Author: Dr Val Phua
Estimated reading time: 9–10 minutes
Childhood Myopia Is Becoming More Common Than Ever
More children are becoming short-sighted (myopic) than at any other time in history.
In Singapore, myopia has become a major public health concern. Studies have shown that around 65% of children are myopic by the end of primary school, and more than 80% of young adults are myopic. Singapore has one of the highest rates of myopia in the world.
While glasses or contact lenses can correct blurred distance vision, they do not stop myopia from progressing. More importantly, high myopia increases the lifetime risk of serious eye diseases such as retinal detachment, glaucoma, cataracts and myopic macular degeneration.
Understanding why childhood myopia is increasing is the first step towards protecting your child’s long-term vision.
What Is Myopia?
Myopia, also known as short-sightedness, occurs when the eye grows too long from front to back.
Instead of focusing light directly on the retina, light focuses in front of it, causing distant objects to appear blurred while near vision remains clear.
Myopia usually begins during childhood and often progresses until the late teenage years.
Why Is Childhood Myopia Becoming More Common?
Researchers believe that the increase in childhood myopia is caused by a combination of genetic predisposition and environmental factors.
Increased Near Work
Today’s children spend far more time focusing at close distances than previous generations.
Examples include:
- Reading
- Homework
- Tablets
- Smartphones
- Computers
- Gaming
Although near work alone may not directly cause myopia, prolonged periods without regular breaks are associated with increased risk.
Reduced Outdoor Time
One of the strongest protective factors against childhood myopia is spending time outdoors.
Exposure to natural daylight appears to stimulate dopamine release within the retina, helping regulate normal eye growth.
Research suggests that children who spend approximately two hours outdoors each day have a lower risk of developing myopia.
Importantly, the benefit appears to come from bright outdoor light, not simply physical exercise.
Genetics
Children are more likely to become myopic if one or both parents are myopic.
The risk increases further when:
- Both parents are myopic.
- Myopia develops at a younger age.
- Myopia progresses rapidly.
However, genetics alone cannot explain the dramatic rise in myopia seen over recent decades.
Increased Screen Time
Digital devices have become part of everyday life.
Although research continues to evolve, excessive recreational screen time often replaces outdoor activities and contributes to prolonged near work, both of which are associated with increasing myopia risk.
Why Is High Myopia a Concern?
Higher degrees of myopia are associated with a greater lifetime risk of several serious eye diseases, including:
- Retinal tears
- Retinal detachment
- Myopic macular degeneration
- Glaucoma
- Cataracts
The goal of modern myopia management is therefore not simply to reduce spectacle power, but to reduce the risk of future eye disease by slowing eye growth.
Can Myopia Be Prevented?
Not always.
Children with a strong family history may still develop myopia despite healthy habits.
However, several measures have been shown to reduce the risk or slow progression.
Encourage Outdoor Time
Aim for approximately two hours of outdoor activity every day, where practical.
Outdoor play remains one of the simplest and most effective strategies for reducing the risk of developing myopia.
Reduce Prolonged Near Work
Encourage children to:
- Take regular breaks.
- Avoid reading continuously for long periods.
- Maintain an appropriate reading distance.
- Alternate near tasks with outdoor activities.
Limit Recreational Screen Time
Screens are often necessary for education, but unnecessary recreational screen use should be balanced with outdoor activities and physical exercise.
How Can Myopia Progression Be Slowed?
Several evidence-based treatments are now available.
These include:
Low-Dose Atropine Eye Drops
Daily atropine eye drops have been shown to slow myopia progression in many children.
Orthokeratology (Ortho-K)
Specially designed contact lenses worn overnight temporarily reshape the cornea and may slow eye growth.
Defocus Spectacle Lenses
Newer spectacle lenses are designed not only to correct vision but also to reduce the progression of myopia.
Your ophthalmologist can advise which option is most suitable based on your child’s age, prescription and lifestyle.
When Should My Child Have an Eye Examination?
Children should undergo regular eye examinations, particularly if they:
- Squint to see distant objects.
- Sit very close to screens.
- Hold books very close.
- Complain of blurred distance vision.
- Have one or both parents with myopia.
- Experience rapidly changing spectacle prescriptions.
Early detection allows treatment to begin before myopia progresses significantly.
Frequently Asked Questions
Does using an iPad cause myopia?
Digital devices alone are unlikely to be the sole cause. However, prolonged near work and reduced outdoor time are associated with increased myopia risk.
Is myopia inherited?
Genetics play an important role, but environmental factors such as outdoor activity and visual habits also influence whether myopia develops and progresses.
Can myopia be cured?
No. Once myopia develops, it cannot currently be reversed. Modern treatments aim to slow progression rather than cure the condition.
Is outdoor exercise better than indoor exercise?
The protective effect appears to come mainly from exposure to bright natural daylight, rather than exercise itself.
The Bottom Line
Childhood myopia is becoming increasingly common, particularly in countries such as Singapore. While genetics contribute to risk, lifestyle factors—including reduced outdoor time and prolonged near work—play an important role.
Encouraging regular outdoor activity, adopting healthy visual habits and attending regular eye examinations can help protect your child’s eyesight. For children who develop myopia, modern treatments such as low-dose atropine, orthokeratology and defocus spectacle lenses offer effective ways to slow progression and reduce the long-term risk of serious eye disease.
References
- International Myopia Institute. IMI White Papers and Clinical Management Guidelines.
- World Health Organization. Vision and Myopia.
- Brien Holden Vision Institute. Global Myopia Research.
- American Academy of Ophthalmology. Myopia in Children.
- Singapore National Eye Centre. Childhood Myopia in Singapore.
