The United States is fast becoming a nearsighted nation: More than 40% of Americans have myopia, and the number is climbing fast, especially for children. Experts aren’t sure why, but they believe there’s a strong link to increasing amounts of closeup viewing, especially screen time. The CDC estimates that children ages 8-10 spend 6 hours per day looking at electronic devices including TVs, phones or tablets, and video games.
Once it starts, myopia progresses quickly and can’t be cured. The good news is that there are steps you can take now to slow the progression of your child’s nearsightedness and protect their future eyesight.
Why Is Myopia in Children a Cause for Concern?
Myopia isn’t life-threatening, but this doesn’t mean parents should dismiss the condition. If left unchecked, it can advance to high myopia, which can cause serious sight-threatening conditions in adulthood, including:
- Retinal detachment
- Crossed eyes
Generally, myopia begins in childhood. Once it starts, it can progress at the rate of 0.50 diopter per year. (A diopter is the unit that measures the strength of contact lens and glass prescriptions).
Methods to Slow Down Myopia Progression
Single-vision glasses are the most prescribed treatment for nearsightedness. These lenses will correct the focusing error that causes myopia, but they won’t slow its progression. However, there are ways to do this. These are some of the therapies that have proved to be effective:
- Low-dose atropine drops: These drops are usually given at bedtime for 2 or 3 years to children who are between 5 and 18 years of age. Doctors aren’t sure exactly how they work, but they think that the drops help to stop the lengthening of the eyeball that causes myopia. Some eye doctors report that for up to 90% of kids who use the drops, the rate of myopia progression slows by about half. Side effects include itchiness and redness around the eye.
- Orthokeratology (ortho-k) contact lenses: These special contact lenses are worn overnight. They flatten the front surface of the eye, or cornea, for clear daytime vision. The effect is only temporary: If you stop wearing these lenses, the cornea returns to its original shape. The myopia will come back within a few days, but if the lenses have been worn long enough, it won’t be as bad. Ortho-k lenses are harder to fit than regular ones. There’s also a greater chance of infection, and you’ll need to see the eye doctor for checkups more often.
- Peripheral defocus contact lenses: Children 6 to 12 years old may benefit from this special type of multifocal contact lens. They have different areas of focus to sharpen distance vision while they defocus peripheral (side) vision. This helps slow down the myopia. These lenses don’t work on all children, but they especially seem to help children whose parents also have nearsightedness that’s getting worse. As with all contacts, there’s always a risk of cornea infection.
- Vision therapy: This is a program of exercises designed for your child. It uses aids such as filters, prisms, and computer games to help their eyes and brain work together better. It can train the eyes to adjust focus better between close and distant objects, which can help slow the advance of nearsightedness. It can help ease the eyestrain and headaches that often go along with myopia to make visual tasks like reading easier.
How Your Eye Doctor Tracks Myopia Progression
Caring for your child’s vision should start early. Experts recommend that a child should have their first eye exam around 6 months old, with a follow-up exam at least by age 2 or 3, and then another right before they start school. Even if your child has a vision screening by their pediatrician or at school, they should still see an eye doctor with experience in children’s vision for a thorough exam to check for all the problems that may affect children.
If your eye doctor diagnoses your child with myopia, they will track its progress with regular exams. To do this, they’ll check for the change in refraction of your child’s eyes at each exam. Refraction measures the power of the lens or contact required for clear vision. They’ll also look at the axial length of the eyes. The longer the axial length, the more myopic the eye. Your eye doctor will use these measurements to find out if the therapies are working or if an adjustment is needed.
Lifestyle Tips to Slow Progression of Myopia
Parents can help their kids decrease myopia’s progression by encouraging these practical choices:
Play outside in natural light. Research shows that kids who spend more than 90 minutes outside per day slow down the progression of myopia. Children can let their eyes take a break by looking at things at a farther distance.
Use good lighting. By working in good lighting, children can lessen eyestrain.
Limit screen time. It’s a good idea to take a break from digital devices to help slow down the progression of myopia. Parents can help this process by doing the following:
- Keep track of how much time your child is spending on digital devices to reduce the number of hours they spend on a phone, computer, or tablet.
- Create a “no-phone zone” in the house, such as at the dinner table or during family TV time.
- Set expectations that are reasonable. Instead of slashing their screen time in half right away, work with them to set clear goals to cut it down over time.
- Engage with your children. Spend some time each day talking or doing a fun activity with them; insist on it being a “device-free” time. This is a good way to meet your goal of spending more time outside.
Teach kids to use the 20-20-20 rule. The American Academy of Ophthalmology recommends following a simple rule to reduce eyestrain: Every 20 minutes, focus your eyes on an object at least 20 feet away for at least 20 seconds.
Photo Credit: Carol Yepes / Getty Images
American Optometric Association: “With Childhood Myopia Rates on the Rise, the American Optometric Association Highlights the Importance of Early Intervention through Annual Eye Exams.”
UC San Diego Health (Shiley Eye Institute): “Myopia.”
American Academy of Ophthalmology: “Study Ranks Methods to Slow Myopia,” “Computers, Digital Devices, and Eye Strain,” “Myopia Control in Children,” “Low-Dose Atropine for Kids with Myopia.”
Optometrists Network: “Myopia and Vision Therapy,” “What is Vision Therapy?” “Eye Exams for Children.”
Investigative Ophthalmology and Visual Science: “IMI – Clinical Myopia Control Trials and Instrumentation Report.”
Cincinnati Children’s: “5 Things to Know About Myopia (Nearsightedness) in Kids.”
Mayo Clinic Health System: “6 tips to reduce children's screen time.”
ClinicalTrials.gov: “Clinical Evaluation of a Myopia Control Lens in Slowing Myopia Progression.”
Mykidsvision.org: “All about eye glasses for myopia control.”
CDC: “Screen Time vs. Lean Time.”
American Academy of Pediatrics: “Myopia (Nearsightedness) in Children & Teens.”