Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
28 Jun

Seeing the Light: Why Sun Exposure May Be Good for Your Eyes

Having immersed myself in all things Primal for so long, I find myself viewing nearly everything through the prism of human evolution. Is this food, activity, environmental stimulus, or social more an evolutionary novelty? If so, might it possibly conflict with or impede our pursuit of good health? Is it benign? An improvement, even?

Grok logic will only get you so far. It’ll give you a nudge in the right direction – that is, headed straight to honest inquiry and further research – but it’s not enough. You shouldn’t rest on your laurels if Grok logic suggests what you’re doing is right, and you shouldn’t make big changes just because Grok logic suggests you’re doing something wrong. Instead, use those insights to generate hypotheses, then try to explore them. Research, read, ask more questions. At least, that’s what I try to do. It’s awfully tempting to just go with conjecture (especially if it turns out to be right on a fairly regular basis!).

That little preamble was just my way of setting up yet another question with roots in evolutionary conjecture: does the avoidance of sunlight via indoor living, sunglasses, and general heliophobia have an impact on eyesight, and more specifically nearsightnedness? Going purely by Grok logic and what we know about sunlight’s interaction with other aspects of our health, I think it’s a reasonable question. To whit:

Sunlight and skin – Sunlight exposure is required for vitamin D synthesis. When UVB hits our exposed skin, vitamin D is synthesized and distributed throughout our body. Vitamin D is an essential pro-hormone, necessary for musculoskeletal health, immune system robustness, as well as protection from heart disease and cancer.

Sunlight and circadian rhythm – We need exposure to light at certain times of the day in order to regulate our circadian rhythms. Without daytime/morning light, or with too much evening light, our internal clocks – and general health – go awry.

Given those two extremely basic, widely-accepted interactions between sunlight and our bodies, coupled with the fact that the eye’s express function is to interact directly with light, I think Grok logic regarding the sun and our eye health might be onto something. But we can’t be sure, remember, without confirming through other sources.

So let’s look into those other sources.

I’m sure you’ve heard of myopia. You may have it yourself or know someone who does. In case you don’t, myopia is nearsightedness, which is characterized by blurry vision when looking at distant objects. If it weren’t so easily countered with prescription eyeglasses, myopia would probably be classified as a public health epidemic. It’s that common, and it’s getting worse.

In fact, the latest statistics indicate that 41.6% of Americans aged 12-54 suffer from myopia, way up from 25% in the early 1970s. That’s an awfully big percentage of the tribe that can’t throw a spear, shoot an arrow, spot prey, or see the enemy coming from afar. That’s a ton of squinters who require assistance. In other words, if myopia were just an unfortunate part of growing old (to the ripe old age of 12!), we probably wouldn’t have made it this long.

No, there’s probably an environmental component to the rise of myopia. Genetics could play a part in determining susceptibility to myopia, and probably do, but an environmental factor is likely to be a trigger for the “myopia gene’s” expression. Could sunlight be just such an environmental factor?

Kathryn Rose, a visual disorder researcher, thinks so. First, she points to the weak or inconsistent epidemiology that attempts to link time spent on the computer, watching television, reading, and studying to the development of myopia, instead suggesting that the real problem is lack of sunlight. In cases where digital media usage or inside work appears to be associated with myopia, Rose thinks it’s actually a measure of displaced outdoor time.

Then she points toward the epidemiology exploring the link between time spent outdoors and myopia prevention, which is much stronger. Let’s take a look at a few studies:

In Chinese school children, myopia progression was inversely correlated with outdoor activity.

Near work (studying, reading) did not correlate with myopia progression, but American kids who played fewer sports outdoors had more myopia.

In Taiwanese rural children, outdoor activities might be “an important protecting factor for myopia.”

In teens from Singapore, outdoor activity appeared to protect against myopia progression.

