We are now well into the year 2020, a milestone surging with significance for the world of eye health for many reasons. Eye health bodies the world over have begun 2020 with a resolve to promote vision care and to spread awareness on vision-related issues that the global population continues to face.

For instance, The American Optometry Association’s The Year of the Eye Exam campaign calls upon companies across the country to pledge to uphold the overall health and wellbeing of their employees by encouraging everyone to go for their annual, comprehensive eye examination. In a similar vein, Optometry Australia launched its 2020: The year of good vision for life campaign to underscore the importance of eye health management and the need for every Australian to make regular visits to the optometrist throughout their lives.

The Vision

The growing global movement aimed at promoting eye health comes at a time when countries worldwide are having to shoulder the economic and social burden of tackling the major issue of vision loss. In fact, the World Health Organization (WHO) has been tirelessly working with the International Agency for the Prevention of Blindness (IAPB) since 1999 with the goal of achieving the former’s Global Action Plan target of reducing avoidable blindness by 25% by 2020.

Among the WHO’s priority eye conditions is myopia, and it is easy to understand why: uncorrected myopia contributes more than anything to avoidable vision loss. The good news is that myopia is reportedly among the most easily targeted by preventative interventions; doing so is projected to eliminate a whopping 70% of global vision loss.

Indeed, the year 2020 offers us renewed vigor in the journey to ameliorating eye health issues that plague us. Beyond that, we need to take stock of our efforts thus far to assess where we are as a global community with regards to eye health. While the progress that has been made in the last 30 years is indeed commendable, there is still so much to be done. The impact of the myopia crisis for one, seems to be gathering pace rather than being adequately tackled. One important reason for this is a lack of awareness – something various eye health bodies the world over are hoping to address with their ‘2020’ campaigns.

The time is now.

Plano prides itself on being at the forefront of tackling the myopia epidemic in 2020. We pledge to allocate significant resources to raise awareness about eye health in the community. We are thankful to be in a position where we are able to put eye health on the map especially in countries like Singapore where we are based and where the prevalence of myopia is significant.

Smiles all around!: Happy mummy who signed herself and her son up for a comprehensive eye check using the plano Eyecheck platform at one of our booths in SG

As part of our 2020 campaign, we have already ramped up our efforts to close the loop for eye care service delivery in Singapore with our plano Eyecheck platform. In the last couple of months alone, hundreds of Singaporeans have signed up with the platform to book comprehensive eye checks with Plano’s trusted partner optometrists across the island for themselves and their loved ones.

2020 will also see us channel a significant amount of resources to stepping up our grassroots efforts specifically in raising awareness about eye health and myopia among working adults (plano@work) and school-going children (plano@school) in Singapore.

We must not lose sight of what matters.

In 1999, VISION 2020: The Right to Sight was launched. It sought to promote, “A world in which nobody is needlessly visually impaired, where those with unavoidable vision loss can achieve their full potential.” As we approach the mid-February mark, I urge all of us in the eye health space to ask ourselves: Are we doing all that we can to achieve the shared vision of eradicating avoidable blindness and other vision issues? Until the status quo changes, and we fulfill the world’s right to good vision, we cannot rest and must continue to work together for a better future for the generations to come.

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Fortnite. Facebook. Tinder. Skype. What do these platforms have in common? They have all made it exponentially easier for us to connect with people from virtually all corners of the world. Ironically, while the internet has made us more connected in a practical sense, it has become the ultimate source of a sinister phenomenon that has been sweeping the world: Loneliness.

One would think that with the capacity to connect instantly with anyone with the click of the button, we would feel socially and emotionally fulfilled. But the truth is quite the opposite. These digital connections simply can’t live up to real face-to-face human bonding. There is something missing from the interactions between our digital avatars and the result is that we are feeling more pervasively alienated and isolated than ever before. In fact, one recent study found that nearly half of the American population reported significant levels of loneliness, and the American Psychological Association has declared the loneliness epidemic to be a bigger public health crisis than obesity!

How did we get here?

These days, we see more and more children and teens hunched over their phones, thumbs working furiously to keep up with the pace at which their brains are consuming the slew of online content. For many teens, communication has taken on an avatar form, or an ‘alter ego,’ with a significant amount of their ‘social’ interactions occurring in the virtual world, be it through social media platforms, or multiplayer games. More often than not, they present a fabricated version of themselves through their avatars and consequently, are unable to fully experience what it means to form deep bonds with their peers that stretch beyond a two-dimensional connection.

