Myopia in Kids: It's More Than Just Glasses

Is your child squinting at the whiteboard?

Have you noticed your child sitting closer to the TV, squinting at street signs, or telling you the smartboard at school is getting harder to read? If you or your partner are short-sighted yourselves, your child is at a higher risk of developing it also and i'm sure it's something you are looking out for. Here at SEASONS Optical, we're here to provide accessible eye care services and solutions for children as well as adults. 

Myopia, or short-sightedness, is becoming one of the biggest concerns in children's eye health, and it's only growing. Globally, it's expected that half the world's population will be short-sighted by 2050 and 1 in 10 of those will be classified as having high myopia (prescriptions of -5.00D or stronger). The earlier a child becomes myopic, the more it tends to progress, which raises the risk of high myopia and the complications that come with it later in life.

It's not just about needing thicker lenses, either. Myopia is linked to more serious, sight-threatening conditions down the track: cataracts, glaucoma, retinal detachment and macular degeneration. Catching it early and managing it properly in childhood is one of the best ways to reduce that risk.

What's actually causing it?

Myopia doesn't come from one single thing. Unfortunately, it's a mix of genetics and lifestyle. We can't change our genetics but lifestyle factors can definitely be addressed. 

If one parent is short-sighted, their child's risk goes up. If both parents are short-sighted, that risk roughly doubles. Ethnicity plays a role too, children of Asian background tend to develop myopia more often and it tends to progress faster. Keep in mind that the younger a child is when myopia starts, the quicker it tends to advance.

Lifestyle matters just as much. Kids spending less than an hour outdoors a day have a higher risk of becoming short-sighted. So does prolonged close-up work. Holding a book or device closer than 30cm from the face for more than 30minutes also increases the risk.

What we test for at SEASONS Optical

Cycloplegic refraction. 
This involves eye drops that temporarily switch off your child's ability to focus up close (so yes, your child's vision will be blurry for a few hours afterwards). This allows us to comprehensively assess your child's prescription without interference form the eye's fluctuating focusing. A cycloplegic refraction is a key step for getting an accurate prescription.

Binocular vision assessment.
Our vision is not just determined by the clarity that each eye can see with, but also how the two eyes work together. It's important then to conduct a series of tests to check how well both eyes are working together. This matters a lot in a school setting, where your child needs comfortable, co-ordinated vision to keep up day to day.

Axial length measurement.
This measures how long the eyeball is. The longer the eye ball is, the higher the degree of short-sightedness tends to be. It gives us a reliable way to track how your child's myopia is changing over time. (Just like monitoring how tall your child is growing, we can track how an eye ball is growing). 

Ocular health check with retinal imaging.
We use our OCT and digital widefield retinal cameras here in clinic to assess overall eye health as part of every comprehensive eye examination. 

So what can actually be done about it?

The encouraging part is that myopia management has come a long way, and there are now several effective evidence-based options. Keep in mind that Myopia can not be reversed and it's unlikely that the prescription can reduce but we can certainly slow things down and do our best to prevent the prescription from worsening. 

Myopia Spectacle lenses such as Essilor's Stellest 2.0 which uses peripheral defocus technology. This describes hundreds of tiny lenslets (like dimples on a golf ball) that focuses light in front of the retina instead of behind, which signals the eye to slow its growth. Stellest 2.0 builds on the original Stellest design with a stronger version of this signal, and early clinical data suggests it slows axial elongation even further than its predecessor. These lenses are a great option for kids already in glasses, since it's a straightforward lens switch with no contact lens insertion or overnight wear involved. Full-time wear matters here: 7 days a week, at least 12 hours a day.

Soft contact lenses such as MiSight 1-day and Johnson & Johnson's ACUVUE Abiliti 1-Day, use a similar defocus principle in a contact lens format. Abiliti uses what's called RingBoost technology: a ring-shaped treatment zone built into the lens that bends light to land in front of the retina, signalling the eye to slow down, while the centre of the lens keeps vision clear for everyday activities. As a daily disposable, there's no cleaning or storage involved, which makes it a low-fuss option for busy families. Soft contact lenses like these suit kids who'd rather be glasses-free and are confident putting in and taking out their own lenses. Again, consistent full-time wear is key to it working.

OrthoK lenses are worn overnight and reshape the cornea so your child sees clearly during the day without glasses or contacts. It's a good fit for kids who want to be completely free of correction during school hours, but it does require good routines and regular check-ups to make sure the fit and correction stay on track, and good hygiene since the lenses are reused nightly.

Atropine eye drops used nightly before bed.  One of the longest-studied treatments we have for myopia control. Atropine works differently to the treatments above. Rather than changing how light focuses on the retina, it acts on the growth signalling pathways within the eye itself, helping to slow the eye growth and elongation that causes myopia progression.

There are two main side effects:  1) light sensitivity and 2) slight blurry vision up close. These side effects are usually mild and easily managed by administering the drops at night, just before bed. The dosage is one of the main ways to control these side effects so it is something we tailor carefully. Higher concentrations generally slow progression more, but they also carry a higher chance of side effects. A dosage concentration of 0.025% has been shown to be strong enough to make a real difference, with a gentler side effect profile than higher concentrations. Atropine eye drops need to be compounded specifically at a pharmacy, as they're not available off the shelf.

Lifestyle changes that help too

Alongside clinical treatment, there's a lot you can do day-to-day:

• Aim for more than 2 hours outdoors daily, with appropriate sun protection
• Take regular breaks when doing near-work: 5-minute break after every 30 minutes 
• Keep a good working distance of at least 30cm+ during reading or screen time

Where to from here?

Short-sightedness in kids isn't something you just have to manage with stronger lenses every year. With the tools available now, there's a real opportunity to slow it down, preserve vision and protect eye health long term. Regular eye tests are the starting point: they let us catch myopia early and put the right management plan in place before it progresses too far. 

If you're noticing the signs, or simply want a baseline check, book your child in for a comprehensive eye test with us here at SEASONS Optical in Melbourne CBD.

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References:

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