The national spectacle

Two things often strike foreign visitors to Korea riding the subway: the number of people talking on their cell phones and an almost equal number of bespectacled commuters. The former is a national addiction and the latter, quite possibly, a national epidemic.

Korea is a country plagued by growing myopia, or nearsightedness. Physical examinations of 120,000 primary, middle and high school students last year found nearly 40 percent to have myopia. Ten years ago myopia affected less than 17 percent of school-aged children. According to Ministry of Education and Human Resources Development findings, more than 56 percent of high school students are nearsighted, with 32 percent already wearing glasses.

A nearsighted person sees close objects clearly, while objects in the distance are blurred. The cornea is the transparent part of the coat of the eyeball that covers the iris and lens, and lets light into the eye. Blurred vision occurs when that light is not focused correctly on the retina, the internal layer of the eye that receives light and translates it into signals for the brain. Improper focus happens when the size of the eye does not match the lens. Hence, myopia often develops in rapidly growing children or adolescents when their eyes are growing and changing. Myopia stops progressing as growth is completed in the early 20s.

Some experts view myopia in Korea as the result of genetics. "The eyeballs also grow during the years of physical growth," says Lim Sang-jin, an ophthalmologist in private practice in Apgujeong-dong, southern Seoul. "In Korean and Asian children, the cornea and lens become too curved because they cannot keep up with the growing eyeballs. Myopia is a national trait." While Asian countries have a marked prevalence toward myopia, farsightedness is more common in the West, he adds.

According to this theory, whether you end up having to wear glasses or not is genetically predetermined. Those with a family history of myopia are more likely to develop the condition. In fact, it would appear that there is no way to prevent nearsightedness.

That having been said, what explains the growing amount of nearsightedness over the years? "Doctors are now seeing more patients with eye ailments, not just myopia," says Choi Woong-san, an ophthalmologist in Samseong-dong, Seoul. While cataracts in someone 30 years old was rare enough to call for a case study about 15 years ago, it is now not uncommon to get patients in their 20s with cataracts, according to Dr. Choi.

"We suspect that there are some external factors at work here," says Dr. Choi, "other than just the eyeballs growing too large."

Two of the most commonly blamed culprits, for example, are poor reading habits and long hours spent in front of the computer screen. While there has been no conclusive scientific evidence that such environmental factors are responsible for myopia, there are studies that point to variables other than genetics that may contribute to myopia.

A recent theory suggests that shortsightedness may be tied to a diet rich in refined starches such as breads and cereals. In a report published in a recent edition of New Scientist, a science and technology magazine, a team led by Loren Cordain, an evolutionary biologist at Colorado State University, and Jennie Brand Miller, a nutrition scientist at the University of Sydney, observed that refined starches increase insulin levels, which in turn affect the development of the eyeball, making it abnormally long and causing shortsightedness.

"High insulin is known to lead to a fall in levels of insulin-like binding protein-3," the team wrote, which could disturb the delicate choreography that coordinates eyeball lengthening and lens growth. If the eyeball grows too long, the lens can no longer flatten itself enough to focus a sharp image on the retina, they suggest.

Mothers who yelled at their young children, "Enough with the computer already!" might find justification for their anxieties about too much time in front of the computer causing nearsightedness in a recent finding. A study by Pia Hoenig at the University of California at Berkeley School of Optometry found that children who used a computer for three or more consecutive hours at a sitting suffered from visual impairments, with focusing problems found in 12 percent of those children.

While there are no proven ways to prevent nearsightedness, there can be no harm in following some tips which may protect your eyes. Doctors suggest keeping books at least 30 centimeters away from the eyes when reading, using proper lighting with the light source placed directly above to prevent shadows. Reading should be avoided in moving cars.

Frequently resting your eyes can lessen the strain placed on them from reading. After 50 minutes of reading, rest the eyes for 5-10 minutes by looking at a faraway point, preferably at least six meters away. This is because you blink an average of 10 times a minute when reading, compared to 15-20 blinks per minute when not reading. You tend to blink even less when looking at a computer monitor, as little as 7 times a minute. Also, close your eyes and roll your eyeballs while you rest to relax the muscles in the eyes.

Books should be held at an angle, never flat on the table. Computer monitors should be placed at least 60 centimeters away, slightly downward at a 15-degree angle. As for television sets, sit at a distance of at least five times the size of the screen.

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Jeepers, creepers: a needle in foot may cure myopia

As a first-grader in Seoul, each day for a few minutes I would roll my eyeballs up and down, left and right, along with fellow classmates.

All those eye exercises failed me, however. An eye exam two years later showed that I needed glasses. Dreading the prospect of having her daughter wear nerdy glasses, my mom dragged me to a well-known eye doctor who promised that I might be spared the glasses if I followed his treatment routine.

After several doctor's visits that consisted of an eye exam, eyedrops and staring for several minutes into a black box with a moving picture of a house on a green field, there was no improvement in sight, so I decided I would rather like to wear glasses: They would lend an aura of intellectual sophistication to a third-grader. As a teenager, vanity quickly caught up with me and I tossed away the glasses, which were getting heavier by the year, and got contact lenses. After more than two decades of contact lenses, my doctor is telling me that my days wearing contacts are numbered. "Use them sparingly," he warned.

For those who want to try something different to improve their eyesight, here are two of the latest tools that Koreans have been trying out.

For people who just want to wake up to better vision, "Dream Lens" may be the answer. Lucid Korea, an orthokeratology contact lens manufacturer, claims improved vision after wearing the lenses overnight.

Orthokeratology contact lenses work rather like braces used by orthodontists. It flattens the front surface of the cornea, allowing the lens to focus properly. The lenses are taken out in the morning and their effects can last through the day. Since the cornea is highly elastic, and always returns to its original shape, the mold should be worn every night. You need to see an ophthalmologist to be fitted with the lenses and not everyone can use them.

Needles can actually "cure" myopia, according to acupuncturists. Nearsightedness can be improved by stimulating reflexology points on the hands and feet. Nam Young, an acupuncturist at the National Medical Center, Seoul, claims to have successfully treated 80-90 percent of patients with myopia since introducing the treatment last summer. "The idea is to facilitate the movement of gi energy to the eyes," says Mr. Nam. "Eyes are the windows to the soul and when patients receive treatments for their eyes, they also report improved concentration and a clearer head."

by Kim Hoo-ran