Myopia or nearsightedness is a refractive error where light entering the eye is focused in front of the retina, which results in blurred distance vision while near vision remains clear. In an eye with myopia, the image is not properly focused on the retina because the eyeball is too long or has a corneal curvature that is too steep. This reason is why we note myopic prescriptions with a negative diopter value, typically progressing between –.5 and -1.00 every year.

The elongation of the eyeball, referred to as axial length elongation, is a principal contributing factor to myopia progression. As children grow, their eyes may also grow longer from front to back, which can lead to a greater degree of myopia. This process is significant because the longer the eyeball becomes, the higher the likelihood of future eye health issues. Understanding this growth pattern helps our eye doctors design precise management strategies that slow down the progression and protect your child’s vision.

Typically, myopia starts developing during childhood, often between the ages of 5 and 14, and can continue to progress into early adulthood. The early years are marked by rapid growth in the eye, which can lead to quick changes in the strength of your child’s prescription. Younger children may experience faster progression, which gradually slows as they approach their teenage years. Annual progression gets worse on average by -0.50 diopters to -1.00 diopters, although various factors can impact the actual progression of your child.

Ortho-K, also known as Orthokeratology, Corneal Reshaping Treatment (CRT), or Vision Shaping Treatment (VST), is a unique approach to managing myopia in children. These specially designed rigid, oxygen-permeable contact lenses are worn overnight, gently reshaping the cornea while your child sleeps. The lens uses a reverse-geometry design to flatten the central cornea and steepen the periphery, which not only improves central vision but also helps reduce peripheral hyperopic blur—a key factor in slowing myopia progression. Research has shown that Ortho-K is highly effective at reducing the progression of myopia and reducing axial length gain, making it a top option for myopia management.

Multifocal contact lenses offer an effective method for managing myopia in children by altering the visual stimuli on young eyes. These lenses provide clear distance vision while also supporting good near vision, which can help slow the progression of nearsightedness. MiSight 1 day lenses from CooperVision are the first FDA-approved contact lenses specifically for myopia control in children aged 8 to 12, but other multifocal lenses with broader parameters are also available for kids with higher levels of myopia. These daily disposable lenses are comfortable, require no cleaning, and offer a convenient alternative to Ortho-K lenses.

Atropine eye drops have become a well-regarded option for managing myopia progression in children. Low-dose atropine is used to relax the eye’s focusing mechanism, which can help slow the elongation of the eyeball—a key factor in worsening myopia. Unlike other treatments, atropine does not require the use of contact lenses or glasses, making it a good option for younger children or those who struggle with other myopia control methods. Studies have shown that atropine is highly effective at reducing myopia progression, and it is often used in combination with other treatments, such as multifocal contact lenses, to enhance effectiveness.

Standard corrective methods such as prescription eyeglasses or contact lenses are commonly used to improve blurry vision caused by myopia. While these lenses help bring distant objects into clear focus, they do not address the underlying progression of myopia. Instead, they serve to provide immediate clarity during daily activities, ranging from reading the classroom board to watching TV at home. This form of correction will still leave your child at risk, as their myopia will continue to get worse, requiring new prescriptions as they age as well as significantly increasing the risk of eye disease later in life.

Each child’s eye health is unique, and there is no one-size-fits-all solution in myopia management. Our eye doctors carefully evaluate the individual factors at play by considering age, current prescription, rate of myopic progression, and lifestyle. This personalized approach ensures that any intervention—whether it be advanced contact lenses, overnight corneal reshaping, or pharmacological measures—is well suited to your child’s specific needs.

One of the simplest yet most effective practices you can adopt is to encourage more time outdoors. Natural light exposure helps narrow the pupil, reducing peripheral blur and potentially curbing the stimulus for axial growth. This doesn’t require any fancy equipment—just a daily dose of fresh air and sunlight can make a significant difference. Consider making outdoor play a regular part of your child’s routine; whether it’s a walk in the park or playing a game outside, these activities not only benefit overall health but also contribute to improved eye health. Some studies suggest that increased outdoor time can reduce the risk of new myopia onset by nearly 50 percent.

In today’s digital world, managing screen time is more important than ever. Digital devices are typically held much closer to the face than traditional reading materials, which increases accommodative strain on the eye. Setting limits on screen time and ensuring that near tasks are interspersed with breaks can help ease the burden on your child’s eyes.

Here are some tips to help balance near work with healthy eye habits:

• Scheduled Breaks: Encourage your child to take breaks every 20 to 30 minutes when engaged in near tasks.
• Proper Lighting: Make sure they work or read in well-lit areas to reduce eye strain.
• Distance Management: Teach them to maintain an appropriate distance from screens and books—a rule of thumb is to hold devices at arm’s length whenever possible.

Sleep plays a crucial role in overall physical development, including that of the eyes. A regular sleep schedule, with proper rest of at least eight hours, can help maintain the natural balance required for healthy eyes. Studies suggest that going to sleep earlier and ensuring adequate sleep may reduce the risk of faster myopic progression. By establishing a consistent bedtime routine and minimizing late-night screen use, you promote not only better sleep quality but also a healthier environment for your child’s eyes to recover from the day’s activities.