Myopia and Children: How to Slow an Epidemic

As a pediatric ophthalmologist, I see and treat children every day. From serious injuries that require surgery to more common infections such as conjunctivitis (pink eye), I’m used to dealing with parents rightly concerned about their child’s eye health and vision. One topic that unfortunately is not getting enough attention is childhood myopia. With over 15 million children in the U.S. now myopic and growing, I’m concerned about the impact on children’s long-term eye health from ever-increasing rates and severity of myopia.

Myopia is a condition that occurs when the eye grows too long or has a cornea that is too steep. The symptom of myopia is blurry distance vision because light rays entering the eye focus in front of the retina instead of on it. Fortunately, we can easily correct for the symptom of myopia, blurry distance vision, with glasses or contact lenses. These devices redirect light rays entering the cornea to focus on the retina to ensure the patient can see clearly at distance. Myopia usually starts in childhood and continues to progress or get worse, until a child stops growing. Due to this, a child often has to get stronger glasses to correct their vision.

The only negative with it being so easy to correct for myopia is that we often aren’t addressing the underlying issue, an eye growing too long. As a child’s myopia increases, their eye continues to elongate. Higher levels of myopia increase the lifetime risk of serious eye diseases such as retinal degeneration and glaucoma. This increased risk is because as the eye elongates, it stretches the back tissue of the eye, the retina, and can cause it to tear. This article from the International Centre for Eye Health describes these increased risks in more detail. Rather than just correcting myopia with glasses, we need to take a more proactive approach with myopic children and treat myopia to reduce its progression and reduce the risk of these serious eye diseases associated with higher levels of myopia.

Over the last decade, innovation in eye care research and development has given us several new ways to treat myopia in children. Unfortunately, most parents are not aware of these new treatments and don’t know that there are now ways to slow down or in some cases stop the progression of myopia in their child. Parents are vigilant about their child’s overall health, but often are not aware that myopia is developing in their child because the onset is typically very slow. I often hear from parents who are surprised that their child is myopic because the child never complained of poor vision. This is because a child often doesn’t notice their distance vision has deteriorated until their myopia has already progressed. One way to combat this is to ensure that children are screened with a vision test at their well child exam each year and visit an eye doctor for a comprehensive exam if indicated by the screening.

Given most myopia starts in children, and tends to progress, treating myopia is most effective when started early. Treatments cannot currently reverse myopia, only slow or stop the progression, so early intervention is recommended to have the maximum beneficial impact on a child. Treatments for myopia that are backed by numerous studies showing efficacy and safety include prescription eye drops and optical interventions such as customized contact lenses. Each child is different, so it is important to take your child to an eye doctor with experience in myopia management as they have the equipment and expertise to examine your child and recommend the treatment they believe will work best. These treatments all use FDA approved devices or drugs, but most are not yet indicated by the FDA for treating the progression of myopia in children, so it is important to understand the potential benefits and risks associated with any treatment plan.

Early treatment of myopia in children is important to ensure these children don’t grow up with a higher risk of developing serious eye diseases as a result of high myopia. The incidence of myopia has grown 66% in the last 30 plus years so it is impacting more children than ever before. Myopia impacts more kids than more commonly known diseases such as diabetes or other serious eye diseases such as amblyopia. Now that there are treatments available for childhood myopia, it is important for parents to discuss myopia treatment options with their eye doctor to mitigate this growing and serious issue.

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Dr. Erin Stahl, MD | Pediatric Ophthalmologist
Section Chief – Ophthalmology
Children’s Mercy Kansas City
Associate Professor – Ophthalmology
UMKC School of Medicine