.
Dr. Nate: 09:26 We have other ways of controlling the progression, limiting the progression, reducing how quickly vision gets worse, but going outside isn’t one of them. So the key, like Dr Beth just said, is prevention. So the idea is to go outside, do everything you can before kids become nearsighted instead of after. Now, the third study, which was from Investigative Ophthalmologic Vision Sciences, was taken from the Avon Longitudinal study of parents and children, which was a study, they followed children from age two to fifteen. And this was really, really specific. This was a news for me that I thought was very useful. And the conclusion of that was additional time spent outside between the ages of three and nine was associated with the less likelihood of becoming nearsighted at the ages of between ten and fifteen years old. So now we’re starting to zoom in on the really key age of younger than ten, between three and nine, and that really is when kids should be outside recess playing and paying dividends in the form of not becoming nearsighted once they become teenagers. And it’s just amazing how much research is coming out right now. That’s something that as there is more research we will continue to talk about and will continue to educate our patients about.
Dr. Nate: 10:57 The study that you just referenced also was looking at the amount of time spent reading versus the amount of time spent outdoors and just like outdoors had a positive effect. The amount of time indoors reading had a slightly negative affect and not that we want to tell everyone, go live outside and never read a book. Obviously we need to do both, but it was very interesting that both of those things had a correlation on the nearsightedness of the eye. Another interesting thing that came out of that study was parents who were near sided were more likely to have children who spent more time reading and it also said that parents who were not near sighted, were more likely to have children who spend more time outdoors and less time reading, so those things kind of match up as well. It clearly stated that the impact of outdoor time reduce the likelihood of nearsightedness regardless of those other factors.
Dr. Nate: 12:01 So, the main point here is if you have children, make sure that they spend time outdoors, but also remember if they’re going to be outdoors in bright sunlight when UV light is a risk, make sure that they were sunglasses. So thank you for listening. This is one of my favorite topics. We’re going to talk more in the future about what to do after children become nearsighted. Until then, if you have questions, comments, or suggestions, you can email us at office at firstname.lastname@example.org. Until next time, go outside.
Intro: 12:35 Brought to you by bright eyes, family vision care, and bright eyes kids. Find previous episodes and more detailed information at brighteyestampa.com, creative Commons, copyright attribution, non-commercial use. The only purpose of this podcast is to educate and to inform. It is no substitute for professional care by a doctor experienced in the area you require. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. Please consult your physician for diagnosis and treatment.
Intro/outro music: Lucas Warford of Three For Silver.