Myopia in Children – Causes, Signs, and Treatment

With technology taking over the lives of children from online learning to gaming, several children are becoming nearsighted or short-sighted. The condition often called myopia is when a child can see things close but has difficulty seeing things at a distance. It is one of the most common refractive errors, affecting more than 20% of kids. If a doctor diagnoses a child as myopic, objects far away from them generally appear blurry. It could worsen as the child grows but could be corrected with eyeglasses. With prescription eyeglasses, their vision could benefit to a large extent. Read on to find more about the causes, signs, and treatment.

What Is Myopia?

Myopia or nearsightedness is a condition where objects close to you can be seen clearly, but the objects further away will seem blurry. It generally occurs when the shape of the eye causes light rays to refract or bend incorrectly and focus images in front of the retina instead of the retina. Myopia develops gradually or rapidly and worsens towards childhood and adolescence. As a condition, it tends to be hereditary. Nearsightedness can be compensated with eyeglasses, refractive surgery, or contact lenses.

Causes and Risk Factors of Myopia in Children

Myopia in young children often progresses due to the increase in axial length of the eye. The light does not fall on the light-sensitive tissue, the retina at the back of the eye, and focuses in the front creating blurred images of objects. Below are some causes and risk factors of myopia in children:

1. Eye Growth

Human eyes grow and change shape up to the age of 20. Myopia in children progresses or worsens before this age, during childhood and adolescence, due to the normal growth of the eye.

2. Genetic or Hereditary Factors

If both parents have myopia, the chances for the child to inherit are more.

3. Constant Use of Eyeglasses

Children who wear eyeglasses throughout the day may have worse symptoms of myopia. Children with moderate and severe myopia have a greater risk and need glasses for distant vision. A low level of myopia does not affect distance vision, and children may require it only for close vision tasks.

4. Use of Eyeglasses With Full Correction

If glasses have lenses with full correction, myopia will increase over time. Fully corrected lenses give 100% vision initially but tend to worsen the condition in children.

5. Less Physical Activity

Children who do not have any physical activity, especially less than an hour or two in a day, are at a higher risk of myopia. Physical activity outdoors helps relax the eye muscles and break from tasks requiring focusing.

6. Excess Screen Time

Spending prolonged periods in front of the screen like tablets, computers, smartphones, or television causes strain in the eye and develops into myopia in children.

7. Extended Time on Activities That Involve Close Vision

Activities like reading and writing, which involve being very focused and close vision, can cause strain to the eyes and progress into myopia.

Signs and Symptoms

Signs of nearsightedness in toddlers and children generally appear between ages nine and ten. This could often go unnoticed and is discovered only when the child complains of not seeing distant objects. Common symptoms of myopia in children are:

• A slight squint when looking at objects at a distance
• Constant headaches
• Feeling of nausea while reading
• Sitting close to the television or electronic gadgets for viewing
• Lying head on the table while reading or writing
• Holding an object too close to the face, especially books and electronic devices.

Some children may also display additional symptoms like poor attention span or a drop in academic grades. It is advisable to consult a pediatrician or ophthalmologist to check the child’s vision if you spot or suspect any of these signs or symptoms.

What Complications Can Myopia Cause in Children?

Myopia causes a decrease in attention span and impacts a child’s ability to perform well academically. In most cases, myopia can be corrected with corrective or prescription glasses, contact lenses, or refractive surgery if needed. However, the condition can cause some complications in children as below:

1. Myopic Macular Degeneration (MMD)

In this condition, the macula suffers tears and cracks, which lead to bleeding under the retina as the retina stretches to adjust the vision.

2. Cataract

A cataract is an opaque formation or when the lens gets clouded, preventing the light from entering the retina. Cataracts develop slowly and result in blurry vision in children.

3. Detachment of Retina

The axial elongation of the eye and thinning of the retina occur in cases with high myopia. Girls with high myopia run a risk of retinal detachment during childbirth in the future.

4. Open Angle Glaucoma (OAG)

This condition occurs in children with high myopia. It prevents draining of the intraocular fluid and increases intraocular pressure that damages the optic nerve.

5. Impairment of Vision

If the complications mentioned above are not corrected in cases of high myopia, there could be a serious loss of vision.

Diagnosis

The common signs and symptoms are not sufficient to identify and manage the condition of myopia, especially in the case of children. A pediatrician will conduct a vision screening for the child and then refer them to an ophthalmologist or optician if they suspect any concerns. Eye specialists will perform detailed vision tests, evaluations and prescribe eyeglasses, lenses, or any other corrective treatment depending on the condition.

Treatment Options for Myopia in a Child

Can childhood myopia be reversed? Yes, it can but only gradually. One needs to follow the ophthalmologist’s advice and make significant changes in their lifestyle. Child myopia treatment usually includes prescription eyeglasses or contact lenses. When myopia measures -2.5, lenses are prescribed. The power of the lens will be stronger if the myopia is high. These will help correct the eye’s focus and help the light fall on the retina for clearer and better vision. Vision therapy is also recommended for myopia, and eye exercises are often advised to improve the condition of the eye muscles and help gain focus.

In certain rare cases, ophthalmologists can use the following treatment options to correct myopia in general cases. However, these procedures can help adults avoid eyeglasses or lenses but are not recommended for myopia in children, apart from special cases. This is since the eye keeps growing in children, and such procedures can impair vision as the child grows.

1. Ortho-k or Corneal Refractive Contact Lenses (CRT)

Contact lenses that help correct the cornea for light to fall on the retina will be prescribed.

2. Laser-Assisted in Situ Keratomileusis (LASIK)

A refractive eye surgery that uses laser technology to change the shape of the tissue in front of the camera.

3. Photorefractive Keratectomy PRK

Another kind of refractive surgery that removes the upper layer of the cornea to enhance vision

4. Laser Epithelial Keratomileusis LASEK

This is a combined eye procedure that merges the LASIK and PRK techniques of correction.

5. Phakic Intraocular Lenses

In this procedure, artificial lenses are placed before natural lenses.

6. Intraocular Lens Implant

A new lens is inserted to replace the natural lens in this procedure.

Preventive Tips

While myopia control in children can generally be introduced as a cure, it cannot be prevented if it occurs due to genetic reasons. A few ways in which it can be prevented are:

1. Outdoor Times

Giving the child ample opportunity to play outdoors and relax their eye muscles could help in reducing the progression of myopia. A minimum of 90 minutes outdoors in sunlight is known to reduce the chance of myopia.

2. Proper Lighting

Ensure proper lighting under the table when reading and writing, which will reduce eye strain.

3. Adequate Breaks During Focussed Tasks

Any focussed activity like reading, screen time, drawing, or painting must be interspersed with breaks like looking out the window or going for a walk.

4. Keep a Safe Distance

Ensure that there is adequate distance between books, tablets, or devices to ensure that eyes are not strained.

5. Eye Drops

Ophthalmologists prescribe atropine eye drops to slow the progression of myopia. You must evaluate the side effects before administering them.

6. PMMA Lenses

PMMA lenses are hard contact lenses and a better option than soft lenses as they lower the risk of infections.

Myopia is a condition that cannot be changed, and however, timely diagnosis, appropriate treatment, and care could help reduce the chances of its progression, especially in children. While it is not a condition that needs to be worried about, changes in lifestyle and regular consultations with the opticians or ophthalmologists may help diagnose the condition sooner and get it treated.

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