Myopia, or short-sightedness, is one of the most common vision conditions affecting children worldwide; according to research published in the British Journal of Ophthalmology, more than a third of children around the world were nearsighted in 2023 and it is estimated that by 2050, half of Australia's population will be myopic.
However, despite its prevalence, early indicators of myopia in children often go unnoticed, delaying diagnosis and management.
Dom Willson, optometrist and National Professional Services Advisor at Optometry Australia explains why the initial signs of myopia are easy to miss and how parents, care givers and educators can proactively support children’s eye health.
Lack of regular eye exams
The truth of the matter is that many children don’t receive routine eye examinations.
Unlike other aspects of health, vision testing is often not prioritised unless there are noticeable problems. In fact, findings from Optometry Australia’s 2022 Vision Index Report revealed that almost one third of parents believed visiting an optometrist was only necessary if their child showed signs or symptoms of a vision problem.
However, without regular eye exams, myopia can progress undetected for years.
“We strongly recommend that all children undergo a comprehensive eye examination before starting school, or at least the year they enter primary education, even if no issues are apparent. Regular check-ups every year should then follow.”
Children don’t know what normal vision looks like
Young children may not realise their vision is blurry because they have no frame of reference for clear vision. To them, the way they see the world feels normal, so they rarely complain about difficulty seeing.
"As optometrists, we often remind parents that children assume their vision is 'normal', no matter how fuzzy it might be. They have nothing to compare it to, so they adapt to what they see and that's why regular eye exams with a trusted optometrist are so crucial. Without them, myopia can go unnoticed until it starts to significantly impact their daily life or learning."
Gradual onset of symptoms
Myopia often develops gradually, especially during early stages. Because the changes are subtle, children and even adults in their lives may not notice until the condition becomes more severe. This gradual progression allows symptoms to fly under the radar.
“Children with myopia often find clever ways to adapt to their blurry vision. For example, they might squint to improve focus, move closer to the TV or sit at the front of the classroom. These behaviours can seem normal or go unnoticed in busy routines, delaying intervention.”
Silent sufferers
Some children hesitate to speak up about their vision issues because they’re often embarrassed or because they’re hesitant to visit an optometrist out of uncertainty. This silence can prevent parents from addressing the issue promptly.
“It’s important for parents to foster open conversations about vision and reassure their child that a visit to the optometrist is a simple, comfortable step to help them see more clearly and comfortably. Educating children early on in life about how to look after their eye health and wellbeing is very important on the journey to becoming empowered adolescents and adults.”
Increasing screen time
Modern lifestyles with extended screen use can exacerbate myopia development and progression, but the connection might not always be clear to parents.
"Devices used at close range (< 30 cm) and for extended periods (> 30 minutes) may accelerate the development and progression of myopia (short-sightedness) particularly in children 6-8 years of age, making it crucial for regular eye check-ups to catch potential problems early when interventions are most effective.”
In between visits to the optometrist, it’s suggested that caregivers encourage as much outdoor play as possible, advocate for regular breaks away from phones, iPads and television, make sure screens are positioned at least an arm’s length from the eyes.
A summary for parents to better support children’s eye health
Schedule regular eye exams: All children should undergo a comprehensive eye examination with a trusted optometrist before starting school, or at least the year they enter primary education, even if no issues are apparent. Regular check-ups every year should then follow.
Be observant: Look out for signs like squinting, sitting close to screens or avoiding activities that involve distance vision.
Communicate: Ask your child about how they see, especially if they’re showing signs of eye strain or difficulties in school.
Encourage outdoor play: Time spent outdoors has been shown to help prevent or slow the progression of myopia. Aim for at least two hours of outdoor activity per day. Wearing adequate sun protection (hats, sunnies etc.) is still recommended as the benefits of outdoor time for myopia prevention are still applicable even when the eyes are protected from UV exposure. In fact, being outdoors but in shade will still help to prevent myopia.
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