Myopia, or nearsightedness, is a common refractive error of the eye where distant objects appear blurry while near objects remain clear. In a myopic eye, the light rays from distant objects do not focus correctly on the retina - the light-sensitive tissue at the back of the eye, often because the eyeball is too long or the cornea is too curved.

Although myopia can affect people of any age, it often begins in childhood or adolescence, making early detection and management crucial for long-term visual and overall well-being.

Why Myopia Matters

By 2050, it is estimated that nearly 50% of the global population will be affected by myopia. This dramatic rise is already drawing comparisons with other non-communicable diseases like diabetes and hypertension due to its growing health, economic, and developmental burden.

Myopia is not just a matter of blurry vision. When left uncorrected or inadequately managed, it can lead to:

1. Degenerative changes in the retina and optic disc
2. Social and psychological impacts due to visual limitations and stigma
3. Reduced academic and developmental outcomes in children

What Causes Myopia?

The exact cause of myopia is not fully understood, but research suggests it results from a combination of genetic and environmental factors:
1. Children with one or both parents with myopia are at a significantly higher risk.
2. Prolonged near-work activities, such as reading, studying, or excessive screen time, may contribute to myopia onset and progression.
3. Insufficient exposure to natural daylight is also considered a significant factor.

Risk Factors for Myopia in Children

1. Family history of myopia
2. Intensive near work such as reading or screen use
3. Limited time outdoors or exposure to daylight
4. Ethnicity – Higher prevalence seen in East Asian populations

Treatment Options for Myopia

1. Corrective Lenses
1a. Prescription glasses are the most common and effective way to correct myopia.
1b. Contact lenses may be preferred by older children and teens for cosmetic or comfort reasons.

2. Refractive Surgery
Generally not recommended for children as their eyes are still developing. However, in rare cases involving other eye conditions or developmental concerns, surgery may be considered.
Types of refractive surgeries:
2a. LASIK (Laser-assisted in situ keratomileusis): A popular laser surgery that reshapes the cornea to correct myopia and reduce dependence on glasses or lenses.
2b. Photorefractive Keratectomy (PRK): A surface laser procedure that reshapes the cornea after removing the outer layer, suitable for thinner corneas.
2c. Clear Lens Extraction: A surgical procedure where the eye’s natural lens is removed and replaced with an artificial one, typically used in high myopia cases unsuitable for laser.
2d. Phakic Intraocular Lens (IOL) Implantation: An implantable lens is placed in the eye without removing the natural lens, ideal for very high myopia or unsuitable corneas.

How Does Myopia Affect a Child’s Life?

Children with uncorrected myopia may experience:
1. Academic challenges, such as difficulty reading the board or books
2. Physical discomfort, including frequent headaches, eye strain, or rubbing of eyes
3. Emotional struggles, particularly if they are teased for wearing glasses or feel isolated
In India, social stigma surrounding spectacle use further complicates treatment adherence, especially among children and teenagers. Parents may hesitate to accept the diagnosis or delay seeking correction due to misconceptions or cost-related barriers. As the child grows older, self-esteem issues arising from being singled out for spectacle-wearing end up discouraging the wearer from periodic follow-ups and even discontinuing use.

Addressing the Barriers

To support children effectively:
1. Teachers and parents should be trained to identify visual difficulties and act early.
2. Peer sensitization programs can reduce stigma and boost acceptance of spectacle use.
3. Access to affordable spectacles and routine eye check-ups should be prioritized.
4. Underlying conditions like amblyopia or developmental delays should be evaluated before prescribing corrective lenses.

Myopia Progression Therapy

These treatments aim to slow the worsening of myopia in children:
1. Environmental changes: Encouraging outdoor play, reducing screen time
2. Specialized spectacles: Myopia control lenses designed to slow progression
3. Multifocal contact lenses: Shown to reduce progression in some children
4. Pharmacologic agents: Low-dose atropine eye drops (0.01%) are emerging as an effective option with minimal side effects compared to higher concentrations

Myopia in children is more than just a vision issue—it's a growing public health concern. Early detection, proper education, lifestyle changes, and timely interventions can ensure that children with myopia lead healthy, confident, and productive lives. Collaborative efforts between parents, teachers, and eye care professionals are essential to safeguard the vision and future of the next generation.

Parent Corner: Common Questions Answered