1. The Nearsightedness Epidemic
With American adults spending almost four hours per day staring at mobile devices, you might have wondered if staring at a screen can damage your eyes. The answer is yes—and no. Screens don’t harm your eyes any more than other activities that require you to see close up, like traditional books. However, close-up activities do cause eye strain, dry eyes and tired eyes, which can lead to myopia or nearsightedness. And since we’re looking at things close up—computers, smartphones, video games—far more often than we used to, it’s affecting our eyesight.
In fact, since 1971, the incidence of myopia has nearly doubled in the U.S., up to 42%, and is disproportionately affecting young people. In Asia, teenagers and adults with nearsightedness has jumped to 90%. While there’s clearly something going on, ophthalmologists aren’t aligned on exactly the cause. Is it the increase in time spent focusing on screens? Or the blue light from screens interacting with circadian rhythms and influencing eye growth among children? Or perhaps it’s a lack of natural sunlight? Or something else entirely? The jury is still out on the exact cause, but there’s no doubt it’s happening.
Tech giants have responded to this growing concern with new features. Apple recently released Dark Mode, which enables a dark background on the iPhone and is aimed at “making every element on the screen easier on your eyes." Google is planning to do the same with Android Q. Experts, however, aren’t convinced this feature will help.
“While bright light in the evening is known to disrupt circadian rhythms, there’s no real evidence that white font on a dark screen is easier to read than the reverse,” says Dr. Michael B. Rivers, ophthalmology director at Modernizing Medicine. “In fact, leading experts currently believe the duration of screen use is more of a factor than the brightness of the screen.”
So, what can you do to prevent myopia? Dr. Rivers shares a few tips. “Give your eyes a rest—even a short break can help. When you’re looking at a screen or reading a book, take a break every twenty minutes or so to look at something in the distance. We call this the 20-20-20 rule; every 20 minutes, look at something 20 feet away for 20 seconds.”
2. Artificial Intelligence, Diabetes And Your Eyes
Approximately 30.3 million or 9.4% of Americans have diabetes and each year, another 1.5 million new cases are diagnosed. As the prevalence of diabetes increases, a significant percentage of the population is at risk of developing diabetic retinopathy, an eye disease that can lead to blindness. Diabetic retinopathy is highly treatable–but only if it’s caught early enough. However, because it’s asymptomatic in its early stages, most diabetic patients don’t know they’re at risk. In fact, a study published in the American Journal of Preventive Medicine found that 73% of adults aged 40 and over with diabetic retinopathy were unaware of their condition.
As the incidence of diabetes continues to increase, ophthalmologists are looking toward a potential solution: artificial intelligence (AI). It takes a highly trained professional to diagnose the signs of retinopathy, but a really smart algorithm could help. In April 2018, the FDA approved the first AI-based diagnostic tool for detecting diabetic retinopathy, which uses a self-guided fundus camera to take high-resolution photos of the patient’s eye, then scans for signs of the disease. With the device, primary care physicians and optometrists can help screen for retinopathy, greatly increasing the chance it’s caught early enough to prevent blindness.
“This technology gives primary care physicians, optometrists and ophthalmologists another ‘set of eyes,’ if you will, allowing initial screenings to take place even when we’re not in the room,” explains Dr. Rivers. “While a trained ophthalmologist still needs to review and officially diagnose, artificial intelligence—or intelligence amplification, IA, as I like to think of it—is showing promise in helping with the early detection of retinopathy.”
3. Cataract Surgery Then Vs. Now
Cataract surgery is one of the oldest known surgical procedures, yet just 30 years ago, it was very different than it is today. The procedure used to require weeks of recovery and improved eyesight only to a degree. Today, it takes less than ten minutes and patients are back on their feet within days. The continuous evolution of cataract treatment is well-documented, with the most recent major breakthrough coming in 2010, when the FDA cleared the use of lasers for intraocular lens (IOLs) implantation.
Overall, this has resulted in a major surge in the number of patients undergoing cataract surgery–especially considering the aging Boomer population. According to Dr. Rivers, “In any given day, a busy ophthalmologist may perform between 30 to 50 surgeries, each lasting about seven minutes. Instead of in a hospital outpatient setting, ambulatory surgery centers (ASCs) have become the common location for these surgeries.”
Looking Ahead: Trends Among Ophthalmologists and In Patient Care
With more of the population needing glasses, the increasing prevalence of diabetes, and cataract surgery on the rise, ophthalmologists and optometrists are in high demand. The supply, however, is low, and decreasing every day.
“Each year, about 550 ophthalmologists retire, but only around 450 residents enter the field. So, you can see the problem,” explains Dr. Rivers. “The demand for ophthalmic procedures continues to rise, but there are not enough students entering the field to meet the industry’s needs.”
Technology is helping keep up with the increasing demand. New tech can supplement an ophthalmologist's skills, helping them to do their job better and faster than before. For example, tech like AI (or IA) can help with cataract surgery planning and is also showing promise in helping screen for over 50 types of eye diseases. Screening via AI can even take place via telemedicine using a smartphone attachment. Companies from other industries are jumping into the ophthalmology field as well—take Gortex, for example, working on the development of artificial corneas.
Technology such as this can help us see healthcare in a new light. We often think of ophthalmology, oral health, and our overall well-being as separate disciplines, each requiring different care. However, as researchers continue to develop a deeper understanding of the human body, discoveries demonstrate that our well-being is a highly complex, interconnected system. Retina screenings, for example, can be used to identify the early signs of Alzheimer’s Disease. From liver disease to high cholesterol to the likelihood of a stroke, our eyes can be a window into our overall health.
Next time you visit your ophthalmologist, you may be learning more from the screening than just about your eye health.
