School Age Myopia (Nearsightedness)

Have you noticed your child squinting, or have you heard from teachers that your child has trouble seeing the board at school? If so, your child might have myopia, or nearsightedness, an increasingly common visual condition that impacts the sight of many school-age children.

Nearsightedness is frequently a misunderstood term, as this condition describes a difficulty seeing objects at a distance. Wearing glasses will improve your vision when worn, but glasses won’t change the progression of myopia. Parents and visual researchers continue to search for answers regarding how and why myopia develops and progresses.

The size and shape of the eyeball and its internal structure cause refractive error, a common visual problem.  A refractive error, such as myopia, occurs when the focusing power of the eye is mismatched with the size of the eye. A myopic eye is typically larger and longer in shape. Researchers have investigated what makes a child’s eye longer and what might prevent the progression of myopia in school-age children.

Like most physical traits, the size and shape of the eye are inherited. Myopia is a condition that runs in families. If you wore glasses for nearsightedness, your children probably will too. Nearly half of all Americans are myopic, and school-age myopia is becoming more prevalent. Myopia has increased by nearly 50 percent in the past two generations. School-age myopia is twice as common as adult-onset myopia. In addition to the billions of dollars spent annually on eyewear, myopia also increases the risk of sight-threatening diseases such as glaucoma, retinal detachment, and cataract.

Most parents recognize that children spend less time outdoors and more time with electronic devices than children did a generation ago. Visual researchers have suspected the risk of indoor activities instead of outdoor play as a factor for the progression of myopia in childhood. However, no specific indoor activity such as playing games on tablets, reading books, or watching TV carries an increased risk. American children fare better than children in some countries in outdoor activity, but the days have passed when school-aged children are outdoors for hours upon hours of unstructured play.

If childhood myopia is a visual aspect of modern life, do we have any effective way to delay the progression of school-age myopia? Probably not, but many methods have been tried, from bifocal lenses and atropine eye drops to wearing contact lenses. While LASIK has offered millions of adults an alternative to glasses or contact lens wear for myopia, refractive surgery is not indicated for school-age myopia.

Wearing glasses is highly effective in improving visual acuity and is the widely accepted traditional treatment for children with myopia. Alternative methods of treatment are under investigation, but presently there are no evidence-based, preferred practice recommendations for slowing the progression of school-age myopia.

Dr. Steven Goodrich is a Mercy Kids pediatric ophthalmologist with Mercy Children’s Hospital.