Screens also hinder our children from practicing their social skills which start to develop from an early age. For instance, a highly problematic behaviour that has become commonplace is the tendency for shy or anxious children to hide behind their screens when they become uncomfortable in social settings. In the long run, with children not consciously working to overcome their discomfort, this type of behaviour will only serve to perpetuate their shyness and social anxiety.

Unlike in the past, children today are not compelled to engage in face-to-face interaction as more and more of their ‘social needs’ are ostensibly met in the virtual world. As our children grow up with an inadequate amount of in-person socialisation with their peers, the development of their social skills is stunted, making it harder for them to make and keep friends, consequently leading to them experiencing loneliness, well into their adulthood. In fact, a recent study revealed that among American adolescents, high screen time and a low frequency of face-to-face interaction were associated with the highest levels of loneliness.

What needs to be done

At the end of the day, we need to confront the uncomfortable reality that an entire generation’s mental health is currently being jeopardised by their obsession with the virtual world.

In order to avoid the pitfalls of an unhealthy relationship with screens, it is our responsibility to instill in our children from a young age the importance of face-to-face communication as well as to provide sufficient opportunities for them to create real-world connections. The benefits of something as simple as putting down their phones and picking up their footballs to play with their friends is grossly underappreciated. Real-world interaction really does have the power to make or break a child’s ability to form deep human connections in the long run, and considering how high the stakes are for their happiness in adulthood, it is crucial to help children to step back into the real world so that they can get the most of life.

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On every bus or train, at every café or restaurant and even while crossing the street or walking on the footpath, we see people looking down, hunched over their smart devices, their necks contorted into unnatural postures while they scroll away, lost in the digital world on their phone screens.

Considering how pervasive this scene is, it should come as no surprise that the incidence of device-related musculoskeletal disorders is on the rise, with some of the most common symptoms being neck and shoulder pain as well as stiffness or pain in the thumb, affecting up to 60% of smartphone users. You might have noticed these symptoms yourself without paying too much attention to them: you sit huddled over your screen for an extended period of time, only to look up and realise your shoulders hurt or your neck has started to feel tight, or your thumb is tender and aching after scrolling through Instagram for a few too many minutes.

These kinds of symptoms are all too easy to dismiss as just normal aches and pains, but they are ignored at your own peril. 

The postures and movements that we engage in when using our devices may actually be causing us serious long-term harm. In fact, these issues are becoming so pervasive and problematic, that ‘text neck’ and ‘smartphone thumb’ are now common terms used to describe them by health care professionals.

‘Text neck’ and ‘smartphone thumb’ 

How do these afflictions develop? The former occurs when device users slouch and bend their heads down and forward during long periods of smart device use. Text neck leads to rounded shoulders, tenderness, stiffness, soreness and weakness in the neck, back and shoulder muscles, as well as reduced neck mobility. ‘Smartphone thumb’ on the other hand is a type of tendinitis caused by the repetitive motion of typing on a flat smartphone screen, which affects the wrist joint and causes pain around the thumb.

How does your posture impact your spine and neck?

Think about how often you stare down at your phone every day. Of these instances how many times do you look at your screen using the correct posture? The degree of neck tilt directly scales with the force applied to the cervical spine, so a poor neck tilt angle and prolonged time in this position may lead to strain and discomfort. 

The figure above illustrates the amount of weight experienced by the neck with respect to the neck tilt angle, i.e. an increase in neck tilt angle leads to higher weight and pressure on the neck, increasing the susceptibility of the neck and spine to pain and abnormalities. Some people may experience temporomandibular joint dysfunction, which is a very painful condition that affects the jaw. The severity and duration of these symptoms may increase with the amount of time spent on smart devices.

The solution?

Practice good posture habits and use these quick ergonomic tricks to ensure that you are using your screens in a healthy way. 

Ultimately, we need to realise that the consequences of excessive screen time are debilitating. As we shift towards an increasingly digitalised world and spend more time on our smart devices, we become naturally inclined to gaze downwards for a prolonged period of time. This behaviour will irrevocably bring with it an array of postural and musculoskeletal problems, which may even cause the wear and tear degeneration of the cervical spine in the long run.

