Myopia in Children: Causes, Early Signs, and the Best Treatment Options

Published: July 6, 2025

1. Causes of Myopia in Children

Myopia develops when the eye elongates too much front-to-back or when the cornea/lens system focuses light in front of the retina. Key contributors include:

Genetic Factors

• One myopic parent: ~25–30% chance of developing myopia
• Two myopic parents: >60% chance

Environmental & Lifestyle Influences

• Excessive Near Work: Extended reading, screen time, or homework sessions increase accommodative stress.
• Limited Outdoor Time: Less than 2 hours/day outdoors under bright light; natural daylight releases dopamine in the retina, which helps regulate eye growth.
• Urban Living: Higher prevalence in cities, where children spend more time indoors and on near tasks.

Educational Pressures

Intense early schooling and high academic demands can amplify near-work load and reduce outdoor playtime.

2. Early Signs to Watch For

Spotting myopia early allows for prompt intervention. Look for:

• Frequent squinting or blinking
• Holding books or devices very close
• Complaints of blurry distance vision (whiteboard, TV)
• Tilting the head or covering one eye to see clearly
• Eye rubbing, headaches, or eye strain after near work
• Decline in school performance or avoidance of distance-vision tasks

If these persist, schedule a comprehensive eye exam with an optometrist or pediatric ophthalmologist.

3. Best Treatment Options

Beyond standard glasses, these evidence-based strategies can slow progression:

3.1 Spectacle Lenses

• Single-Vision Glasses: Correct refractive error but don’t slow axial growth.
• Myopia-Control Lenses: Peripheral defocus designs that signal the eye to slow elongation.

3.2 Contact Lenses

• Orthokeratology (Ortho-K)
  Nightly rigid lenses reshape the cornea temporarily; studies report a 30–50% reduction in axial elongation over two years.
• Soft Multifocal Lenses
  Concentric zones create clear central vision and peripheral myopic defocus; trials show ~40% slowing of progression.

3.3 Pharmaceutical Intervention

Low-Dose Atropine (0.01–0.05%)
Nightly drops reduce progression by up to 60% with minimal side effects; requires regular monitoring for light sensitivity and near-vision changes.

3.4 Behavioral & Lifestyle Modifications

• Increase Outdoor Activities: Aim for 1–2 hours daily in natural light.
• 20-20-20 Rule: Every 20 minutes, take a 20-second break to look at something 20 feet away.
• Limit Continuous Near Work: Encourage regular breaks and varied focus distances.

4. Tailoring the Approach

Customize treatment based on:

• Age & Degree of Myopia: Younger children and higher prescriptions often benefit from combined therapies.
• Child’s Compliance: Ability to manage drops or contact lenses properly.
• Follow-Up Schedule: Eye exams every 6–12 months to monitor progression and side effects.

Collaboration among parents, eye-care professionals, and schools ensures adherence and timely adjustments.

Conclusion

Myopia in children is increasing, but early detection and a combination of optical, pharmacological, and lifestyle interventions can slow its progression. Regular eye check-ups are essential to tailor treatments and protect your child’s vision for the future.