Myopia in Children

Myopia, or short-sightedness, is a refractive error where distance objects appear blurry but near objects can be seen clearly. It arises from the excessive growth of the eyeball, such that light from a far object falls out of focus within the eye. Spectacles, contact lenses and refractive surgery (LASIK) can be used to achieve good vision but do not address the problem of increased eyeball lens.

Myopia is the most common eye condition affecting children in Singapore today. More than half of the children in Singapore develop myopia by the age of 12 years old. It is also a worrying trend that children are becoming myopic at a younger age.

The earlier the myopia begins in life, the higher is the risk of it progressing to severe levels in adulthood. Refractive errors in young children can lead to amblyopia (“lazy eye”) which can lead to permanent visual loss if not corrected early. High myopia is also a risk factor for various eye complications, including:

• Cataract
• Glaucoma
• Retinal detachment
• Macular degeneration

Myopia is suspected in a child when they cannot see well in the distance. Signs which suggest myopia in children include children going up close to watch the television, or squinting their eyes.

Routine vision screening is important in pre-school children to pick up refractive errors early.

Vision screening/testing is performed by reading a series of letters or numbers of diminishing size on a chart placed 3 or 6 meters away. If the vision score is found to be reduced, refraction (spectacle power check) will be performed to look for any refractive errors.

Cycloplegic eye drops are often used in children to obtain accurate refraction. These eye drops serve to reduce the eye muscle spasm, which is a natural occurrence in children can causes them to focus more for near than for objects far away. These eye drops also dilate the pupils and allow the doctors to perform a full eye examination. It is important to note that the child’s vision may be blurred for up to a day after dilatation, although the effects are only temporary.

Myopia cannot be cured. However there are options to control / slow down the progression of myopia in your child:

• Your child should be encouraged to practice good eye care habits, including:
  • Reducing the time spent on near work (e.g. using of computer and mobile devices, reading or writing) and take frequent eye breaks every 20 to 30 minutes
  • Sitting upright while reading and hold the reading material 30cm away from the eyes
  • Sitting at least 50cm away from computer screens and adjust the light for minimal glare
  • Spending more time on outdoor activities (e.g. playing sports, having fun in the playground)
• Atropine Eye Drops
• Atropine eye drops in multiple randomised controlled clinical trials in Singapore have shown results to be effective in children in preventing their myopia from increasing with minimal side effects.
• The eye drops are administered every night over a period of two years or more, it can slow myopia progression by 50% to 60%.
• The pros and cons of using this form of treatment will be discussed with you by your doctor after your child’s eye has been examined.