Parents who wear glasses know how myopia, or nearsightedness, can affect quality of life. According to the American Academy of Ophthalmology, myopia is becoming more common among children, and very recently, researchers in China found that the prevalence of myopia among children ages 6 to 8 increased in 2020, compared with the previous five years. The World Health Organization estimates that half of the world’s population may be myopic by 2050.
“Typically, we don’t expect young children to have any myopia. Kids in grade school developing myopia is considered early onset, and we know this can lead to higher rates of progression and higher prescription levels later in life,” says Samantha Rice, O.D., FAAO, Associate Dean of Academic Affairs with the Midwestern University Chicago College of Optometry.
While experts believe there is a genetic component to nearsightedness, research into environmental factors is underway, Dr. Rice says. “What we are learning is that more time indoors for young children puts them at a higher risk. We’re not sure why, but it could be because they are doing extensive near work, such as on an iPad, phone or computer.”
There is no known cure for nearsightedness and as the condition progresses, kids not only need to wear thicker glasses but are at increased risk for cataracts, glaucoma and retinal detachment, especially if the child experiences a rapid progression, Dr. Rice says.
But that early diagnosis doesn’t necessarily have to mean continual progression, says Dr. Rice.
“This is not something that parents have no control over and there are prevention options available,” she says. “If there is early onset in grade school or if the condition is progressing quickly, with the prescription changing by a good amount, parents can consider some form of myopia control. Options can vary from special glasses to contact lenses or eye drops.”
Slowing the progression of myopia can be a game-changer for a child’s eyesight and for their quality of life — and can reduce a child’s risk for vision-threatening disorders later on. Here are some of the treatments that are becoming available.
A very low concentration of atropine, a medication that is FDA approved to be used to dilate eyes for examination by eye doctors, can be used to slow the progression of myopia while a child is still growing.
“Every night, children or their parents can put one drop in each eye before bed. For the most part, there are generally low side effects,” Dr. Rice says, adding that this 0.01-0.05% concentration can usually only be made by specialist pharmacies.
Most research suggests that children can start this therapy around age 4 or 5 and continue to use it until they reach age 18 or 20 or stop growing, or until they switch to another method. “While this method can slow the progression of myopia, children still need to wear glasses to be able to see clearly,” Dr. Rice says.
Multifocal contact lenses
Unlike a typical single-vision contact lens, multifocal contacts are designed to provide distance vision through the center of the lens, and near vision around the periphery of the lens. This adjustment allows the brain to adapt to see clearly at each distance, reducing the elongation of the eyeball that causes blurred distance vision.
“This is a popular option to slow the progression of myopia in children,” Dr. Rice says.
This soft contact lens is typically very comfortable for children to become accustomed to and does away with the need to wear glasses — a boon for active kids.
This therapy involves the use of a special rigid, gas-permeable contact lens that reshapes the cornea while the child is sleeping to correct blurred distance vision during the day.
“The concept is a little bit like a retainer. It reshapes the eye overnight, and when the child takes it out in the morning, they can see clearly,” Dr. Rice says. This therapy is monitored very closely throughout use and is typically very effective.
“Ortho-K is very effective as a form of myopia control, and has the added benefit that kids no longer need to wear glasses or contacts during the day,” she says.
Multifocal or bifocal glasses
For younger children or those who aren’t as cooperative with drops or contact lenses, special glasses with lenses designed to help them see both at a distance and up close can slow the progression of myopia.
“These special glasses work in the same way as multifocal contact lenses by inhibiting the signals the brain sends to elongate the eye,” Dr. Rice says.
The choice of therapy depends upon the child’s age, ability to cooperate with drops or contact lenses, and lifestyle factors, Dr. Rice says.
“If your child is a competitive swimmer, maybe Ortho-K is the best option, then you don’t have to worry about prescription googles or wearing contacts in the water. Another factor is convenience for parents. If they work in the evenings and aren’t available to put drops in their child’s eyes, this therapy choice might not work for them,” she explains.
For all parents who are concerned about their child developing myopia, research suggests that time spent outside is preferable to inside playtime, especially if it includes screen time. “Limiting screen time is good for the development of your child’s eyes and brain, and there’s a possibility that this will also help prevent the progression of nearsightedness,” Dr. Rice says.
“Catching myopia early is important,” she adds. “Optometrists start seeing kids at 6 months old, and then parents should take their child for annual eye exams beginning at preschool and kindergarten age, or even earlier if there is a family history of glasses wear or eye disease.”
Midwestern University Clinics has a specialized Myopia Control Center with a team that is skilled at working with children. “We always recommend children see a pediatric optometrist,” Rice says.