The best way we can address this is to develop a more responsible relationship with our screens and remember that while screens are here to stay, our lives do not have to revolve around them. In fact, we need to wake up to the fact that our unhealthy obsession with our screens are at the heart of our productivity and health problems and address them immediately!

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Plano was developed with a clear purpose; to save sight and empower lives. With a culture of disruptive thinking grounded in real scientific research, Plano promotes the use of innovative technology to provide a solution to help mitigate the public health, societal and economic issues posed by excessive device usage.

The Ecosystem

Plano’s ecosystem comprises of the parental management and eye health application (plano app), an E-commerce directory for device free activities (plano Shop), an online optometry service delivery platform (plano Eyecheck), an online platform that raises awareness on the amount of time that people are spending on smart devices (Plano Time Machine), school outreach programmes (plano@school), workplace consultancy services (plano@work), a bestselling children’s book series (The Plano Adventures) and Big Data analytics.

plano Application

The plano application was developed to address the rising issue of unhealthy smart device use in children and to assist parents to cultivate healthy eye care habits in children. As the world’s first science-based eye health app with the Singapore government’s support and affiliations with scientific institutions (SNEC and SERI), plano combines a suite of child safety functions and science-based features that help modify behaviour in children to reduce myopia related risk factors, such as excessive near work and lack of outdoor activity, and empower healthier device usage in children. 

App Features

The app runs in the background of smart devices, sending friendly alerts and reminders that recommend good eye care practices, including optimal face-to-screen distance, proper device use posture, spectacle detection and for children to take timely eye breaks. The app also reminds parents on when to take their children for regular and timely comprehensive eye examinations according to the recommended national guidelines. Smart algorithms are utilised to generate detailed digital eye health progress reports that inform parents on their children’s device use behaviour and eye health on a weekly basis. *For the full list of parental management and vision health smart features, visit https://www.plano.co/plano-app/

plano Shop: Points based rewards system

The plano Shop is a unique aspect of the plano app that aims to foster healthy device use and encourage outdoor activity in children through a points based rewards system. Children earn plano pointsby following and complying with the in-app reminders. With these points, children can request for exclusive device-free activities available in the plano Shop, which parents can approve and purchase through the plano app as well. The in-app rewards platform reinforces children’s good device use and eye health practices and empowers them to take the initiative in their own vision care journey through fostering a love for device-free activities.

Pricing

The app uses a freemium model – it is free to download and use, with a subscription fee of S$29.98/year if parents wish to subscribe to its premium functions. Parents can also subscribe to the Clear Vision Kit bundles. These bundles tie in the premium version of the app with The Plano Adventures book series (The Learning Bundle) or rewards from the plano Shop (The Activity Bundle) for S$29.98/year. *The Clear Vision Kit is currently only available in Singapore.

plano Eyecheck

Plano’s newly launched product, plano Eyecheck, was developed to address the global blind spot in eye care which is the under-utilisation of eye care services, delayed diagnosis and the lack of preventative management in eye care. plano Eyecheck is an easy-to-use, patient-centered online platform that connects users to their nearest optometrist and allows them to book comprehensive eye checks for themselves and their children, and better manage their eye health and myopia. Existing plano app users will be able to use the plano Eyecheck service directly as it is seamlessly integrated with the plano app, which allows them to book and amend appointments as well as record and track their children’s eye health information all within the plano app.

It is believed that plano Eyecheck will help to close the loop for eye care service delivery in Singapore and in the near future, globally. With a variety of major optometry partners including Videre, Nanyang Optical and W Optics onboard, Plano aims to get families with children from as young as 6 months old into the eye care system, even for children who do not have perceived vision problems. Early detection and intervention are key in addressing problems before they deteriorate unnecessarily. *plano Eyecheck is currently only available in Singapore.

