Myopia in children

Myopia in Children

What is myopia or nearsightedness?

Myopia, or nearsightedness, is a condition of the eye in which glasses or lenses with a minus prescription are needed to see clearly. This occurs because the eyeball is too long, causing the focal point of incoming light rays to fall in front of the retina rather than on it, resulting in a blurry image. An elongated eyeball (greater axial length) is not inherently problematic, as long as it does not continue to grow excessively. The higher the minus prescription required, the longer the eye. A very long eyeball (>25 millimeters) can lead to problems later in life. Myopia is increasing rapidly in the population: among people in their sixties, one in four is nearsighted; among those in their forties, one in three; and among people in their twenties, half. By age 13, already one in four children is nearsighted.

What Causes Myopia?

Nearsightedness is partly hereditary. However, not every child with nearsighted parents will develop myopia. Lifestyle also plays a role in the development of myopia. Activities such as extensive reading—or spending a lot of time in front of screens, like computers or smartphones—can influence the growth (length) of the eyes.

Myopia Treatment

Unfortunately, there is no miracle cure for nearsightedness, but there are ways to slow the growth of the eyeball. The child’s eye continues to grow until around the age of 20, so during this period it is possible to influence axial length growth. This can be done by adjusting lifestyle habits and following the 20-20-2 rule: after looking at something up close for 20 minutes, look away for 20 seconds, and make sure to spend at least 2 hours outdoors each day. Exposure to plenty of natural light—even on cloudy or rainy days—slows the growth of the eyeball. Outdoor light stimulates the release of dopamine in the retina, which ultimately slows down the elongation of the eye.

Drops, Lenses, or Glasses?

For children with increasing myopia, there are currently several treatments to slow the growth of the eyeball. This can be done with eye drops, special contact lenses, or glasses. Below, we explain some of these options in more detail. However, there is no method to completely prevent myopia.

Atropine Eye Drops

Atropine eye drops have long been used in ophthalmology. These drops dilate the pupil and relax the muscles that make the lens rounder for near vision (a process called accommodation). In recent years, atropine has also been used to slow progressive myopia. These drops are prescribed by an ophthalmologist. Atropine drops come in different concentrations. Higher doses of atropine are likely to have a stronger effect on slowing eye growth, but higher concentrations can also cause more side effects.

Contact Lenses

Special contact lenses can correct the focal point of incoming light rays so that a sharp image falls across the entire retina. This can help slow the abnormal growth of the eyeball.

Currently, there are two types of lenses available:

With treatment using special contact lenses, hygiene is extremely important to prevent infections. It is therefore essential to follow the instructions carefully and have the eyes checked regularly.

Glasses

Specially designed eyeglass lenses are the newest option to slow the growth of the eyeball. In these lenses, the central part provides clear vision, while the peripheral part contains many small plus-power zones that send “slow-down” signals in front of the retina to help control eye growth. A combination of atropine drops, special contact lenses, and/or glasses is also possible.