Nearsightedness and children: Q&A with Lurie Children’s pediatric optometrists
Myopia, or nearsightedness — when objects far away appear blurry — is one of the most common vision conditions in the world. It’s also the most common vision problem among children and teens, and some Lurie Children’s pediatric eye experts say they’re seeing more of the condition in children in the last two years.
Children and teens are spending more time focusing up close 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 with optometrist Dr. Noreen Shaikh.
While typically correctable with glasses or contact lenses, myopia left to progress can lead to high or severe myopia which increases the risk of vision threatening complications. While not reversible, today there are more options than ever that help slow the progression of myopia.
Read more below for answers to common questions about myopia answered by Drs. Stec and Shaikh.
What is myopia? How common is it?
Noreen Shaikh, OD: Myopia is another word for nearsightedness, a condition in which you can see items close to you clearly, but things far away appear blurry.
It is very common. It affects about 1 in 3 people in the world. Statisticians predict myopia will affect five billion people by 2050.
What causes myopia?
Magdalena Stec, OD: Myopia occurs when an eyeball grows too long, and it causes the light rays to bend incorrectly. Two primary factors contribute to the onset of myopia – genetics and environment. Children with parents who both have myopia are six times more likely to experience it. The genetic component is largely unpreventable. Environmental factors can impact the severity of myopia as well. Near work activities that require a short working distance, such as reading, homework, video games and using a tablet or smartphone, without frequent breaks in focusing (looking away) – can lead to the onset or progression of myopia. Therefore, following healthy near vision hygiene is critical and we encourage it. We also encourage spending time outdoors as research shows that natural light promotes less eyeball growth. We recommend 1-2 hours of outdoor time each day.
When does myopia typically first appear?
Dr. Shaikh: It depends on the child. It can be present in infancy, though it most often appears between ages 6 and 12, when the eye, like the child, is growing at a faster rate.
Dr. Stec: We recommend a comprehensive dilated eye exam with an eyecare specialist before preschool. If there is a family history of eye problems or an abnormal vision screening, the child should be seen sooner.
The dilating eye drops are a particularly important aspect of a pediatric eye exam.
Dilation allows us to see the health of the structures in the back of the eye. It also relaxes the focusing system, so that we can use lights and lenses to determine the glasses prescription. Without dilation, children’s focusing system fluctuates, making it impossible to determine an accurate prescription. Our teams are trained in to work with children to make the dilation experience as comfortable as possible for them.
Is screen time a factor in myopia?
Dr. Shaikh: Spending a lot of time on screens increase the severity of myopia. But there are ways to have screen time safely. Take frequent breaks by following the 20-20-20 rule. After every 20 minutes (of near work or screen time), look 20 feet away for 20 seconds Sitting next to a window when doing near work helps facilitate the 20-20-20 rule, and the outdoor lighting offers exposure to beneficial natural light. Another “screen hygiene” best practice is to ensure a child’s computer or tablet is about an adult arm’s length away from their face. Read other screen hygiene tips here.
How is myopia treated?
Dr. Stec: Typically, we prescribe glasses or contact lenses for children.
Additionally, children with risk of progression, or an increase to their myopia in short time, can be treated with eye drops or specialty contact lenses. These options are relatively new preventive options that are safe and effective. The eye drops are a very low concentration of eye drops that are used for dilation. They are specially formulated at a compounding pharmacy and are prescribed for nightly use. The contact lenses recently received FDA approval specifically for myopia control. Both are effective ways of slowing down the progression of myopia.
Why is Lurie Children’s the best place for myopia care?
Dr. Shaikh: Lurie Children’s takes a comprehensive approach to your child’s health. We work with specialists across divisions. Even within our Division of Ophthalmology, we have ophthalmologists and retinal specialists that help us minimize the risk of complications that can be associated with high myopia. They are trained in pediatric care and we work together under one roof to provide the best possible treatment tailored to each child.
Dr. Stec: There is a real advantage to seeing an eye doctor who has training to work with children. The approach to doing an eye exam with adults versus children is very different. We also work with special populations who may not be able to get care other places. We offer a team approach along with the latest treatments — and we are super friendly!