Nearsightedness in kids on the rise, but more options exist to manage it
Myopia, or nearsightedness -- when objects far away appear blurry -- is one of the most common vision conditions in the world, affecting about 1 in 3 people. It's also the most common vision problem among children and teens, and some experts say it's on the rise.
Children and teens are spending more time focusing up close on activities for extended period without breaks which can accelerate myopia progression, said Dr. Magdalena Stec, a pediatric optometrist at Lurie Children's Division of Ophthalmology who co-runs the hospital's Myopia Clinic along with optometrist Dr. Noreen Shaikh.
While usually corrected with glasses or contact lenses, when untreated or left to progress, myopia can lead to eye disorders that cause further vision loss. While not reversible, today there are more options than ever that help prevent or slow the progression of myopia.
'Near work' and screen hygiene
The COVID-19 pandemic may be playing a role in the general uptick of myopia in children, said Stec. The pandemic's restrictions have kept children largely indoors and required virtual schooling, so many children have been doing more of what eye doctors call "near work" than usual. Near work refers to any activity that requires a short field of vision for the eye such as reading, homework and anything that involves watching or reading from a mobile device or computer.
When near work is unavoidable, Shaikh recommends following what's known as the 20-20-20 rule, meaning to look away from a screen or near object every 20 minutes, for at least 20 seconds, off in the distance at least 20 feet. Sitting next to a window when doing near work to help facilitate the 20-20-20 rule, and the outdoor lighting offers exposure to beneficial natural light, Shaikh said. Another "screen hygiene" best practice is using larger screen and to ensure a child's computer or tablet is about an adult arm's length away from their face.
Spending less time outdoors, which many children and teens may have done over the last year-and-a-half due to COVID-19 restrictions, may worsen the severity of myopia. Many studies have shown that children who spend more time outdoors were less likely to develop myopia, said Shaikh. This is thought to be due to exposure to the full spectrum of light. This exposure may help children's eyes grow in a way that deters nearsightedness, said Shaikh. Spending at least one to two hours per day outside is recommended.
Still, environmental factors are only part of the reason a child may experience myopia. There is an unpreventable genetic factor in myopia as well; children with two parents who have myopia are six times more likely to experience it, said Shaikh.
Options for preventing and managing myopia
When an intervention is needed to prevent the progression of myopia, today's children have more options than any generations previously, Stec said. These options include eye drops and daily FDA-approved contact lenses with proven efficacy to slow the progression of myopia.
Still, depending on situation, good, old-fashioned glasses are an important first-line treatment, said Shaikh.
"Under-correcting myopia can cause it to progress at a faster rate," said Dr. Shaikh. "It's better to wear glasses to help slow it down."
Key to children's eye health maintenance are comprehensive eye exams that include dilation drops, said Dr. Stec. A child's first comprehensive eye exam should be before preschool, or sooner if known family eye conditions are present, or any abnormalities are detected by a vision screening. Myopia or another eye condition can be detected at that time. If no conditions are detected, a dilated eye exam should be repeated before kindergarten. After that, annual or biannual eye examinations are recommended into adulthood, especially for children 6-12, the ages when the eye is growing the most.
For more information about Lurie Children's Division of Ophthalmology, visit LurieChildrens.org and search for "Ophthalmology."
• Children's health is a continuing series. This week's article is courtesy of Ann & Robert H. Lurie Children's Hospital of Chicago. For more information, visit www.LurieChildrens.org.