I was diagnosed with myopia at 4 years old, which prompted the simultaneous diagnosis of my sister, then just 2 years old. I've probably been myopic longer than I could read, and maybe even longer than I could walk on two feet.

I spent a lot of time reading as a kid. When I've heard other people, sometimes doctors, speak as though that somehow caused my high myopia, or my sister's, it has struck me as obviously laughable. The sunlight theory is interesting.

My sister and I also share an inherited retinal disease that causes photophobia (severe light sensitivity). Because the disease is progressive (degenerative) and we were only diagnosed as adults, we never had any ERGs taken as kids, so we don't know whether or how it was affecting us then. But from even pre-school, I remember walking around with not just my face pointed down, but my eyes closed, opening them only every couple seconds, in order to escape the extremely bright sun where we lived. So does she.

I wonder if to some extent, our early visual impairments and light sensitivity exacerbated our myopia by making outdoor times and outdoor activity less rewarding for us.

Aside: as someone with high myopia, content like this, seemingly fixated on preventing, curing or 'ending' myopia, reminds me a lot of some things I've seen on Reddit. Out of some personal interest, I sometimes browse r/myopia as well as r/blind. And it strikes me over and over how r/blind seems like a much more sane place to me. r/myopia is full of people absolutely panicking over myopia that is fully correctable! It's got post after post of people desperately trying to 'reverse' their myopia, people going to great lengths to try to shave one or two diopters. Many posters there describe feeling depressed and deflated by their first prescriptions, obtained in adolescence or young adulthood, and anxious about the future.

I've never really known what it's like to have normal vision. In that sense, I know I'm inclined to underestimate the sense of loss that some people will naturally and rightly feel when their once-perfect vision degrades. But I can't help but look at r/myopia and think it all seems a bit unhinged. It's strange to watch people with highly correctable vision, whose vision will likely never seriously affect their mobility, independence, or work act like the sky is falling because they're nominally myopic while half of my immediate family is blind or slowly going blind.

In contrast to r/myopia, r/blind seems so much more grounded. There's grief and worry there also, but for the most part, people posting there are just figuring out how to live their lives. It's a place that feels much less depressing, much less despairing, to me.

To some extent, I think the OP and the shift in thinking it describes is aligned with r/myopia, while the older view that myopia is largely genetic and something more to be managed than to avoided, with r/blind. I think from a public health perspective, interventions like the OP describes are absolutely warranted. But when it comes to individuals, I think a lot of people would serve themselves better by taking up a looser posture. Even 'high' myopia is extremely manageable, if that's all you've got going on. It's not the end of the world to be myopic (or even to be blind, as a brief scroll through r/blind makes clear). By all means, let school systems and health departments and scientists keep working out how to address myopia at scale. But individuals with myopia, or children with myopia, should know that they're okay.