Parental myopia status interacts with risk, too, though. In one study, kids with two myopic parents were at the greatest risk of developing myopia themselves, more so if they did not engage in outdoor sports. Kids with no myopic parents and who played a lot of sports outside had the lowest risk. Genetic predisposition expressed by an environmental trigger, anyone?

Of course, any good Primal thinker knows that epidemiology, like Grok logic, only goes so far. It’s certainly interesting, and it can inspire new avenues of inquiry, but science cannot live on epidemiology alone. You need something else to look into, like perhaps a physiological mechanism. Rose’s proposed mechanism was retinal dopamine, a “known stimulator of eye growth whose release is stimulated by light.” A lack of retinal dopamine – from avoiding the outdoors – means excessive eye growth. This is bad, for the eye is a delicate, extremely complex structure with many components, and a lot can go wrong if those components grow faster and bigger than they’re supposed to grow. Like the progression of myopia, which is characterized by excessive eye growth.

But wait – isn’t excessive amounts of light one of the big issues with modern living? Even if we stay indoors most of the day working, browsing, or watching TV, we’re still parked in front of a screen beaming light into our eyes and we’re still immersed in artificial overhead lighting. If all that light is enough to disrupt our circadian rhythms and ruin our sleep patterns, why isn’t it enough to stimulate retinal dopamine release?

It’s the magnitude. Try looking up at the sun in the afternoon. I mean really give it a good, long look. You can’t do it (in fact, that is definitely bad for your eyesight!) for more than a second or two, tops. If you squint, you might make three. Now try the same with an illuminated lightbulb. It’s easy and nearly painless. It doesn’t compare. To quantify the massive gulf between sunlight and artificial light, let’s look at another study. Researchers trying to study the link between light exposure and myopia exposed chicks to various amounts of light. Normal laboratory lighting was 500 lux, “intense” laboratory lighting was 15,000 lux, and sunlight was 30,000 lux. Only intense lab light and sunlight were able to retard the development of myopia, while normal lab lighting – which is still quite bright and very similar to standard office lighting conditions – did not adequately protect. Oh, and good news for you sunglass wearers: the chicks who were continuously exposed to bright lighting while wearing “translucent diffusers” also showed resistance to eye lengthening and myopia.

To get an idea of how many lux you can expect to “get” in various situations, check out the Wikipedia article on the subject. Prepare to marvel at the insane brightness of the outdoors and the comparatively piddling illumination found indoors. Note that direct sunlight is ridiculously bright (up to 130,000 lux), while just being outside in “full daylight” will provide plenty of light for your retinal dopamine labs. No need to stare at the sun or avoid dark forests. Just be outdoors and the sun will take care of the rest. If you can see stuff, that means light is getting to your eyes, it’s from the sun (and thus bright enough) and you’re good to go.

Of course, us oldsters might be too far gone for sunlight to have an effect on nearsightedness. Myopia develops early (hence the inclusion of 12 year-olds in myopia statistics), so it’s absolutely crucial that kids get plenty of time outdoors. I’d say “as much as possible,” but if you want a specific number, Kathryn Rose suggests between 10-14 hours a week as a bare minimum. Barring that, I suppose you could blast your toddler in the face with a halogen bulb every couple hours. No, but really: let those kids get outside, get dirty, play with bugs, climb stuff, and get some sun. Although the chick study showed that sunglasses may not be problematic, I don’t think kids need ’em, and they might still interfere with normal eye development. They’d just fall off, anyway, unless you hooked the kid up with some Horace Grant-style goggles.

Given all that, I think it’s safe to say that sunlight exposure probably plays a role in the development of nearsightedness. It’s not the only player – physiology is rarely that simple – but it appears to be a major factor. Anyway, I think we’ll have a better idea in the coming years. My Pubmed trawling pulled up a ton of very recent studies on the subject, all in the last few years or so, so we can probably expect more definitive answers in the near future.