Plano Time Machine

Plano Time Machine is Plano’s latest and most innovative development. Using the latest scientific research and data which is inputted by the user, Time Machine is an online experience that provides users with insight on how their tiny screens are impacting their lives significantly. Time Machine informs each user about the time lost on their screens over their lifetime and makes recommendations on how they can develop a healthier relationship with their devices. With over 2000 surveys already completed within a week of its launch, Time Machine is establishing itself to be one of Plano’s greatest scientific and data-driven development.

plano@school

Plano is aligned with the Health Promotion Board in Singapore and presents to all primary schools across the nation about myopia and how to mitigate it, as well as the basic anatomy and optics of the eye. These talks aim to empower children across the island with the knowledge of how to properly take care of their eyes from an early age.

plano@work

Plano is ramping up efforts to bring vision health to companies and industries across Singapore. The plano@work consultancy programme educates corporates on responsible device use and eye health management at the workplace. As part of the programme, staff-training on methods to improve work productivity and job satisfaction through good eye care habits and responsible device use will also be provided, along with evidence-based recommendations to achieve a vision-friendly workplace.

The Plano Adventures series

The Plano Adventures is a bestselling children’s book series which has been featured on The Straits Times bestseller’s list. Out of Order, the 5th book in the series has also been nominated for the Popular Reader’s Choice Award. Singaporeans and Permanent Residents can vote for it here. These early chapter books take young readers on the adventures of Professor Plano as he defeats Lord Myopic with the help of his adorable twin sidekicks. Each book in the series is grounded in scientific research and was written to empower children to tackle the adverse effects of excessive device use. These include myopia, cyber bullying, and screen and gaming addiction.

10,000 copies of the books have been sold in Singapore alone. The books are sold in all major bookstores in the United Kingdom, United States, Australia and Singapore and will be available in China soon. They are also available for online orders in Singapore on The Plano Shop, and worldwide on AmazonBook Depository and Marshall Cavendish.

Big Data

Plano’s long-term objectives are to develop interventions to reduce the onset and slow the progression of myopia in children worldwide. Building the world’s largest repository of myopia-related data and quantifying the prevalence, incidence and progression of myopia and high myopia, and the contribution of behavioural risk factors associated with these processes will provide the knowledge base on which future interventions for myopia are being developed. These findings and interventions will better inform our understanding of the epidemiology and risk factors of myopia and will be used to guide specifically-tailored awareness campaigns on eye health and smart device use behaviour in children globally.

The journey so far

Plano’s journey first began in the Singapore Eye Research Institute (SERI) – Singapore National Eye Centre (SNEC) Incubator programme. From the app’s humble beginnings in Singapore, the team’s passion and vision has not only propelled the plano app to launch worldwide (over 1 million downloads), it has enabled the creation of an entire ecosystem; a comprehensive solution to excessive device use. We believe that this ecosystem is the answer to keeping all eyes healthy in this digital world, and as a company, we welcome government and industry partnerships.

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To coincide with the recent launch of our brand-new smart optometry referral system, plano Eyecheck, we would like to provide you with guidance on how often you and your loved ones should get your eyes checked.

There is a lot of confusion, uncertainty and outright lack of awareness around the question of eye examination frequency. There is a tendency for many people to neglect their eyes because they do not experience noticeable problems with their vision and because they are simply too busy to set aside the time. Many of us do not actually know how often people at different life stages should get their eyes examined. In fact, there currently is not even consensus among experts internationally, with governments and ophthalmological and optometric organisations frequently differing in their guidelines, and some countries do not even have official guidelines. This makes it difficult for members of the public to find authoritative information on how to stay on top of their eye health.

With that said, experts agree that regular and timely eye examinations are important for people of all ages, and that includes people who have not been diagnosed with an eye condition. Some eye diseases can strike at any time and their onset and progression may go unnoticed for many years as they silently wreak havoc on the health of your eyes. For this reason, we believe it is important to raise awareness about the necessity of getting eye exams throughout your life so that long-term problems such as vision impairment and blindness can be avoided.

This general guide provides an idea of how regularly you and your loved ones should get your eyes tested at different stages of life and what the greatest risks are to your eye health at each of these life stages.

