Rising Myopia In Children: Causes And Risks Of Short-Sightedness In Children

Myopia, or short-sightedness, is on the rise among children globally, with experts warning of a looming health crisis. A recent global study reveals that 35% of children are currently affected, a figure projected to climb to 40%, equivalent to 740 million children, by 2050. Far from being a minor inconvenience, myopia poses significant risks to long-term eye health, potentially leading to severe and irreversible conditions if left untreated. The alarming increase raises questions about the causes of this trend and what can be done to combat it beyond reducing screen time.

Understanding Myopia and Its Causes

Myopia is a refractive error that causes distant objects to appear blurry, while close objects are seen clearly. The primary reason for myopia is that the eyeball becomes longer than normal, either growing too quickly or growing longer than it should. As a result, light entering the eye doesn't focus directly on the retina, but in front of it, causing blurred vision. While genetics plays a significant role in the development of myopia, environmental factors, particularly the amount of time children spend looking at screens and engaging in near-vision tasks, are also contributing to the increase in myopia cases.

A study published earlier this year reviewed over 276 studies and included data from 5.4 million children and adolescents between the ages of 5 and 19, across 50 countries. The findings revealed that nearly one in three children are already affected by myopia, and by 2050, the number is expected to surpass 50% in adolescents aged 13-19. This rise is not confined to specific regions. Studies in Australia and New Zealand also predicted that 36% of children in these regions would be affected by myopia by 2020, with the number expected to increase to more than half by 2050. This upward trend highlights that myopia is becoming a global epidemic with far-reaching implications for children's eye health.

The Role of Screen Time and Outdoor Activities

One of the significant contributors to the rise in myopia is the increased amount of time children spend looking at screens. With the growing dependence on smartphones, tablets, and computers, children are engaging in prolonged near-vision activities, which have been associated with the development of myopia. When screens are held too close to the eyes, it forces the eyes to focus at a short range for extended periods, potentially contributing to the elongation of the eyeball and the development of myopia.

While limiting screen time is often recommended as a preventative measure, many parents find it challenging to manage in today's digital age, where screens are an integral part of education, entertainment, and daily communication. However, research suggests that reducing screen time alone may not be enough to combat the rising rates of myopia in children.

Studies have shown that spending more time outdoors—referred to as "green time"—may be more beneficial in preventing myopia. Outdoor exposure, especially to natural light, has been found to stimulate the release of dopamine, a chemical that helps regulate eye growth. One to two hours of outdoor activity per day have been shown to reduce the onset of myopia by as much as 20% over a two to three-year period. However, it’s important to note that while outdoor time can help prevent myopia from developing, it has limited effects on worsening myopia once it has already developed.

The Risks of Untreated Myopia

Although myopia is easily corrected with glasses or contact lenses, untreated myopia, particularly high myopia (severe shortsightedness), can lead to significant health risks. People with high myopia have a higher likelihood of developing serious and potentially vision-threatening conditions, including:

Retinal detachment: This occurs when the retina tears and separates from the back of the eye, which can lead to permanent vision loss.

Glaucoma: This condition causes damage to the optic nerve, which can result in progressive vision loss and, if untreated, blindness.

Myopic maculopathy: The elongation of the eyeball in high myopia can stretch and thin the macula (the central part of the retina), leading to tissue degeneration, breaks, and bleeds, which may permanently impair vision.

The long-term risks associated with high myopia underscore the importance of early diagnosis and intervention. Treating myopia early—especially in cases of high myopia—is critical in preventing the progression of these serious eye conditions. If myopia is left unchecked, it not only affects a child’s ability to see clearly but can also hinder their academic performance, as they may struggle to read from a distance or focus on classroom activities.

Managing Myopia: Interventions and Treatment

Recent research and technological advances have led to more effective methods of managing and slowing the progression of myopia. In addition to traditional methods like wearing glasses or contact lenses, there are several treatments that have shown promise in controlling myopia progression.

One such treatment is orthokeratology (Ortho-K), which involves wearing specially designed hard contact lenses overnight. These lenses temporarily reshape the cornea, helping to improve vision the following day without the need for glasses. Ortho-K lenses are convenient as they are worn only during sleep, but they require careful cleaning and maintenance to prevent eye infections.

Another treatment option is atropine eyedrops, which have been shown to effectively slow the progression of myopia. Atropine is a medication that can be administered in small doses to children, and studies have found it to be effective in halting or slowing myopia’s progression with minimal side effects. The use of atropine eyedrops offers a less invasive option than contact lenses, with no risk of infection.

Both Ortho-K lenses and atropine eyedrops are gaining popularity among eye care professionals as effective treatments to slow myopia’s progression. However, parents should consult an optometrist to determine the best course of action based on their child’s specific needs.

The Importance of Regular Eye Tests

The key to preventing and managing myopia lies in early diagnosis. Regular eye tests with an optometrist are essential in detecting myopia and determining the best approach to managing the condition. If myopia is diagnosed, an optometrist can help parents create a tailored plan to track and manage the condition, which may include lifestyle changes, corrective lenses, and/or medical treatments.

Parents should watch for signs that their child may have myopia, such as squinting when trying to see objects in the distance, or holding books, screens, or objects too close to their eyes. These behaviors are common indicators of vision problems and should prompt a visit to the optometrist for a comprehensive eye exam. Early intervention can make a significant difference in preserving a child’s vision and preventing further complications down the road.

The rising prevalence of myopia among children is a growing public health concern that requires immediate attention. While screen time and limited outdoor activity are contributing factors, there are effective strategies to manage and slow the progression of myopia. Early diagnosis, regular eye exams, and advanced treatments like Ortho-K lenses and atropine eyedrops can significantly reduce the risk of serious eye conditions associated with high myopia.

Ultimately, parents and caregivers must be proactive in ensuring their children’s eye health by promoting outdoor activities, limiting excessive screen time, and seeking early intervention when necessary. With the right combination of lifestyle changes, medical treatments, and preventive measures, it is possible to manage myopia and protect children’s vision for the future.