Are you nearsighted? Did you play a lot outdoors as a kid? What’s your family history of myopia – do your parents have it too? Let me know in the comment section!

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. does anyone know if sunlight can work wonder for presbyopia as well? ^_^
    (Lady Grok does not like reading glasses!)

    PHK wrote on July 15th, 2011
  2. Hey,

    I am short sighted. Played a lot outdoors as a kid but both parents short-sighted too. Genetics won this round I reckon Developed it in late-teens/early 20s.

    Rory Mulhern wrote on July 19th, 2011
  3. I was an extremely active kid who was *always* outside and was still in glasses by 12 years old.

    Perhaps kids play fewer outside sports due to the onset of myopia which makes it more difficult to excel at physical activities?

    sqt wrote on August 16th, 2011
  4. So to state the obvious, we know that there must be genetic predisposition. Clearly, some people are luckily not susceptible to myopia no matter how much indoor reading or junk-food eating they do. My theory: For those with the “bad” genes (which express themselves through a weakened sclera or accomodative lag or both, but especially the latter), I believe myopia begins with so-called “pseudo-myopia” caused by “accomodative spasm” (lens remains in focused state) after prolonged near work. But contrary to what is commonly theorized, this in itself does not cause axial elongation of the eye and permanent elongation through increased intra-ocular pressure. If anything, I would think the spasm would PREVENT further nearsightedness because any blur on the retina at that point would be myopic blur and under this condition the eye stops growing. However, glasses move the focal plane back to the retina and at this point no amount of focus (accomodation) will bring the closest objects into focus since the lens was already focusing to some degree during the fitting of the glasses and further focusing is beyond its range. Therefore, the only way for the eye to regain emmetropia is through axial elongation, and this is where the retinal defocus pathways come into play. I have read that cycloplegic refraction is not guaranteed to eliminate the spasm to allow for measurement of the true prescription (which indicates that the “spasm” is not so much a ciliary muscle (lens muscle) spasm as it is a condition of the lens retaining its shape after the near-work), so my theory is feasible even under those conditions. So from there on out, most of the myopia increases are probably due to further axial elongation. It’s possible that the lens also changes more and more over time but it has no muscle acting on it to thicken it (it thickens when the ciliary muscle relaxes). I have read convincing arguments that the lens can be shaped through vitreous fluid pressure during focusing, but it is indisputable that myopic eyes are on average longer than emmetropic eyes, so I think it’s safe to say that elongation is a main factor. Anyway, by moving the focal plane back, you are back at square one and near-work again causes a lot of retinal defocus which leads to even more axial elongation (and possible lens thickening, according to some). How many diopters you will max out at is a function of how strong your sclera is, so both the onset and the limit of myopia is genetic, but the progression itself I believe to be caused by the “treatment” which is glasses. The actual RATE of progression is where nutrition, near-work, ad other environmental factors come into play.

    I have two brothers. One got glasses at the same age I did and progressed to near-severe myopia just like me within a matter of years. One refused to wear glasses and never progressed beyond 20/40. There are other stories describing the same thing right here on this site. You be the judge. Nutrition (and by extension sunlight) plays a role in lense and scleral structure and is a contributing factor in the rate of progression, but I can guarantee you that if you put -3.00 glasses on 100 different people, each with different diets (some “primal”, some high-carb), they’ll all end up as -3.00 myopes sooner or later. The high-carb, book-worm, basement-dwelling types might beat the rest to the prescription, but they’ll all get there. They tested this on monkeys and they all got nearsighted to -3.00. Note that my argument is not applicable to those with congenital conditions that caused myopia. Also, I believe they have already compared incidences of myopia between countries at different latitudes and concluded that the varying amounts of sunlight did not have a statistically significant effect. (Also, it is common knowledge among the scientists that Eskimos have a very low incidence of myopia).

