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From reading books to increased smart device screen time
  1. Mohamed Dirani1,2,
  2. Jonathan G Crowston2,3,4,
  3. Tien Y Wong1,2
  1. 1 Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
  2. 2 Plano Pte Ltd, Singapore, Singapore
  3. 3 Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital & Melbourne, Melbourne, Victoria, Australia
  4. 4 Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
  1. Correspondence to Tien Y Wong, Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore; wong.tien.yin{at}

Statistics from

The number of people with myopia is expected to rise from 1.950 billion in 2010 to 4.758 billion by 2050.1 In Asia, the prevalence of myopia in teenagers has been reported to be as high as 96.5%.2 One study demonstrated that 11% of Singaporean preschoolers were already myopic, placing them at a significantly higher risk of developing high myopia and myopic macular degeneration.3 This myopia ‘epidemic’ has become a profound public health concern. In Singapore, the direct cost of managing myopia was estimated at US$755 million annually, and globally at US$328 billion per year.4

It is now thought that because of the rapid increase in the prevalence of myopia in under one generation, environmental factors perhaps play a greater role in its development than our genes. Environmental risk factors include urbanisation, higher educational attainment, higher IQ, but more important has been two consistent risk factors: increased near-work activity and reduced outdoor activity.5

Studies often quantify near-work activity by the number of books …

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