AsianScientist (May. 8, 2015) – Last month, a Singaporean math Olympiad problem (#cherylsbirthday) took the world by storm, catching the attention of international media outlets like the New York Times and even earning the eponymous Cheryl a cartoon in the New Yorker.
This month, our Prime Minister Lee Hsien Loong showed the world that he knows a thing or two about C++, publishing his source code for a sudoku solver on his Facebook page. (Although the fact the PM Lee can code is hardly surprising, considering that he has an diploma in computer science on top of being the 1973 Senior Wrangler at the University of Cambridge.)
But are these mathematical marvels sufficient grounds to call Singapore a nation of nerds?
Glasses, glasses, everywhere
Well, it also helps that Singapore is pretty much the epicenter of the East Asian myopia epidemic, and as we all know, you can’t be a nerd unless you wear glasses. (Not you cool kids wearing ‘GEEK’ t-shirts and lensless glasses; you know who you are.)
So are Singaporeans just born with geeky genes which predispose them to wearing glasses? You might certainly think so if you picked up any medical textbook from a few decades back and came across the entries on myopia which matter-of-factly state that myopia is genetic.
However, the meteoric rise in myopia rates over the last 50 years has changed that narrative. According to a study published in The Lancet in 2012, a whopping 80-90 percent of school leaving children in East Asian countries now have myopia, up from approximately 30 percent half a century ago. While 50 years might seem like a long time, it is nowhere near enough time to observe the drastic phenotypical changes we’ve seen in East Asia, strongly suggesting that environmental factors are in play.
All work and no play?
But what exactly are the specific environmental factors that are driving Singapore’s sky-high myopia rates? Higher education levels and the immense pressure to succeed academically have been blamed; we are after all probably the only country where the ‘Homework God Helpline’ could have even been conceived.
And Singaporean children who read more than two books a week did indeed have a higher likelihood of myopia, while those who had tuition classes or regularly used computers were twice as likely to have more severe myopia. However, an earlier, smaller study published in 2000 found no association between near-work activities (i.e. studying and computer games) and the progression of myopia.
Whatever the underlying cause, the solution may turn out to be relatively simple to implement: encourage kids to play outdoors. In 2008, researchers put forward the argument that exposure to sunlight during outdoor activities had a protective effect on vision in children. They found that the more time children spent playing outdoors, the less likely it was that they would develop myopia, even if they engaged in a high amount of near-work activities. Interestingly, this protective benefit was not seen in children who played indoor sports, ruling out the effect of just getting more exercise. These findings have been corroborated by other research, including studies in Taiwan and Denmark.
Get out of the city and into the sunshine
Unfortunately, as those working in public health will share with a weary shake of the head, scientific evidence is seldom enough to encourage behaviorial change. Professor Saw Seang Mei, an epidemiologist affiliated with the National University of Singapore (NUS), Duke-NUS Graduate Medical School and Singapore Eye Research Institute, knows this first hand. In 2011, Saw and her team ran a clinical trial to test whether interventions such as step counters, organized outdoor activities and even cash incentives would help get Singaporean children outdoors. But no matter what they tried, the trial showed no significant improvement in outdoor time.
This is worrying as myopia is not simply an inconvenience that can be ‘cured’ with either a simple pair of glasses or LASIK, but is also associated with severe problems later in life such as cataract, glaucoma, macular degeneration and even retinal detachment.
Still, Singapore’s situation is not completely bleak. Take a closer look at the graph above and you’ll notice that myopia rates, although still high, began to plateau in the mid-1990s. Hopefully, as parents become more aware of the value of sending their kids outdoors to play we will begin to see those numbers fall.
And I take back what I said; maybe nerds don’t need to wear glasses after all.
This article is from a monthly column called From The Editor’s Desk(top). Click here to see the other articles in this series.
Copyright: Asian Scientist Magazine; Photo: Bro. Jeffrey Pioquinto, SJ/Flickr/CC.
Disclaimer: This article does not necessarily reflect the views of AsianScientist or its staff.