Is Myopia the new Rickets? A new study compares the history of school myopia with the bone disease rickets. During the 17th century, rickets was common among children in England and then reached epidemic levels through northern Europe and North America. In some cities, 80 percent of children were affected.

The remedy proved elusive until the 1920s, when scientists discovered that a lack of sunlight, resulting in vitamin D deficiency, was the cause of rickets. 

Over the last 30 years, short sight, or myopia, has become a global health problem. The most dramatic rise has been in Singapore, Taiwan, China's cities and elsewhere in East Asia, where rates can be as high as 80-90 percent among children leaving secondary schools in the region. As many as a fifth of them have severe myopia and so are at high risk of eye problems in later life.

In Western countries rates are increasing; although not as rapidly as in East Asia.  Myopia, like rickets, is a seasonal condition which seems to get worse in the winter, according to a new paper. Recent papers on myopia have revived an old hypothesis from the 1890s, that school children who spend more time outdoors have lower levels of myopia. However, unlike rickets, low ambient light levels rather than low vitamin D levels seem to be the deciding factor in myopia. 

The Myopia Mystery

The cause of myopia, and the means to prevent it, are unclear despite more than 150 years of scientific research. Many theories have been put forward to explain why children's eyesight gets worse as they go through school. Too much close work is one of the more popular ones, while heredity is another. Both have been hotly debated down the years. 

A century ago, it was widely believed that high daylight levels in schools could prevent myopia. Education departments built classrooms with large windows to try to stop children becoming short-sighted. Then in 1960s, medical thinking changed. Myopia was thought to be an inherited condition; so less was done to prevent it.

Today, it is known that children's education has a far greater impact on their sight than genetic factors. Evidence that daylight in classrooms prevents myopia is lacking.

"It has not been investigated properly since the connection was first made in the 1860s," said the author of this study Dr. Richard Hobday. "But, given the rapid increase in myopia among school children worldwide, this should be revisited."

Citation: Richard Hobday, Myopia and daylight in schools: a neglected aspect of public health?, Perspectives in Public Health March 23, 2015 doi: 10.1177/1757913915576679