    Scott wrote on September 17th, 2011
  5. I just heard a report on the BBC, which lead me to Google, which lead me here.
    It seems the correlation between exposure to outside light and myopia is becoming well recognised. The report was about the results of a study, the aim of which was to try to understand the high rates of myopia in Asia and SE Asia. Too much indoors time, studying, napping during daylight time and more study at night. Singapore (where I am) was of special interest because of the racial mix. All races are being affected equally, because the lifestyle (study patterns in particular) are identical for all races here.
    My daughter is myopic and getting worse. I’m going outside.

    Yee Mei wrote on May 4th, 2012
  6. There could be something to the light-exposure hypothesis; my own myopia onset at about 7th grade, correlating both with loss of elementary school recess, starting to become a Coke-aholic, and a lot of reading. My eyes gradually got worse, to about 20-200 & 20-150. Stayed at that level until two years ago, when I started going without my glasses except for reading (use a pair of 1.50 diopter reading glasses from the $0.99 store) and driving. Now my eyes test at about 20-40, presumably due to just a readaption. Amazing, since I never bought into those ‘throw your glasses away after doing these simple exercises’ books that were popular years ago.

    I read some years ago of a study claiming a relationship between sugar consumption and myopia, supposedly from the loss of chromium from the body. I wonder if that was ever supported in subsequent studies.

    BillP wrote on June 24th, 2012
  7. Im 19, i started to use glasses at 12, my family didn’t have myopia, they are clean, and yes, i didn’t use to play outdoors, i spent a big time playing computer and family game. I wasn’t a very social boy.
    After 12,the story changed, i began to be outside more often and get more friends, and my myopia’s progress stoped. How i know that? I went to the doctor 4 month ago because i broke my glasses, he prescribe me the same that when i was 12 1(L), 0,75(R)

    Just a coincindence

    Matias wrote on June 25th, 2012
  8. I was diagnosed with Myopia, 2 years ago. Since then, my vision has been getting worse, and despite of 3 months ago the prescription values were -0.75(L)/-0.5(R), I feel that overnight, I dont see perfectly, even with glasses.
    Anyway, my question is about other thing…
    I recently started to do outdoor sports and usually I just have time to do them at the evening, or at night, when the sky is completely dark. I dont wear the glasses during that time, even knowing that my vision at distance is clearly blurry.
    Should I wear them?
    Is an obligation that I should take into account, when doing sports?
    This situation, by being at night, can bring risks, since can worsen more?

    I am aware that those questions should be made to an ophthalmologist, but is only to find an opinion. Thanks!

    John S. wrote on November 20th, 2012
    • Myopia usually refers to nearsightedness. If distant vision is good, then you don’t need glasses for those purposes. If, however, your distant vision is blurry (as you indicate), not wearing glasses for evening sports could be risky or even dangerous depending on just how bad your vision is and what sports you’re involved in. Have you considered contact lenses? They might work better for you than glasses.

      Whatever is causing your vision to worsen is definitely a question for an opthalmologist, not a web site, and you should get it checked ASAP. There could be something else going on with your eyes.

      Shary wrote on November 20th, 2012
      • Since I was diagnosed with Myopia (2 years ago), I have already consulted 5 different ophthalmologists, just to be sure of what was going on… At daytime, I see well, with or without glasses, but at night I really have to use them, because my vision at distance is blurry.
        At night, when I do sports (started recently), like running or jogging, I never wear them, even knowing that I see worse, because it is darker… in that situation, I dont know if it’s a risk or not.
        I’ve never used contact lenses, and for now, I do not plan to use them.

