Will eating sugar make myopia worse?

Myopia has become a global epidemic, affecting kids of school age, sometimes as early as 6 or 7. Left untreated, myopia may progress 1 diopter each year, resulting in high myopia when kids become adults. Myopia is not just an inconvenience, it is an eye disease that significantly increases a person’s risk of developing retinal detachment and myopic macular degeneration, both can lead to blindness.

Naturally parents become concerned when their kids fail the vision screening at school and have to wear glasses to see well. As food is a key part of our health, many often wonder if food contributes to myopia development. For example, does eating sugar and refined carbohydrates increase myopia? Surely sugar is bad for your teeth and just bad for your health in general. Is it also to blame for myopia?

Will sugar coma cause you to see worse?

When I was a student at New England College of Optometry in Boston, we learned extensively on myopia, which is a major topic of interest for optometry. While many factors affect myopia, for example, genetics, prolonged near work, lack of outdoor activities, sugar intake was never mentioned as a factor to affect myopia. Yes diabetes can affect a person’s vision by making them temporarily more myopic or hyperopic, but that is reversible and after blood sugar levels are controlled, the eye returns to baseline refractive state. Most people, especially school aged children, do not have diabetes or constantly fluctuating sugar levels. So is there any evidence for a role of sugar in myopia that is not in context of diabetes?

It turns out not many studies have been done on this topic. In 1956, Gardiner proposed that carbohydrates and fats in the diet could cause myopia 1, but this hypothesis was discarded later in the scientific community. When this happens, it’s either because not enough research was done to support it, or that it did not hold water by subsequent research. In deed there was a scarce of literature on this topic. But one actually found that more sugar intake did not increase risk of developing myopia in children 2. This study in turn, found out that too much saturated fatty acid in the diet correlated with more myopia.

Most recently a French study evaluated 180 children aged 4-18 via questionnaire about their diet habits, and discovered that for girls, more sugar and refined carbohydrates correlated with more myopia, but in boys, this was actually the opposite, that is, when boys eat more sugar/carbs, they show less myopia development 3. This type of study has flaws in that it relies on questionnaire which can be highly subjective. In addition, many variables were not controlled, such as outdoor time, reading and screen time. Even if it’s to be trusted, the study like many epidemiological studies, evaluate a correlation, not causation. Besides, how do you interpret the data that sugar reduces myopia risks in boys? Would you recommend boys to eat more sugar and refined carbohydrates? I don’t think so.

In summary, little evidence exists to indicate sugar or refined carbs increase or decrease risks of myopia. Maybe this is just a factor that has not much to do with myopia. To advocate better oral hygiene and health, we certainly want children to control their intake of sugar and refined carbs, possibly for everyone really, not just kids. However, if you think that by eating less sugar you will not develop myopia, you are up the wrong tree.

References

1.            Gardiner PA. The diet of growing myopes. Trans Ophthalmol Soc U K 1956;76:171-180.

2.            Lim LS, Gazzard G, Low YL, et al. Dietary factors, myopia, and axial dimensions in children. Ophthalmology 2010;117:993-997 e994.

3.            Berticat C, Mamouni S, Ciais A, Villain M, Raymond M, Daien V. Probability of myopia in children with high refined carbohydrates consumption in France. BMC Ophthalmol 2020;20:337-337.

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