Early onset myopia is nearsightedness that appears in early childhood, generally before the age of 10. It occurs when the eye grows too long from front to back, or the cornea becomes too curved. This physical change causes light entering the eye to focus in front of the retina, the light-sensitive tissue at the back of the eye, rather than directly on it. Consequently, distant objects appear blurry while near objects can be seen clearly. This condition is becoming increasingly common in children around the world.
Symptoms and Diagnosis in Children
Parents and caregivers are often the first to notice the behavioral clues that may indicate a child is developing myopia. A common sign is frequent squinting when trying to see things far away, like a school whiteboard or a television screen. Children may also consistently sit very close to the television or hold books and tablets near their face to compensate for poor distance vision.
Other observable signs include frequent eye rubbing, tilting the head to see better, or blinking excessively. These actions can be accompanied by complaints of headaches or tired eyes, which may result from the constant strain of trying to focus. A sudden drop in school performance can also be a sign of a vision problem, as the child may be unable to see educational materials clearly. Since children often do not realize their vision is different from others, they may not complain about blurriness.
Myopia is diagnosed during a comprehensive pediatric eye exam, which is more thorough than routine school vision screenings. An optometrist or ophthalmologist will use eye charts to test distance vision and instruments to measure the eye’s refractive error, which determines the degree of nearsightedness. Regular eye exams are recommended for all children, especially before they enter first grade, as early diagnosis is a foundation for effective management.
Causes and Contributing Risk Factors
The development of early onset myopia is a result of both genetic predispositions and environmental influences. A family history of nearsightedness is a significant predictor; a child with one or more myopic parents has a higher chance of developing the condition. The hereditary link is well-established, suggesting some children are born with a greater susceptibility to the eye elongation that causes myopia.
Environmental factors and modern lifestyles play a large part in the increasing prevalence of myopia. Extensive time spent on “near work,” including activities like reading, using smartphones, and playing video games, is strongly associated with the onset and progression of nearsightedness. These tasks require the eyes to maintain close focus for prolonged periods, which may encourage the eye to elongate.
In contrast, time spent outdoors has been identified as a protective factor. Research suggests that exposure to natural, bright sunlight helps regulate the healthy growth of the eye. The mechanism is believed to involve the release of dopamine in the retina, which can inhibit the axial elongation of the eyeball. A lifestyle with limited outdoor time and excessive close-up activities is a primary contributor to a child’s risk.
Managing Myopia Progression
The goal of modern myopia management extends beyond correcting blurry vision; it focuses on slowing the rate at which nearsightedness worsens. Progressive myopia, where the prescription continually increases, is associated with higher risks of serious eye conditions later in life. The primary strategies are aimed at slowing the physical elongation of the eyeball.
Several clinical treatments are available to slow myopia progression:
- Low-dose atropine eye drops are administered daily to relax the eye’s focusing mechanism, reducing the strain that contributes to eye growth.
- Orthokeratology (Ortho-K) involves wearing rigid gas-permeable lenses overnight to gently reshape the cornea, providing clear vision during the day while controlling progression.
- Multifocal soft contact lenses, worn during the day, create different focusing zones to alter how light hits the peripheral retina, which is believed to slow eye elongation.
- Specialized eyeglass lenses have been developed to mimic the effect of multifocal contacts by changing the focus of light in the peripheral field of view.
Standard Vision Correction
While advanced treatments work to slow myopia’s progression, standard vision correction provides clear day-to-day sight. These methods ensure a child can see distant objects clearly, allowing them to participate fully in school and other activities. They correct the refractive error but do not address the underlying issue of eye elongation.
The most common method for correcting myopia in children is eyeglasses. Lenses are prescribed to sharpen distance vision, and for children, they are often made from polycarbonate, an impact-resistant material that offers safety during play. A proper fit is important to ensure the child is looking through the optical center of the lenses for the best vision correction. A child might need to wear their glasses constantly or only for specific tasks.
Standard contact lenses are another option, though they are generally for older children and teenagers who can handle the responsibility of proper lens hygiene. For some, contacts offer a wider field of view and sharper vision compared to glasses. It is important to differentiate these standard tools from the specialized lenses used for myopia management, as they are not designed to slow the progression of the condition.