        John S. wrote on November 21st, 2012
  9. There is a russian eye doctor Oleg Pankov who is famous for treating myopia in people ( Along with doing eye exercises he has people looking at the evening sun (even with their eyes closed if it’s too bright). Seems to be the same concept, and reported to be effective. Great article, Mark

    Alexander wrote on April 25th, 2013
  10. My family all has perfect or almost perfect vision. I had perfect vision until 10th grade when my eyesight got slightly worse. I think it was due to the fact that I had to do a lot of work for my college applications. Most of the teachers knew that the students eyesight got worse during that period and everyone thought it was because of all the late night reading and computer work. However, my eyesight was still around -1.25 which was fine by me ( a jump that happened in 2 years btw, I was -0.25 before that). In uni however, I was in a city where the weather was atrocious and rained everyday. I also had classes twice to three times a week and barely spent any time outdoors at all. My eye sight jumped from the -1.25 before college to the -3.25 I have now. -2 in 4 years, I started uni at 19. Around 20 most opticians will tell you your eye sight will no longer change much. Everytime I’d ask if its’ gonna stop getting worse, they’d say yes, this is the final change you’re getting too old for that. I’m 23 now and it’s still changing. There’s nothing otherwise wrong with my eyes btw, since I wear contacts I get in depth eye check ups. It’s funny actually, how little they know about what causes myopia. They just throw glasses/contacts at you as if it solves everything. It’s a huge problem that affects the lifestyles of millions of people around the world and there’s been literally no breakthroughs as to what exactly causes this!

    Ina wrote on August 5th, 2013
  11. Interesting post.

    But too late for me as I am an (older) adult.

    From what I can tell from reading here and there, it was originally thought that “close work” – – lots of reading – – and maybe lots of reading in poorly-lit places – – caused near-sightedness. And since atropine empirically helps slow the progression of near-sightedness (by paralyzing the ocular muscles which pull and tug at the cornea to help it focus), it was concluded that “eye strain” caused by too much “close work” caused myopia.

    And this was the thinking up until maybe a decade ago.

    But within the past 5 years or so, it seems there is now research that:

    -disruption of a higher mammal’s circadian rhythm …

    -reduces dopamine within the eye …

    -and the reduced dopamine level permits the eye to continue growing (“over-growing”) axially (meaning, the eye-ball continues to elongate excessively … apparently in youth an eye-ball “grows” … elongates … during the day but usually contracts at night) …

    -which in turn causes it to be difficult for the cornea to correctly focus incoming light rays onto the correct spot on the retina …

    -and there it is, myopia.

    More specifically, you can read the words of the Australian researcher herself in, “New research an eye opener on cause of myopia” – By Greg Hughes and Pauline Chiou – CNN – June 1, 2011:

    ” … the effect of light was mediated by retinal dopamine, a known inhibitor of eye growth whose release is stimulated by light … “.

    So yes, in a way, “close work” and “eye strain” were causes of near-sightedness … BECAUSE they almost always occurred over long hours inside a classroom, or library, or at one’s desk at home, reading under lamp-light. The actual cause seems to be significant lack of real sunlight (as you mentioned), which in turn disturbed our circadian rhythm, which in turn allowed the eye-ball to over-elongate.

    And so, 75% of college students in Taiwan are near-sighted, and many studies show that the higher one’s educational attainment is, the more near-sighted they usually are.

    I’m stable now at around -8.00 diopters in both eyes, but it would have been nice to know that maybe getting an hour of sunlight each day, regularly, back when I was 8 years old (and keeping up with it constantly and consistently), could’ve kept me at minimal near-sightedness …

    kurt hall wrote on September 16th, 2013
  12. Hi, This is so interesting.
    I had a overprotected mother who would never let me go outside and play. I was only playing with my sister who is a years younger than me. I was born with a lot of vision problems but nobody in my family has any issues with their vision. I have antisemitism and myopia. I thought the reason was lack of vitamin A. I don’t really know what to think.
    As i mentioned before, my sister and I are a year apart and we have been raised together the same exact way, I started wearing glasses when I started elementary school and never did any exercise or has surgery at all. I am not doing any surgery. I have been reading about improving the vision with exercises.
    Hope it works. I know it has worked for people that have been consistent with the exercises.

    Jaqueline wrote on February 22nd, 2015

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