As an optometrist in Hamilton Square, Dr. Nicholas Despotidis wasn't too alarmed by an increasing number of youth requiring eyeglasses at a young age in order to help with nearsightedness  — until his two sons needed glasses by the second grade.

He took a closer look and found children's prescriptions related to myopia had shot up "astronomically" in his practice. And Myopia affects 66% more Americans than it did 50 years ago, according to findings from the U.S. National Health and Nutrition Examination Survey, referenced in a December 2009 issue of Archives of Ophthalmology.

"When I went to school, like so many other eye doctors, we were taught it was genetic," Despotidis told the Townsquare News Network.

But much more plays into the medical equation, he said he found. And it's not just the hours many children spend in front of screens on a daily basis, he said.

"Scientists found in general the amount of children needing glasses has increased in part due to lack of outdoor play," Despotidis said. "Kids aren't playing outside, and it turns out that daylight seems to inoculate our children from becoming nearsighted."

Add this to the intensity at which children concentrate on what's referred to as "near work" — using tablets or phones, for example — and progression of the condition can be accelerated.

"While it is well-documented that excessive near work is correlated with nearsightedness, this does not provide the full picture," write Despotidis and Dr. Noah Tannen, another optometrist in Mercer County, in their recently published book "A Parent's Guide to Raising Children with Healthy Vision." "Perhaps more detrimental than the near work itself is that it is performed indoors, away from natural light. Scientists now know that daily exposure to outdoor light protects against the development of nearsightedness."

Near work can also include hobbies such as reading and sewing, the doctors said. But those tasks don't have the same addictive effect on children as using electronics.

My kid needs glasses — so what?

The doctors describe myopia as a "boulder rolling down a hill," difficult to slow down once it starts.

"The younger the child develops myopia, the more rapidly their eyesight deteriorates, increasing the likelihood a side effect from myopia will occur in their lifetime," they said.

These side effects include such sight-threatening conditions as glaucoma, cataracts, retinal detachment and macular degeneration (the leading cause of vision loss).

According to the World Health Organization, nearly 50% of the global population will be affected by myopia by 2020.

"We're in an epidemic now, and I truly feel that screens are keeping all of us indoors," Despotidis said.

How can I help?

There are a few ways parents can help slow this trend, the doctors said.

Understanding that a general suggestion of at least two hours per day outdoors may be unattainable for many, the doctors say children would benefit from at least 30 minutes of daily outdoor time.

The authors agree with the American Academy of Pediatrics' recommendations that children under 18 months get zero screen time besides video-chatting, and those aged 2 to 5 be limited to 60 minutes per day of high-quality programming. They also recommend all elementary school children avoid electronics at home during the school week, as they get plenty of screen time in school.

"I was as much to blame as the screen my kids were on, because it was convenient to have my kids inside," Despotidis said.

"Off-label solutions" to stop the progression of myopia, and avoid a child's need for a stronger pair of glasses every year, include special overnight contact lenses, multifocal contact lenses, and a nightly eye drop called atropine, the doctors said.

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