What You Need to Know About Myopia in Children

However, it can also often manifest as visual-related behaviors, including:³

• Holding books or other writing close to the face
• Writing with the face close to the page
• Sitting close to a television or screen
• Squinting at faraway things

If children are exhibiting these signs, it's important to get them to an optometrist sooner than later so corrective treatment, such as glasses, contact lenses or eye drops (or a combination of these treatments), can begin.¹ In rare or severe cases where traditional, noninvasive treatments do not work to correct the myopia, certain surgical procedures, such as refractive surgery, may be recommended instead.⁴

What Causes Myopia in Children?

The physical cause of myopia is simply that the child's eyeball is too long from the front to the back, or the cornea is too curved. This means light entering the eye does not reach the retina, which is the light-sensing tissue in the eye. Thus, faraway objects tend to be blurry, while close up objects are sharp and clear.¹

However, the origins of myopia are not fully understood. It may be inherited — a child with a parent who has myopia is more likely to also develop it. Or, it may be due to environmental factors, such as spending too much time on screens. Some of the symptoms of myopia may also be an indicator of the changes in blood sugar levels signaling diabetes. They can also be early signs of a cataract.¹

Pseudomyopia

There's also a condition that mimics myopia in people who spend a lot of time doing near-vision work. Blurred vision in these people is often caused by an overuse of focusing up close and an atrophy of focusing longer distances. These people can restore their long-distance vision after resting, though repetitive strain of excess near-distance work can cause permanent vision reduction as well.¹

How Is Myopia Diagnosed in Kids?

Since some of the symptoms of myopia can masquerade as other problems, it can be easy to miss. It is important for children to get routine eye exams to catch this problem early. Most newborns will have an initial exam at birth. The American Academy of Ophthalmology recommends that another exam should occur between 6 and 12 months.⁵

For premature babies or those with a family history of myopia, it may be necessary to have frequent eye exams.⁵

Tests and tools for diagnosing myopia

An optometrist or ophthalmologist will put your child through several tests to diagnose myopia.⁵ These tests may include:⁶

• A visual acuity test. This measures each eye individually to see how well they can see objects at a distance, and is often written as a fraction, such as 20/40.
• A refraction test. This test helps the eye care professional decide what lens will be prescribed.
• Eye focusing, eye teaming and eye movement testing. This test determines if and how well a person's eyes are working together.
• An overall eye health evaluation. Utilizing a variety of microscopes, lenses and other technology, a doctor of optometry or ophthalmology will assess your eye's overall health.

Treatment Options for Children With Myopia

Treating myopia is necessary, not only to correct the issues that impair a child's vision now but to stave off other complications down the road. Treatments can include several approaches, such as glasses, contact lenses and prescription medication.

Eyeglasses

To determine if a child with myopia needs glasses, an ophthalmologist will dilate the pupils and relax the focusing muscles of the child's eyes with a special medicated drop, and use a retinoscope — a tool that holds a number of lenses of different strengths — to determine the correct prescription.⁷

For kids who need glasses to treat their myopia, an eye doctor may prescribe:⁸

• Single focus glasses. These only come in a single power, and may not be enough when the child grows up and their eyes change due to aging.
• Multifocal glasses. These glasses correct more than one focus power and involve having the child look across the lens to use the appropriate lens power. Most commonly, myopia correction will be at the top of the lens, and other vision correction that helps with reading at the bottom.
• Bifocal glasses. These are essentially two lens types put together, with myopia correction and reading vision correction.

Children and teens may need to wear multifocal or bifocal lenses if they have both problems with eye focus and eye muscle coordination.⁸

Contact lenses

For children who are comfortable touching their eyeballs and inserting lenses, contact lenses may be a good fit to treat their myopia. Multifocal soft contact lenses can improve vision at multiple focal distances. Research has even shown that multifocal lenses were better at slowing the progression of myopia over single vision lenses.⁹

Since some children are sensitive to lenses touching their eyes, daily wear disposable lenses that don't need to be cleaned or disinfected may be easier to start with.⁹

