Myopia, or near sightedness, is on the rise among young people.
One reason is that in today’s digital age, screens and devices are a larger part of children’s lives. When children spend extended periods focusing on screens, books, or other nearby objects, their eyes must work harder.
This prolonged close-up activity is thought to trigger signals that promote the eyeball’s elongation. It’s the combined effect of all near-work tasks throughout the day—not just screen time—that contributes to this risk.
Douglas R. Fredrick, MD
In this Q&A, Douglas R. Fredrick, MD, Chief of Pediatric Ophthalmology at Mount Sinai Health System, explains why physicians and researchers are concerned that children are more susceptible to nearsightedness these days and what parents can do about it.
“By educating parents and pediatricians about the importance of limiting screentime and spending time outdoors, we can work together to slow myopia development in children and decrease the risk of irreversible visual loss down the road,” says Dr. Fredrick, who is also Professor of Ophthalmology and Pediatrics at the Icahn School of Medicine at Mount Sinai.
What is myopia?
Myopia, or nearsightedness, is when the eye focuses light in front of the retina instead of directly on it. This makes far away objects look blurry while close objects stay clear. If your child has myopia, their eyeball is slightly longer than normal from front to back, and the only way to focus the light properly is by using glasses or contact lenses.
What is causing an increase in nearsightedness among children?
Contributing factors include extensive time spent on personal devices, too much time spent indoors, genetic factors, and less time in the daylight. Children with one or both nearsighted parents are more likely to become myopic. We don’t yet understand why researchers have found light plays an important role in healthy eye development. However most physicians and parents agree that spending more time outdoors, in natural light, is good for children’s physical and mental well-being.
What symptoms should parents look for?
Children with myopia may exhibit the following symptoms:
- Difficulty seeing distant objects, such as the smartboard in a classroom
- Squinting their eyes to see better
- Frequent headaches or eye strain, especially after prolonged near work
What can a parent do about this?
A few ways parents can help lower the risk or slow myopia from getting worse include having your children:
- Keep screens at least 12 inches away from their face
- Follow the 20-20-20 rule: Every 20 minutes, look 20 feet away for 20 seconds
- Spend at least one hour outdoors every day
Should parents limit screen time for their children?
Experts recommend setting screen time limits for children and teenagers to promote healthy development and prevent the negative effects of excessive screen time. Some general guidelines are:
- Up to 18 months: No screen time, except for video chatting with family members
- Age 18 months to 2 years old: Less than an hour of screen time, for educational use
- Ages 2 to 5: Up to an hour of non-educational screen time is acceptable
- Ages 6 to 17: Two hours of recreational screen time a day should be the limit with breaks every 20 minutes
What else can parents do?
Early intervention can yield significant, long-term benefits for your child’s vision and overall ocular health and lays the foundation for long-term myopia control. Your ophthalmologist may recommend the use of spectacles or contact lenses specifically designed to slow the progression of myopia or may even recommend the use of nightly eyedrops shown to also slow progression. Screen time with educational content can be beneficial when balanced well with other activities.
Why are eye exams important?
Regular eye exams are important for children to ensure early detection and treatment of vision issues, including myopia. Children should have their eye health and vision screened by their pediatrician or family doctor at birth, three months, six months, three years, and before kindergarten. This is especially important if there is a family history of myopia. If any concerns are discovered at a screening exam, your child should be referred to a pediatric ophthalmologist for a more thorough examination.
It’s important to diagnose myopia early to ensure kids don’t fall behind in school because they cannot clearly see the board in the front of the classroom. If not detected and treated, children with a higher degree of myopia can develop more serious vision problems later in life such as cataracts, glaucoma, and macular degeneration and retinal detachment.
What occurs during an eye exam?
During your child’s eye exam, clinicians perform several tests to check for myopia. Your ophthalmologist may prescribe eyeglasses to help make vision clearer and keep myopia from worsening. Nearsightedness is usually treated with eyeglasses, contact lenses, or, in adults, laser surgery (where a laser beam of light reshapes the cornea by removing a small amount of eye tissue).