Why is myopia increasing in children, and what can parents do about it?

What is myopia?

Nearsightedness, also known as nearsightedness, is an eye condition in which a person cannot see far away objects clearly.

What are the first signs of myopia?

“Signs of myopia are usually noticed when a parent or teacher first notices that a child is holding things close to the face to see them better, or sitting close to the TV, or can only read the classroom whiteboard when he or she sits in the front. of the room, but not at the back,” said Dr. Annegret Dahlmann-Noor, pediatric ophthalmologist at Moorfields Eye Hospital.”

How is myopia diagnosed?

“Myopia is usually diagnosed by an optician who will carry out eye checks and measure their eyes for glasses,” says Dr Chris Hammond, pediatric ophthalmologist at Guy’s and St Thomas’ NHS Foundation Trust. “For children under the age of six, they may need to put out eye drops to accurately measure whether a child is myopic (nearsighted) or farsighted. Older children often do not need the drops.”

How is myopia treated?

Although the simple treatment for nearsightedness is to wear glasses or contact lenses to correct vision, this often gets worse with age and, according to Hammond, “as glasses become more powerful, the risk of long-term sight-threatening problems later in life increases.” to. ”.

Hammond adds that this is especially true when myopia appears in children before the age of 10. “(This is because) eye growth (which causes myopia) slows during adolescence but does not stop until around age 20-25. There are now treatments that attempt to control the progression of myopia, including special glasses, dual-focus soft contact lenses, or hard contact lenses worn at night (orthokeratology).

According to Bhavin Shah, a myopia specialist at Central Vision Opticians, treatment options such as orthokeratology and special dual-focus contact lenses and eyeglasses have “had a huge impact on slowing the rate at which myopia changes.”

What is the connection between myopia and screen time?

“Working more closely means that a child has to focus his eyes at close range,” said Shah. “Focusing on nearby things for long periods of time has been shown to accelerate the progression of myopia in children, and holding a device close to the eyes for long periods of time can worsen myopia.”

According to Hammond, the main risk factors, aside from having a family history of myopia, are working too much close-up and not enough time outdoors.

Close work is not limited to screen time, but can also include reading. “Reading too much and holding books too close can also cause children to become more myopic,” says Shah.

There have also been several studies indicating that “pandemic lockdown and the associated massive increase in screen time and lack of time outdoors caused a significant increase in the number of children with myopia.”

Hammond adds: “Myopia was already a major problem in urban East Asia (affecting up to 90% of teenagers) before children used screens, probably due to the intensive education system there, so the situation is likely more complex. While further research gathers evidence, it seems sensible to limit screen use, especially in young children, as screens keep children indoors and encourage children to see things up close.”

What challenges do medical professionals face when treating myopia?

For Shah, the main challenges are raising awareness among parents about the condition and changing children’s lifestyles. There is also a need to raise awareness about the different options to manage myopia, rather than just treating it. “The other challenge is that having myopia increases the risk of eye disease in adults,” says Shah. “Myopes are more likely to develop several eye conditions, including retinal detachments, glaucoma and cataracts. More information should be sent to GPs and other health professionals, especially those who come into contact with children.”

Our increasingly urban lifestyle also poses a challenge in the treatment of myopia, according to Dahlmann-Noor. “(This means) that even young children have fewer and fewer opportunities to spend time outdoors, and we know that exposure to sunlight slows the onset and progression of myopia,” says Dahlmann-Noor.

What can be done to better understand myopia?

More research is needed into how many children suffer from myopia and how current treatments work, Hammond says. “Continued research is needed into risk factors and newer treatments that are more effective, as current treatments only slow the progression of myopia by about 50%-60% on average,” Hammond adds. “Finally, we still have no effective treatments for the long-term vision loss that people who are highly nearsighted experience as they age.”

With myopia on the rise among children, what can parents do to prevent their children from developing this condition?

“The recommendation is 14 hours a week outdoors, for sports or leisure. Many experts recommend that screen use should be avoided in children under two years of age, limited to one hour per day until age five, and then two hours per day until age 12,” says Hammond.

“When using screens and reading, children should be encouraged to take breaks every 20 minutes. Teach your children healthy habits: get off your screens and do an outdoor activity together with the whole family. Not only is it good for your children’s eyes, it also reduces the risk of a worrying rise in obesity and improves their fitness. If there is a family history of myopia, make sure your children’s eyes are checked regularly, approximately every year.”