Myopia Management in Children: What Parents Need to Know and How We Can Help Slow It

If your child has been diagnosed with myopia or nearsightedness, you are not alone. More children are becoming myopic than ever before, and many parents have questions about what this means for their child’s vision now and in the future.

The good news is that myopia is something we can actively manage. Research shows that with early detection and the right treatment plan, we can slow how quickly myopia progresses and help protect long term eye health. This article explains what myopia is, why it matters, and the safe, evidence based options available to help reduce future risks while supporting clear, comfortable vision throughout childhood.

What is myopia?

Myopia, also called nearsightedness, is a condition where distant objects appear blurry while near tasks like reading or using a tablet remain clear. Children with myopia may struggle to see the classroom board, recognize road signs, or notice details at a distance. This occurs because the eye grows longer than normal, causing light to focus in front of the retina instead of directly on it (Flitcroft 2012).

Why is myopia a growing concern?

Myopia is increasing rapidly worldwide. Large population studies show that about 22 percent of the global population was myopic in 2000, increasing to 33 percent by 2020. Researchers project that nearly half of the world’s population may be myopic by 2050 (Holden et al. 2016).

Most childhood myopia develops because the eye continues to elongate during growth. While some eye growth is normal, excessive elongation increases the likelihood that a child’s prescription will worsen every six to twelve months through the teenage years (COMET Group 2013).

The concern is not just blurry vision. As the eye stretches, even small changes in length increase the risk of future eye disease. Higher levels of myopia are associated with an increased risk of:

• Myopic macular degeneration

• Retinal detachment

• Cataracts

• Glaucoma

These long term risks have been well documented in large clinical studies, making myopia more than a simple need for glasses (Flitcroft 2012; Tideman et al. 2016).

Why take action early?

Myopia progresses most rapidly in younger children, especially those under age ten. Studies show that early onset myopia is associated with faster progression and higher final levels of nearsightedness (Chua et al. 2016).

Clinical experts recommend beginning myopia management for most children under age twelve and continuing treatment into the late teen years, when eye growth naturally stabilizes (Gifford et al. 2019; Brennan et al. 2020).

Short term benefits of early myopia management include slower prescription changes and more stable vision between visits. The long term benefit is a reduced lifetime risk of vision impairment and degenerative eye disease.

Research has shown that reducing a child’s final level of myopia by just one diopter lowers the lifetime risk of myopic macular degeneration by approximately 40 percent and reduces the risk of vision impairment by about 20 percent (Bullimore and Brennan 2019).

What treatments help slow myopia progression?

Standard single vision glasses and contact lenses correct blurry vision but do not slow myopia progression (Brennan et al. 2020). Evidence based treatment options shown to reduce the rate of myopia progression include:

• Stellest specialized spectacle lenses designed for myopia control

  • FDA approved.

• MiSight soft contact lenses designed for myopia control

  • FDA approved.

• Orthokeratology lenses worn overnight

• Low dose atropine eye drops

Each option has unique benefits and considerations. Your Reflect Vision Care optometrist will help determine the most appropriate approach based on your child’s prescription, eye health, lifestyle, and readiness for treatment.

Safety and expected experience

Contact lenses

Certain contact lenses are designed to slow myopia progression while providing clear vision during daily activities. Large safety studies show that the risk of contact lens related infection is low when lenses are worn and cared for properly.

The estimated risk of infection is about 1 per 1000 wearers per year for reusable soft contact lenses or orthokeratology lenses, and about 1 per 5000 wearers per year for daily disposable contact lenses (Stapleton et al. 2008; Bullimore et al. 2013).

With proper hygiene and avoiding all water exposure, these risks can be minimized. Most children adapt to myopia control contact lenses within one to two weeks. Research also shows that children aged eight to twelve are often safer contact lens wearers than teens and adults (Bullimore 2017).

Atropine eye drops

Low concentration atropine eye drops, typically ranging from 0.01 to 0.05 percent, have been shown to slow myopia progression with significantly fewer side effects than higher concentrations (Yam et al. 2019).

Possible temporary side effects include mild light sensitivity, occasional difficulty with near work, or mild irritation in a small percentage of children. These effects are generally manageable and often improve with simple adjustments such as glasses for near tasks.

Atropine drops are usually administered at bedtime and can be an excellent option when contact lenses or specialized glasses are not the best fit.

Benefits of myopia management for children

Studies show that children who wear contact lenses experience improved confidence in school and sports and greater satisfaction with their vision (Walline et al. 2007). Myopia management also allows active children more freedom and reduces long term risks associated with higher levels of nearsightedness.

Children learn contact lens handling quickly, taking only slightly longer than teens to master proper use (Walline et al. 2007). Most importantly, slowing myopia progression helps protect eye health throughout childhood and into adulthood.

Final thoughts on myopia management

If you are concerned about your child’s vision or have noticed changes such as squinting, sitting closer to screens, or frequent prescription updates, we encourage you to start the conversation with us. An eye exam can help determine whether your child is developing myopia and whether myopia management may be appropriate.

Our team at Reflect Vision Care is here to guide you through the options, answer your questions, and partner with you in protecting your child’s vision now and for the future. To learn more or to schedule your child’s eye exam, please contact our office or book an appointment online.

Schedule your child's eye exam at one of our convenient Reflect Vision Care locations:

• Northlake Mall

• Concord Mills

• Biltmore Park

• Asheville Mall

📞 Call us or schedule online to book your visit today! We’re here for your child’s vision journey, every step of the way.

References

• Holden BA et al. Global prevalence of myopia. Ophthalmology. 2016.

• COMET Group. Myopia progression in children. Invest Ophthalmol Vis Sci. 2013.

• Flitcroft DI. Pathophysiology of myopia. Prog Retin Eye Res. 2012.

• Tideman JW et al. Axial elongation and myopia risks. JAMA Ophthalmology. 2016.

• Chua SY et al. Early rapid progression. PLoS One. 2016.

• Brennan NA et al. Evidence based myopia management. Clin Exp Optom. 2020.

• Gifford KL et al. Myopia clinical management guidelines. Clin Exp Optom. 2019.

• Bullimore MA, Brennan NA. Myopia control efficacy. Optom Vis Sci. 2019.

• Stapleton F et al. Lens related infection rates. Ophthalmology. 2008.

• Bullimore MA et al. Orthokeratology safety. Eye Contact Lens. 2013.

• Bullimore MA. Contact lens safety in children. Optom Vis Sci. 2017.

• Walline JJ et al. Contact lenses and children’s self esteem. Optom Vis Sci. 2007.

• Yam JC et al. Atropine safety in children. Ophthalmology. 2019.