Urbanization as a factor for myopia progression

Urbanization is the process of forming big cities whereby huge numbers of people become continually concentrated in comparatively small regions [1-4]. With reference to the review of the United Nations (UN), World Population Prospects, the world’s population is estimated to increase from 7.7 billion in 2019 to 10.9 billion in 2100 [5]. Population growth, population ageing, migration, and urbanization are part of four important global trends indicating economic, social, and environmental development [6]. Therefore, distinct conception of the size, location, and distribution of the human population is essential for productively achieving a viable future [7]. An effectual observation of global population alteration will undoubtedly allow employment of well-organized policies to assign financial support, plan services, and compute populations at risk [7]. Urbanization results in many health issues including poor nutrition, pollution-related health problems, contagious diseases, poor hygiene, housing problems, and related health conditions [8]. Many factors may influence urbanization. These may include differences in natural population growth between rural and urban areas, rural-to-urban and international migration, and the extension of urban settlements through annexation and reclassification of rural settlements into small and big cities [1]. In addition, economic transformation, housing, infrastructure, and service delivery also play important roles [1]. Implications for migration and forced displacement are linked to ongoing demographic and technological trends [1]. These demographic and technological trends are obviously affecting people’s lives and in particular their lifestyle [1-4]. These factors change people’s lifestyle so that people are pushed into more near work activities [1-4]. Therefore, rapid urbanization is not only linked to an unavoidable rise in city populations, but also affects people’s ways of interacting with new environmental conditions, which are full of near activities [1-4]. In addition, they are exposed to limited living space, and thus once more sub- jected to near distances all the time [1-4]. Due to the fact that more near work activities combined with less outdoor time are going to be part of people’s lifestyle in urban settings, this formulates urbanization as a significant feature in the development and progression of myopia [1-4]. This is simply due to the fact that there are plentiful documented lines of evidence to support the association between increased near work activities [1-4, 9-11] and less outdoor time with myopic progression [1-4, 9]. The more daily close work is done, the greater will be the rate of myopic progression [1-4]. This is strongly related to job requirements in small and big cities as intensive near work is required [1-4]. Since inadequate time spent outdoors [1-4, 11] and increased duration and intensity of near work activities [1-4, 10, 11] have been identified as chief environmental risk factors for myopia progression, home confinement during the outbreak of emerging infectious diseases such as coronavirus disease 2019 (COVID-19) will lead to further development of the myopic crisis [1-4, 11]. Environmental etiologies and epidemiological studies of myopia also show a strong association with urbanization, which can be confirmed by looking at the prevalence of myopia in urban areas versus rural areas [1]. In this context, there have been numerous studies proving a higher prevalence of myopia in adults and children living in urban settings, compared to adults and children living in rural areas [1]. Furthermore, generational differences of prevalence of myopia and high myopia have been found, with the highest rates in young adults and the lowest rates in older adults [1]. In conclusion, there should be appropriate and effective approaches toward urbanization and its lifestyles in order to prevent myopia progression [1-4]. This is extremely important as the observed rise in the prevalence of myopia and high myopia worldwide is a significant public health crisis and it is vital to immediately provide more necessary data to update researchers, clinical practitioners, public health workers, and policymakers [1-4].

Acknowledgements

The author would like to express his honest gratitude and high respect for the lifetime support of his father, Mohammad Nouraeinejad.

Disclosure

The author declares no conflict of interest.

References