Myopia in Children
What you need to know about nearsightedness also known as myopia?
Nearsightedness, or myopia, is a condition that has become one of the three leading causes of legal blindness in the world. Commonly beginning in childhood and progressing throughout our adult lives, myopia affects an estimated 30% of the Canadian population.
In myopia, the shape of the eye is abnormally long or the cornea is too curved. Rather than light being focused directly and precisely into the retina, the eye or retina shape causes light to converge and focus in front of the retina, blurring faraway objects.
In children, onset is now being observed earlier than ever before, with symptoms beginning at around 6-7 years and increasing drastically from grades 1-8 during the eye’s rapid growth years. It is now estimated that 1/3 of these cases are left undiagnosed and untreated. That is because most children do not complain. If they do, they may only comment on difficulty seeing farther away, eye rubbing, headaches or may position themselves more closely to see things.
Even in lower amounts, myopia is associated with increased risk of serious eye disorders including macular degeneration, retinal detachment, cataracts, and glaucoma. In childhood, it can create difficulties in school and learning.
While myopia is on the rise globally – particularly in children- researchers cannot point to a clear cause or mechanism. There is evidence between an increased risk of myopia and time spent indoors, performing closeup tasks such as using computers, phones and reading. Children are also more likely to develop myopia if their parents are nearsighted.
Treatment and Prevention
As reversal of myopia is not possible at a young age, treatment focuses on slowing its progression, which is known as myopia control. Treatment can protect children’s eye health in the long run from serious complications, though they must continue to wear speciality eyeglasses or contact lenses to reduce myopia progression.
Low-Dose Atropine Drops:
Atropine eye drops, the very same ones used to dilate your pupils during an eye exam, may slow progression down between ages 5 to 18 years old. Daily nighttime administration is standard
Glasses or Contact Lenses:
The most popular way of correcting myopia are eyeglasses or contact lenses. Depending on the degree of impact, children may either need to wear these daily or only when distance vision is required such as reading chalkboards, playing ball or watching movies. If your child prefers contact lenses, they are also a good option for active children, but they do require good hygiene practices and care. We can teach children how to insert, remove and care for contact lenses or have the parents help out when needed until they practice enough and learn to do it themselves.
Ortho-K (Orthokeratology) Contact Lenses:
Some children with mild myopia could benefit from Ortho-K lenses, which are worn overnight to temporarily flatten the cornea and correct vision. During the day, the reshaped cornea will correctly converge light and improve vision without the need for eyeglasses or normal soft contact lenses. Ortho-K is 30-100% effective according to current research. Ortho-K is a specialty process and treatment plan that takes time to fit to achieve certain results. The lenses use a hard contact lens material, which requires more training and practice for insertion and removal. We recommend consulting with an Optometrist to help explain Orthokeratology and determine if your child is a good candidate.
Time outdoors is specifically important for kids with myopia as it allows the eye muscles an opportunity to relax and prevent eye strain. Research has shown that children who spend at least 90 minutes in natural sunlight each day have slower rates of myopia progression. Always make sure to wear hats, sunglasses, and sunscreen to protect your eyes from the sun’s harmful UV light.
Typically, children should have eye examinations at 3 to 6 months and every year since the Ontario government covers children 19 and under for an annual eye health exam with a valid OHIP (Ontario Health Insurance Plan) card. If you have a family history of nearsightedness or other conditions, it is especially important to get regular check ups. Children with a high degree of myopia require more frequent checkups if interested in a treatment plan for myopia control and to ensure their eyes remain healthy.
Learn more about myopia in children from the American Academy of Pediatrics: https://www.healthychildren.org/English/health-issues/conditions/eyes/Pages/Myopia-Nearsightedness.aspx
Read about myopia from the Canadian Association of Optometrists here: https://opto.ca/sites/default/files/resources/documents/myopia_position_statement_with_references_october_23_2018_0.pdf