Considerations for wearing lenses include such factors as:⁹

• Pupil size
• Eye shape
• Eye sensitivity
• Personal hygiene
• Maturity
• Compliance
• Lifestyle
• Sporting activities

Ortho-k or CRT

For mild myopia, there's another treatment known as orthokeratology (ortho-k) or corneal refractive therapy (CRT). With this treatment, the patient wears specially designed, rigid contact lenses that reshape the curvature of the cornea over time by placing mild pressure on the cornea, thus flattening it. Unlike other contact lenses, these are worn for a limited time, often overnight, and then removed.¹

There is some concern about children using them, however, as wearing them overnight can increase a child's chances of developing an eye infection and irritation, as well as other vision problems.¹⁰

Atropine prescription medication

Research has found that a prescription medication called atropine can reduce the progression of myopia.¹¹ In higher doses it is used to dilate pupils, but in low doses it does not affect the size of the pupil.¹¹ While children can take this medication with generally good results, it usually needs to be made by a compounding pharmacy.¹¹ It is only administered to children whose eyes are still growing or whose myopia is increasing.¹¹ Typically, this is only given to children between the ages of 5 and 18.¹⁰

Every parent will need to discuss the best possible treatment approaches, its benefits and side effects with their child's eye care professional.

Myopia Control and Progression

Myopia can't be cured or reversed, but it can be treated to prevent it from getting worse, which is why it's essential to catch it as early as possible and control it through treatment. While much myopia research is still ongoing, some studies show that if children get a minimum of two hours of daylight every day, it may lower the chances of developing myopia. Researchers don't yet know exactly why time outdoors may protect against or slow myopia — some theories include the spectrum of light may have an impact.¹²

It's important to note that while sunlight and outdoor time may slow the progression of myopia, it can't reverse myopia in children who already have it.¹²

Potential Complications of Myopia

Though myopia isn't a life-threatening condition, it does need to be treated and controlled or it can lead to greater complications. Once it is diagnosed, it continues to worsen as long as the eyes continue growing, and will stabilize (but not improve without treatment).¹²

If myopia is not treated, further complications can include:¹³

• Macular degeneration
• Retinal detachment
• Cataracts
• Open angle glaucoma

It is essential to make regular exams and follow-up appointments with eye care professionals and not leave anything to chance.

Cost Considerations and Insurance Coverage

Parenting Tips for Children With Myopia

While treatments can help halt and control myopia, there are other things parents can encourage their children to do to manage their condition:

• Encourage good eye hygiene habits, such as washing hands before touching eyes or handling contact lenses.²⁰
• Create a screen time hygiene plan. This can include spending two hours per day outdoors, spending less than one hour per day of screen time if not for schoolwork, proper lighting and proper monitor placement. And remind kids to blink frequently when performing near tasks.²¹
• Address any concerns or challenges proactively. Don't wait on myopia, or it will get worse.
• Stay in contact with your child's eye care professional to make sure they are having the appropriate exams, follow-up appointments and treatments. A child's treatment may need to be adjusted over time.

Don't Panic, Treat Myopia!

If your child has myopia, you don't need to panic. While it can't be reversed, it can be controlled and treated, especially when caught early. Parents should be proactive about treating their child's myopia to prevent worsening cases or other vision problems. Your child's eye care professional should be able to find the best treatment avenue for them, and can adjust it over time as needed. So long as you practice good vision hygiene and make sure your child takes breaks from screens and spends several hours outdoors when possible, you can successfully manage the condition.

CareCredit Credit Card Financing for Myopia

Whether you're paying for eye surgery or getting an eye exam, the CareCredit credit card can help you pay for care where your insurance leaves off.* Use our Acceptance Locator to find a vision specialist near you that accepts CareCredit. Continue your wellness journey by downloading the CareCredit Mobile App to manage your account, find a provider on the go and easily access the Well U blog for more great articles, podcasts and videos.

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Author Bio

Jordan Rosenfeld has been freelance writing for 21 years about finances, health, education and more. Her work has appeared in The Atlantic, The Billfold, Good Magazine, GoBanking Rates, Daily Worth, Quartz, Medical Economics, The New York Times, Paypal, The Washington Post and more.