Infants and children under 2 years of age:

It is often recommended that infants have their first eye examination before they reach 2 years of age, preferably between 6 – 12 months of age. The Singapore health authority, SingHealth, also recommends that children in this age group, even up to 3 years old, should have their eyes screened during regular paediatric appointments. Children this young cannot cooperate with eye exams that use vision charts so techniques called auto-refraction or retinoscopy are used. The paediatrician may refer for further eye testing if the mother had complications during labour or pregnancy, if there is a family history of congenital cataracts, amblyopia, strabismus, very high refractive error or retinoblastoma or if any of the following conditions are detected:

  • strabismus (crossed eyes)
  • amblyopia (lazy eye)
  • congenital cataracts
  • a rare cancer called retinoblastoma
  • developmental delay

Children aged 2 to 5 years

The American Optometric Association recommends that children should have their eyes examined at least once between the ages of 3 and 5 years. Some children in this age group can comply with eye examinations that use age-appropriate vision charts. This should be performed by an optometrist or ophthalmologist and not by your regular paediatrician. Young children fine-tune their vision and use it to learn, develop hand-eye-coordination and play. It is therefore critical to ensure their vision is functioning normally. As children become glued to screens at younger ages, it is now more important than ever to make sure that their eyes are examined regularly as their risk of conditions such as myopia is higher than any other time in history.

Children aged 5 years and older

From the age of 5 years and onwards, children should have their eyes tested upon first entering school and then those with no previous issues should have their eyes examined at least every 2 years, while those with a refractive problem like myopia should be checked annually. Some experts even suggest that all children, irrespective of whether they have an eye condition, should get tested annually as this is the age at which myopia typically begins to develop. School age children need frequent eye tests because their prescription can change very rapidly during this time.

If you or your child’s teacher notice that your child is positioning herself closer to televisions, computers and classroom whiteboards, squinting to see distant objects more clearly or complaining of vision problems, it is important to have an eye examination as soon as possible. 

Myopia is becoming more common in children of younger ages, but many people do not know that the progression of myopia can actually be slowed down if it is detected early and managed correctly. For those whose prescription changes regularly, it is important to change their glasses or contact lenses to keep up with their changing eyesight.

Young adults

Many governments and eye health organisations do not have well-defined guidelines for eye examinations for people aged 18-39 years as any myopia is likely to have stabilised and the risk of blinding eye disease is low. However, the American Optometric Association still recommends an eye examination every 2 years. People with pre-existing eye diseases and those at risk, such as diabetics or people with high blood pressure should go more regularly.

Adults aged 40 years and above

Adults should get an eye disease screening at the age of 40 years because this is when the risk of age-related eye diseases begins to increase. Common eye diseases that are tested for are glaucoma, diabetic eye disease and cataracts. Catching these diseases early provides the best chance of preventing irreversible blindness, so it is very important to have this test. The screening test can also reveal systemic diseases such as diabetes and high blood pressure. Once the baseline screening is done at 40 years old, you should return for an eye examination approximately every 2 years or for follow-up according to the advice from your doctor.

An additional matter to consider is that, beginning in their 40’s, adults may start facing problems with seeing objects at close distances. This progresses with time and one should seek an immediate examination to get prescribed appropriate reading, bifocal or multifocal glasses.

Adults aged 65 years and above 

Seniors have the highest risk of vision impairment and blindness. Advanced eye disease, including cataract, diabetic eye disease, glaucoma and age-related macular degeneration become much more common as you get older, and it is therefore crucial to have an eye examination every 1-2 years.

Book your next eye test today

With this information, it should be clearer when you and your loved ones should get your eyes examined to protect vision which, after all, is one of life’s most precious gifts. If you live in Singapore, use our new plano Eyecheck smart optometry system to book an appointment with one of our trusted partner optometrists today.

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Macular degeneration, retinal detachment, glaucoma and cataract and other sight-threatening diseases are associated with high myopia. They can creep up on you and may eventually lead to irreversible blindness even if glasses or contact lenses are used or if surgery is performed.

Currently, 5-6% of people, or almost 400 million people, have high myopia. What’s truly alarming is that this statistic is expected to triple by the year 2050. The global cost to healthcare systems of myopia correction is at an all-time high, estimated at US$328 billion, and this is further exacerbated by the increase in the prevalence of high myopia. On an individual level, those with myopia, especially high myopia likely experience a reduced quality of life due to the psychological, societal and financial strains, among others.

What exactly is high myopia and why does it need to be on our radar?

Myopia is classified into 3 main types based on severity:

• Low myopia: -0.50D to -2.99D

• Moderate myopia: -3.00D to -5.99D

• High myopia: -6.00D or greater

Around 12% of those with myopia develop high myopia. The majority with low or moderate myopia usually do not develop further problems with their eyes and their vision can usually be corrected with spectacles, contact lenses or surgery. People with high myopia are at a much greater risk of developing serious complications because of the more extreme elongation of their eyes, and this is known as pathological or degenerative myopia. In such cases, even if glasses or contact lenses are used or if surgery is performed, irreversible blindness may be a real possibility.

