Myopia — commonly known as nearsightedness, the ability to see close objects clearly while distant objects appear blurry — has reached epidemic proportions globally. In urban areas across Asia, myopia affects 60–80% of school-age children. The trend shows no signs of slowing.
Beyond the inconvenience of glasses or contact lenses, high myopia (over -6 diopters) significantly increases the risk of serious eye complications in adulthood: retinal detachment, glaucoma, cataracts, and macular degeneration. This makes early detection and slowing progression genuinely important — not just a matter of convenience.
Signs Your Child May Be Developing Myopia
Young children often don’t realize they can’t see clearly in the distance, because they’ve never experienced any other way of seeing. Watch for these behavioral clues:
- Squinting to see the classroom board, TV, or objects across the room
- Sitting very close to the TV or holding books very close to their face
- Frequent headaches, particularly after school or extended near-work
- Eye fatigue or rubbing after reading or using screens
- Academic difficulties without a clear explanation (child can’t see the board)
- Closing or covering one eye when looking at something in the distance
- Saying “I can’t see…” when looking at things across the room
Why Is Myopia Increasing?
Genetics
Children with one myopic parent have a notably higher risk; with both parents myopic, the risk approximately doubles. But genetics doesn’t explain the dramatic recent increase — environment plays a major role.
Insufficient Time Outdoors
This is the most robustly supported environmental factor in current research. Natural outdoor light stimulates dopamine release in the retina, which regulates eyeball growth. Children today spend far less time outdoors than previous generations. Studies show children who spend at least 2 hours outdoors daily have significantly lower rates of myopia onset and progression.
Excessive Near Work
Extended reading, homework, and especially screen use at close distances places sustained demand on the focusing muscles of the eye and appears to promote elongation of the eyeball — the physical change underlying myopia.
When Should You Have Your Child’s Eyes Tested?
- Before starting school (age 5–6): Baseline eye examination to detect any refractive errors or alignment issues
- Every year during primary and secondary school: Annual check-ups are especially important during the growth years when myopia progresses most rapidly
- Immediately if you notice any of the behavioral signs listed above
- Every 6 months if your child already has myopia, to monitor progression
Evidence-Based Strategies to Slow Myopia Progression
Myopia cannot be fully prevented once it begins, but its progression can be meaningfully controlled.
Increase Outdoor Time
This is the most accessible and evidence-supported intervention. Aim for at least 2 hours of outdoor activity per day. The key factor appears to be exposure to bright natural light, not visual distance or physical activity per se.
The 20-20-20 Rule
For every 20 minutes of near work (reading, screens, homework), look at something 20 feet (6 meters) away for 20 seconds. This relaxes the eye’s focusing muscles and reduces near-work strain.
Maintain Appropriate Viewing Distances
- Books and homework: at least 30 cm (12 inches)
- Desktop screens: 50–70 cm
- Television: at least 2–3 meters
Medical Myopia Control Options
For children with rapidly progressing myopia (increasing by more than 0.75 diopters per year), an eye doctor may recommend:
- Orthokeratology (ortho-k): Specially designed contact lenses worn overnight that temporarily reshape the cornea, providing clear daytime vision without glasses while slowing progression
- Low-dose Atropine eye drops: Clinical studies show significant slowing of progression with minimal side effects at low concentrations
- Multifocal contact lenses or spectacles: Designed to reduce the visual stimulus driving eyeball elongation
Tips for Choosing Your Child’s First Glasses
- Have the prescription measured by an eye care professional — not just a glasses store
- The prescription must be accurate — under-correction doesn’t slow myopia and may worsen it
- Choose frames suitable for an active child: flexible, durable materials
- Ensure proper fit — poorly fitting glasses defeat the purpose
At Ky Hoa Medical Center, our Ophthalmology department provides comprehensive vision screening for children, including refraction testing and myopia progression monitoring. Contact 028.3868.1097 to schedule an eye examination for your child.