How To Spot The Signs Of Myopia In Your Child 

It's common to see young children in Singapore wearing glasses – and it comes as no surprise to find out that our country is often referred to as the 'myopia capital of the world'. Is it something we're proud of? Definitely not. But it's certainly spurred us on to do something about this issue. Before we go into how we can help children reduce or avoid it, we first have to know what causes myopia in kids. 

Dr Deborah Tan, Head and Senior Consultant, KK Eye Centre, KK Women’s and Children’s Hospital (KKH), says that childhood myopia – also known as short-sightedness – is the condition of the eye when distance vision is more blurred compared with near vision. 

“It arises from excessive growth and elongation of the eyeball. This results in light rays from distant objects focusing in front of the retina instead of on the retina. Distant objects are thus seen to be blurred but near objects remain clear,” she explains. 

While the exact cause of myopia isn't known, certain risk factors increase the likelihood of myopia, such as genetic and environmental factors. 

“Myopia tends to run in families; if one of the parents is myopic, the child has two times the risk of developing myopia. The risk is eight times higher if both parents are myopic,” says Dr Tan. “Lack of outdoor activities and excessive near work like reading, playing games on handheld electronic devices or computers also expose one to the risk of developing myopia.”

Dr Tan, who is also Senior Consultant, Paediatric Ophthalmology & Adult Strabismus Department at Singapore National Eye Centre (SNEC), reveals that about 80% of children in Singapore will develop myopia and many of these children develop myopia around six to eight years of age. 

How to spot signs of myopia in your child

If you have a child under or around this age, start looking out for signs that could mean they have myopia. These include:

• Difficulty seeing distant objects, the whiteboard in school, or road signs
• Squinting to see properly 
• Eye strain or headaches. 

However, Dr Tan cautions that many young children with myopia may not complain about their blurring of vision. Hence, regular vision checks are important in young children.

Myopia is diagnosed through a comprehensive eye examination. Dr Tan explains that refraction is performed to measure the degree of myopia, and appropriate spectacles will be prescribed to allow the child to see clearly. 

There is currently no cure for myopia so it's best to catch it as early as possible. The key is to manage it either by preventing it or slowing down its progression. This is because it increases the risk of blinding eye diseases later in life, such as glaucoma (where vision is lost due to damage to the optic nerve), early-onset cataracts (clouding of the clear lens of the eye), retinal tears and detachment and macular degeneration. 

“Myopia control treatment options include atropine eye drops, myopia control spectacles and myopia control contact lenses. Treatment is individualised and we will have to assess each child before recommending appropriate therapy,” says Dr Tan.

Atropine eye drops are used nightly over a period of two years or more and can slow the progression of myopia by 50-60%. 

What causes myopia in children?

The best way to prevent myopia in children is to encourage them to adopt good eye care habits from a young age. Dr Tan lists some tips:

• Spend more time outdoors (at least one to two hours each day)
• Spend less time on intensive near work (eg. handheld computer games)
• Take regular eye breaks (30-30-30-30 rule: hold reading/writing material more than 30 cm away, and after 30 minutes of work, to look 30 feet away for 30 seconds or more). 

Myths about myopia

Remember the times when our parents would tell us our eyes would be ruined if we watched too much TV? The good news is that that's not true. Here are some other myths Dr Tan is happy to clear up:

Does reading in the dark cause myopia?

Currently, there is no strong evidence yet to suggest that reading in the dark or poor light causes myopia. However, reading in the dark does cause more strain on the eyes to make out the words and can make reading strenuous, and the eyes get tired more quickly. Hence, I would still advise adequate lighting when reading or writing to avoid eye strain. 

Does lying down to read or watch TV cause myopia? 

Some studies have shown that poor reading/writing posture (lying down to read, maintaining distance of <30cm between eyes and book etc) leads to greater risk of myopia and eye strain. 

Does staring at a screen for too long cause myopia? 

Excessive screen time is a risk factor for myopia, so moderation is key.