The blinding conditions that can occur due to high myopia:

1. Myopic macular degeneration

Myopic macular degeneration occurs when the elongation of the eye causes stretching and degeneration of the retina and irreversible blindness. It is the most common blinding complication of high myopia.

2. Retinal detachment

If the retina is stretched too much, it may pull away from the underlying layer, causing irreversible blindness if not treated quickly.

3. Glaucoma

Glaucoma is a disease in which the nerves at the back of the eye gradually die.

4. Cataract

Cataract is the clouding of the crystalline lens in the eye. Cataracts in those with high myopia tend to be very dense.

Giving our eyes the due protection they deserve

The reason why high myopia creeps up on us is largely, neglect. It is lamentable that our eyes remain one of our most neglected organs, despite the long-term risks associated with myopia progression, one of which is high myopia. More than half of children who develop myopia before 7 years old develop high myopia. As such, early intervention is key and it is the best chance we have to prevent high myopia. In fact, children need to start going for regular comprehensive eye check-ups from as young as 6 months of age so that myopia can be detected early and the progression of myopia can be slowed. 

While the world is waking up to the problem of myopia and myopia progression, there is still a global blind spot in eye care that we at Plano aim to address – the under-utilisation of eye care services, delayed diagnosis and lack of preventative management in eye care. That’s exactly why we developed and launched plano Eyecheck

Getting children into the eye care system early needs to be a national priority. More importantly, we need to work together to get those who have never seen an optometrist or eye doctor for a comprehensive eye check-up into the eye care system. It is only then we can hope to change the status quo and eradicate the myopia epidemic and associated issues of high myopia altogether.

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The cornerstone of the traditional Singaporean route to success has typically been education, as parents instill the value of studying hard in their children. Generations of parents, influenced by their own families, have cultivated a mindset of success defined by studies. It sounds like a good thing, but there’s a flip-side – overly competitive environments. Children are pressured to work hard and spend more time on homework and in front of devices and computers. The benefits of this hard work to our children and to our society are clear, but is there a negative impact of these long hours spent studying?

The answer is most likely a yes. Excessive near work is a well-defined risk factor for the development of Myopia, or short-sightedness, and the problem is bigger than you may think. Myopia has become a global epidemic, affecting more than 2 billion people, and in Singapore, more than 10% of children already have myopia by the time they leave pre-school. Rates reach 50% by primary school, and soar to 80% by the end of secondary school. 

With the high prevalence of myopia in our schooling children, parents should be majorly concerned. Yet, many easily treat short-sightedness as an almost inevitable effect of working hard in our education. However, research shows that this problem is caused by the environment that our children grow up in. Having lived in Singapore for many years myself, I have seen how urbanisation and education pressures force our children to spend too much time indoors on books and technological devices like smartphones and computers. This takes away precious time kids spend outdoors playing.

It’s possible to manage and even slow the onset of myopia in children, even as they excel in their studies. One of the ways to do this is exceedingly simple – by obtaining a healthy balance between near work and outdoor time.

The government has made some efforts to tackle the problem with programs like Kids for Nature, the Programme for Active Learning, and the National Myopia Prevention Programme. However, as parents, we can do more. We are integral in preventing or stalling the development of myopia in children as early as possible. Ensuring healthy device usage is paramount to protecting children’s eyesight.

It’s almost impossible, however, to be able to monitor your child’s device usage all the time. A parental control app comes in very handy, as you can ensure that your child takes regular eye breaks without having to be physically present. Our Singapore-based health tech company has developed plano, a health application to do just this. Your child can also be empowered to take active steps to protect his or her own eyes. 

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What comes to mind when you think of a ‘nerd’? The stereotypical image of an awkward whiz pushing up a pair of spectacles sliding down his or her nose, buried in a book may arise. It’s hard to imagine a nerd without glasses. The perception played out in TV shows and movies for years that spectacle wearers are bookish and introverted has carried over to real life. But are people who wear glasses really more likely to be nerds or is this just a myth?

