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Myopia, or nearsightedness, affects 1 out of every 2 people. And the numbers of children who have it continues to rise.
According to Serena Wang, M.D., Pediatric Ophthalmologist at Children's Health℠ and Professor at UT Southwestern, "Myopia is very common nowadays. It's almost like a pandemic. All over the world, more and more kids are becoming nearsighted."
Dr. Wang helps explain why the significant increase in myopia in kids is happening – and how you might help prevent or treat it.
What is myopia in children?
Myopia is the medical term for nearsightedness. Children with myopia can clearly see objects that are near them. But they’re unable to clearly see objects that are further away.
When a child has myopia, they have one of these changes to the shape of their eyes:
The eyeball is longer than usual
The cornea (the clear outer layer of your eye) is overly curved or steep
Myopia has no cure. But early treatment can help improve a child’s vision – and prevent myopia from getting worse.
Why are kids developing myopia?
Experts don’t know exactly what’s causing myopia to become more common in kids. But there are likely a few causes.
"There’s no single age group that's more prone to myopia. But it does appear to be starting younger and younger. And that’s why a lot of research is looking into its causes," says Dr. Wang.
The factors that have been shown to play a role in kids’ developing myopia include:
Genetics. Kids whose parents have myopia and children of Asian descent are more likely to develop myopia.
Spending a lot of time in front of screens. Looking at screens for many hours a day causes our eyes to contract. This extra strain can affect how well kids’ eyes develop – and their ability to see objects that are far away.
Spending too much time indoors. In order for kids’ eyes to develop well, they need exposure to natural light. Experts believe sunlight helps release retinal dopamine, which helps regulate eye growth.
What are signs and symptoms of myopia?
The two main symptoms of myopia in kids are:
Fuzzy or blurry vision
Squinting
It's common for a child who has myopia to:
Not be able to see the board well at school (especially when the lights are dim).
Hold a tablet or book very close to them, or move closer to the television.
Have a delayed response to a ball coming at them.
How is myopia diagnosed?
Most pediatrician’s offices have a tool to screen for myopia in kids younger than 4 years old. This camera-like tool (called a photo refractor) allows them to examine the shape of a child’s eyeballs and corneas.
Then, around 4 years old, kids are typically asked to read an eye chart – either at school or their pediatrician’s office. Eye charts may also help diagnose myopia. But they’re not 100% reliable because some kids have an easier time identifying letters or reading aloud than other kids.
How to prevent myopia and tips to keep your child's eyes healthy
Limit screen time
To help ensure proper eye development, Dr. Wang recommends that parents cut down on electronics and screens as much as possible.
She points parents to the screen time guidelines from the American Academy of Pediatrics (AAP):
Children under 2: Avoid all screen time for kids 18-24 months old – except video-chatting or co-playing with parents on educational apps.
Children ages 2-5: Less than one hour per day of high-quality, educational screen time.
Children ages 6 and older: Set screen time limits that make sure screen time does not interfere with sleep, exercise or other healthy behaviors.
She also tells parents about the 20-20-20 guideline from the American Academy of Ophthalmology (AAO), which says that for every 20 minutes you’re on a screen, stop for 20 seconds and look at least 20 feet away.
"This is a good recommendation because it’s easy to remember. But I always encourage longer breaks than 20 seconds – and to look even further away than 20 feet. Ideally, kids would take a screen break outside," says Dr. Wang.
Learn more about how and why to limit your child’s screen time.
Keep a safe distance from screens and books
The closer a child is to what they’re looking at, the more their eyes can get strained.
Whether they’re looking at a book or a tablet, a child should be an arm’s length away from that target. And that’s basically the distance between their hand and their elbow.
"I never recommend that kids watch more television. But I do tell parents that watching TV puts less strain on the eyes than being on a phone or computer screen," says Dr. Wang.
Encourage outdoor time and outdoor activity
One of the simplest ways to help prevent myopia in kids is to get your child outside, in natural light.
We have research that shows that kids who spend more time outside have lower rates of myopia. I always tell parents to make sure their kids get some outdoor time every day, if possible. Even if they’re reading a book, it’s better to do it outside than inside.
Dr. Serena Xiaohong Wang
Get regular eye checkups and exams
Any child with myopia needs an annual checkup with an eye doctor to help them see as clearly as possible – and to help prevent the progression of myopia.
Kids who don’t have vision problems can continue to have yearly eye screenings at school or at their pediatrician.
How is myopia treated?
If your child has myopia, it can be treated with:
Glasses. The most common treatment for myopia is glasses. Your child may wear them all the time or only when looking at things far away – or playing sports.
Daytime contact lenses. Some kids prefer contact lenses over glasses. But they can be tricky to put in and keep clean, so they often work better for older kids. Learn more about contact
lens care for kids.Surgery. LASIK surgery is not done to treat myopia in kids because their eyes are still developing. But after your child turns 21, LASIK surgery can reshape their cornea to correct myopia.
Can you slow down the progression of myopia?
Dr. Wang says there are a few treatments that have been proven to slow down the progression of myopia in kids. But they don’t work for every kid. So it’s important to discuss them with your child’s eye doctor.
Treatments that may slow down the progression of myopia in kids are:
Peripheral defocus contact lenses. For some kids, these special contact lenses can slow down the progression of myopia. They intentionally blur side (peripheral) vision, which may slow eye growth and limit myopia.
Orthokeratology (Ortho-K) contact lenses. These are contact lenses that flatten a child’s cornea while they sleep. This flattening can make distant images clearer the next day. But once a child stops wearing the lenses, their cornea returns to its normal shape – and myopia returns too.
Atropine eye drops. Studies show that using these eye drops at night – over a period of a few years – can slow the progression of myopia in some kids. Experts aren’t exactly sure how they work. But they think they may prevent the eye from lengthening too much.
What are the risks or complications of myopia in kids?
If a child progresses from "low myopia" (mild nearsightedness) to "high myopia" (severe nearsightedness), they have a much greater risk of serious eye problems. These problems include glaucoma, cataracts and retinal detachment and retinal tears.
"The more serious risks associated with high or severe myopia are why the medical community is very concerned about reducing the numbers of kids with myopia. For example, a child younger than 5 years old with high myopia that’s not corrected can develop amblyopia or delayed visual development," says Dr. Wang.
When to see an eye doctor
Dr. Wang recommends that parents take a child to an ophthalmologist if:
They are bumping into things
Their eyes are not straight or go outwards
They have rapid vision changes
"For children younger than 5, I almost always recommend they see an ophthalmologist over an optometrist. They have additional training and diagnostic tools that can be particularly helpful for younger kids who may not be able to describe what they’re experiencing very well," says Dr. Wang.
Get eye care for your child
If your child is experiencing rapid vision loss, blurred vision, headaches, squinting or eye strain, it may be time to see an eye specialist. Our pediatric ophthalmologists provide eye exams for kids under 6 years of age and for kids with special needs. We also offer expert care for dozens of eye disorders and diseases, along with cutting-edge research and education. Learn more about our
ophthalmology services and request an appointment.
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