Why is myopia on the rise? And why is it an issue? What’s wrong with needing glasses?

Myopia Management

Dr. Yocheved Shira Kresch

When I was in fifth grade, I was overjoyed when I failed my vision screening at school. I needed  glasses!

But it doesn’t usually stop there. Often, a prescription will continue to climb year after year, finally stabilizing sometime after high school.

Myopia is the technical term for nearsightedness, which means that you can see what's nearby without glasses, but need glasses to see the board, drive, play sports, etc. The World Health Organization (WHO) recognizes myopia as a “significant public health concern” and emphasizes that it’s on an alarming rise specifically among children and adolescents.

Why is it on the rise? And why is it an issue? What’s wrong with needing glasses?

Once a prescription reaches a -5.00 and higher, the risk of eye disease increases significantly. This is because the eye’s structures are literally being stretched thin, which can lead to a host of problems later on down the line. Retinal tears, retina detachments, myopic maculopathy, glaucoma, early cataracts, and a host of other vision issues are much more likely in people who have high myopia. These can be visually debilitating. It doesn’t mean these will happen; there are many people who live with these risks and nothing ever happens. However, since the risk is much higher, people with these prescriptions need to be monitored carefully.

The lifestyle we live today has caused an enormous uptick in myopia. In 2020, an estimated 30 percent of the world was myopic. By 2050, it is estimated that at least half the world will be myopic. Causes for this increase include an increase in near work, such as reading and looking at a screen, and a decrease in outdoor activities. Having myopic parents, as well as other genetic and environmental factors, can also contribute to the likeliness you’ll be diagnosed with myopia.

Interestingly, in early myopia studies, the primary group studied was young, frum boys who studied Talmud for a dozen hours a day. In fact, a 2019 survey of over 20,000 Israeli Jewish 17-year-old boys showed the prevalence of myopia was 82.2 percent among chareidim, 50.3 percent among datiim, and 29.7 percent among chilonim.

Now, with the increase in the amount of screen time in young kids, as well as academic pressures, the rest of the world’s numbers are going up as well, putting kids at a higher risk of having myopia earlier than ever before. On the flip side, limiting screen time and spending time outdoors can be very beneficial for preventing and slowing myopia's progression.

Today, in 2024, we can slow down myopia's progression. While working at Columbia University’s Department of Ophthalmology, I spearheaded the launch of their first myopia control clinic utilizing evidence-based methods. I’ve been utilizing these practices in my clinic since then, and while they’re not a guarantee, these methods work for many children. There are three forms of treatments: peripheral defocus glasses, contact lenses (orthokeratology or soft multifocals), and compounded dilute atropine eye drops. Most of the forms of treatment are still considered “off-label,” meaning they’re FDA approved for purposes other than myopia management. If you have a child diagnosed with myopia or whose prescription continues to climb, instead of just changing their glasses prescription at every visit, ask your doctor about these options.

Dr. Yocheved Shira Kresch is an optometrist who is currently Assistant Clinical Professor of Ophthalmology at Wayne State University School of Medicine and practice owner of Michigan Contact Lens.

Subtle Sabotage

Abby Delouya

Passive-aggression is a way of expressing negative feelings such as resentment, frustration, anger, hurt, or annoyance indirectly instead of directly. It’s designed to hurt, belittle, or confuse people. The most common signs are refusing to discuss concerns directly, avoiding responsibility, and being deliberately inefficient. Giving the silent treatment or a backhanded compliment are also passive-aggressive ways to get the point across and can subtly sabotage others.

A passive-aggressive mode of communication may stem from underlying anger, sadness, or insecurity. This behavior may be due to fear or avoidance of confrontation, and be modeled on patterns of communication in someone’s childhood home. It may even be subconscious.

The best strategy for dealing with passive-aggressive behavior is by calmly and directly addressing the situation at hand:

“No, really, it’s okay. I don’t need your help. I’ve only been on my feet all day without five minutes to myself. But I’m fine,” she says with a martyr-like sigh.

“It sounds to me like you have been working all day and need a break,” he says with a kind smile.

Hopefully, by setting clear expectations of communication in relationships and responding directly, the person who struggles with passive-aggression will feel less threatened and possibly more understood. If, over time, responding clearly and redirecting kindly is not effective, then calmly explain how the behavior makes you feel: “I really want to be there for you, but it’s difficult and frustrating for me when you send mixed messages or don’t share what you’re actually feeling.”

Over time, passive-aggression can cause significant hurt and stress in a relationship. Ultimately, pretending nothing is wrong when something is wrong in a relationship will rarely — if ever — lead to the preferred outcome. As uncomfortable or stressful as it may seem, sharing difficult feelings and needs honestly and directly fosters closeness, authenticity, and trust.

Abby Delouya, RMFT-CCC, CPTT, is a licensed marriage and family therapist in private practice, specializing in trauma and addiction. Abby is also the COO and Director of Intake of Ray of Hope.

The Confusion around Consent

Shoshana Schwartz

When both individuals in a relationship seem to be in constant agreement, there’s a good chance that only one person is actually making the decisions. Reaching a consensus should ideally come from a balanced give-and-take, not from one partner consistently dominating the other.

This imbalance may indicate that the silent or agreeing partner lacks self-esteem or confidence, feels undervalued, or chronically avoids conflict. Such skewed dynamics not only stifle the exchange of ideas, but also prevent both partners from bringing their true selves to the relationship.

Healthy relationships thrive when both parties actively contribute their viewpoints, work through disagreements, and demonstrate healthy respect for themselves and each other. This environment fosters genuine agreement through mutual understanding and respect, which is essential for a truly healthy partnership.

Shoshana Schwartz specializes in compulsive eating, codependency, and addictive behaviors.

(Originally featured in Family First, Issue 899)