It turns out that this idea may have some basis in science. Glasses are often worn to correct a condition called myopia, or short-sightedness. Myopia can be blamed on the fact that people are spending less time outside and more time reading, writing and using technology, which is viewed as typical nerd behaviour. And there is some consolation for glasses-wearers – myopia has been linked to higher intelligence or IQ, according to at least ten studies done.

The link between myopia and nerdiness seems to be well-established, until personality factors are brought into the picture. In a study that I co-authored in Melbourne, findings showed no link between myopia and typical nerdy personality traits like introversion and conscientiousness. Intelligence is not equitable with introversion and shyness. In fact, it’s suggested that the common misperception that intelligent people have nerdy personalities results in the perception that people with glasses are geeky.

But in Singapore, where myopia rates are sky high, wearing spectacles is often viewed as an indicator of how hardworking you are! It is normal for glasses-wearing students to be deemed as “bookish” or “studious”. The trade-off between clear vision and working hard in school seems to be an accepted fact of life – the strain you put on your eyes is a result of the countless hours spent on your books and work.

However, our health is of utmost importance. The development of myopia should be of high concern and not viewed as a “normal side-effect” of working hard. By 2050, almost half of the world’s population, or 5 billion people, will have myopia. Approximately 1 in 5 of those with myopia will develop high myopia, which can lead to sight-threatening conditions such as retinal detachments and glaucoma. Failing to address this problem early, can increase your risk of developing this more severe form of myopia.

This may not even be necessary if the onset of myopia is slowed. To manage myopia, children need to spend more time outside from an early age, and have regular and timely comprehensive eye tests by trained eye professionals. To encourage this, our Singapore-based health tech company has developed plano, an application that helps parents manage their children’s screen time. Outdoor activity can be encouraged during family bonding time, by keeping track and controlling your child’s device usage, whether they are “nerds” or not.

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As the world wakes up to the extent of the worsening global myopia epidemic and public scrutiny of the problem intensifies, most of the focus on myopia has fallen on Asian populations, particularly in Singapore, Hong Kong, South Korea and Taiwan. And for good reason. The prevalence is now as high as 80 – 90% in teenagers finishing secondary school in those countries. In fact, one study reported that as many as 97% of young men in South Korea now have myopia.

It is not surprising then that the growing global conversation around myopia and its social and economic consequences, as well as the majority of myopia research, has been concentrated in Asian countries. Indeed, the majority of the high-quality myopia research in recent decades has been coming out of institutes in Singapore and China.

However, a consequence is that there seems to be a general tendency to conceptualise myopia as primarily an Asian problem, and we often tend to forget that, although developed parts of Asia have been hardest hit by the myopia crisis, this is a growing global epidemic that affects people everywhere.

Myopia does not discriminate – it affects people of all walks of life in every country. In the United States, the prevalence of myopia has doubled in the last 30 years and among children in the United Kingdom, it has more than doubled in the last 50 years. And this trend is showing no signs of abating as it quietly sweeps other parts of the world. Without question, the implications of the global increases in myopia are severe – On top of the billions of dollars lost in productivity, the cost to healthcare of managing and preventing sight-threatening complications and vision loss are dauntingly high.

To understand why the rest of the world needs to take notice of this problem now, we need only consider why the prevalence of myopia is so high in certain parts of Asia. Environmental risk factors including lack of time spent outdoors during childhood, too much time spent on near work activities such as reading, excessive screen time and urbanisation are the key drivers of Asia’s myopia problem. This is supported by the fact that children of Chinese ethnicity in Australia spend 14 hours a week outdoors and their prevalence of myopia is 9 times lower than Chinese ethnicity children in Singapore who spend just 3 hours outdoors.

The conclusion is that the only thing standing in the way of the rest of the world having a myopia prevalence as high as that of Singapore is lifestyle, and research has shown that children around the world are spending less time outdoors and more time glued to their device screens. For example, in the US, 73% of the population will own a smartphone by 2021, and teenagers are spending up to 7 hours per day on their screens. We are therefore likely to see a myopia boom in coming years.

One recent highly cited paper estimated that the prevalence of myopia will increase in every single major world region between now and 2050, including in regions not previously associated with myopia. For example, Latin America will have a prevalence of 54%, while North America will approach Asia, with a prevalence of almost 60%.

In order to prevent this grim future from eventuating, we need to take action now. Awareness campaigns about the dangers of excessive screen time and insufficient outdoor time should be launched around the world and parents and children need to be educated and empowered with the necessary tools to mitigate risks from early childhood.

Plano has already been launched in 8 countries, both in and out of Asia. We are currently helping parents to protect their children from myopia in Australia and the United States, and we look forward to entering European markets and further abroad.

As Plano becomes more popular among children and their parents in countries outside of Asia, we will truly be putting myopia on the map.

We believe in harnessing the power of technology to alleviate the effects of myopia. We are happy to say that we are now in a very good position to assess these associations using the world’s largest cohort developed at Plano. Our doors are now open to industry, research institutes and universities in and out of Asia for contract research.

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There can be no keener revelation of a society’s soul than the way in which it treats its children.

Nelson Mandela

Although the former revolutionary spoke these words in 1995, they still hold true in this digital age. 

Arguably, above all else, raising a child ‘right’ hinges on how committed parents are to give their child the best environment to grow up in.

However, parents need to remember that they are not alone in raising the next generation of movers, shakers and change makers; it takes an entire network of support to ensure they remain protected and healthy, especially in this digital age. What exactly constitutes this ecosystem?

1. A healthy home environment

Technology is a wonderful thing – it is helping an entire generation of children connect to and interact with the vast world around them, in ways in which we couldn’t even begin to imagine in our childhoods. However, as with all good things in life, too much of it is harmful. Excessive device use has spawned several mental and physical health consequences among children worldwide, including myopia (short-sightedness), device dependency and screen and gaming addiction.

In fact, the problem has become so pronounced that the World Health Organisation (WHO) has recently acknowledged gaming disorder as an official mental health condition. An estimated 5% of adolescents now match the profile for a diagnosis of gaming disorder.

Proactivity is key when it comes to helping children develop a healthier relationship with their screens. Setting house rules and communicating why these rules need to be followed is an important way to cultivate healthy device habits. These rules include, device-free time blocks, restrictions on online activity to certain child-appropriate applications and websites and getting parental consent before making any purchases or inputting any personal information online. 

Having an open communication channel and building a relationship on the foundation of trust and support is crucial. Actively looking out for signs of addiction, cyberbullying and more are important measures to ensure that these issues do not escalate.

2. An active friend circle

Early-childhood friendships are an essential part of children’s development, in more ways than one. Not only do friendships create the foundation for their social interactions for years to come, they impact their health.

Children with more active friends are likely influenced to engage in physical activity primarily due to lowered ‘barriers’ such as feeling self-conscious and having the energy and/or self-discipline to participate in such activities.

More time spent having face-to-face interactions with friends ultimately moves children away from their screens. A healthy way they can spend their time is through outdoor play. Going outdoors has a profound impact on their overall wellbeing – and this includes their eye health.

A lack of time spent outdoors is one of the environmental risk factors of myopia and serves as an important reason why the global myopia epidemic is quietly and swiftly sweeping the world. One of the main ways we can ameliorate this daunting phenomenon is by encouraging our children to ditch their screens for the great outdoors with their friends. 

3. The Experts: Keeping children healthy

Regular medical and dental check-ups are important for a healthy body. Parents should also remember to bring their children to regular and timely comprehensive eye checks. Unfortunately, the eyes are rarely given the due protection they deserve. 

Getting them into the eye care system from as early as 6 months of age is essential for early diagnosis and identifying vision problems, which is a huge step in preventing the progression of myopia. 

The global blind spot in eye care, which is the under-utilisation of eye care services, delayed diagnosis and the lack of preventative management in eye care, needs to be addressed. Our data reveals that even in developed countries like the US, among children aged 2 to 14 years old, only 38.6% have ever gotten their eyes checked at an optometrist or eye doctor. 

That’s exactly why we’ve developed plano Eyecheck, an affordable, easy-to-use, patient-centred online platform – to help close the loop for eye care service delivery both in Singapore and in the near future, the world. It is especially necessary in this digital age for our children to get into the eye health system and give their eyes the due protection they deserve.The status quo is simply not acceptable!

It takes a village!

As the old African adage goes, “It takes a village to raise a child.” Indeed, in this digital age, our children need a healthy ecosystem of support not only from parents, but their peers and health experts. Our collaborative effort in monitoring their development will enable them to experience all that our vast world has to offer while remaining protected and healthy. Remember, children are the future, so let’s set them up for success from an early age!

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