Myopia (Short-sightedness) in Children

Myopia, or short-sightedness, is when you can see near things clearly but far things look blurry [1][2]. It happens when the eye grows too long, so light focuses in front of the retina (the seeing layer at the back of the eye) instead of on it.

Myopia usually starts between 6 and 14 years old and tends to get worse until the late teens or early twenties. It is becoming much more common around the world, especially in East and South-East Asia [3].

Why does it matter? The more myopic the eye, the longer and thinner it is. High myopia raises the risk of retinal detachment, glaucoma, cataract and myopic macular degeneration later in life [2][3]. Slowing myopia in childhood helps protect sight for life.

A child is more likely to get myopia if they [1][2]:

• have one or both parents with myopia
• spend little time outdoors
• do a lot of close-up work, such as reading, phones, tablets and games, especially without breaks
• start having myopia at a young age (it then tends to become higher)

Your child may [1]:

• squint or narrow their eyes to see far away
• sit very close to the TV, or hold books and phones close to their face
• have trouble reading the whiteboard at school
• rub their eyes a lot, or complain of headaches or tired eyes
• not notice far-away things that others can see

Many children do not complain, because they think everyone sees like them. A simple eye test at the clinic or school screening can pick it up. An eye doctor may use eye drops to relax focusing and get an accurate glasses prescription.

1. Glasses: correct the blur so your child can see clearly. Your child should wear them as advised. Wearing glasses does not make myopia worse.
2. Contact lenses: may suit older children and teenagers who can look after them safely.
3. Myopia control: treatments that slow down how fast myopia gets worse [2][4]:
   • Low-dose atropine eye drops, one drop at night
   • Special myopia control glasses or soft contact lenses
   • Orthokeratology (special hard lenses worn overnight)
4. Laser eye surgery may be an option for adults once their glasses prescription has been stable. It is not used in children.

Your eye doctor will check your child regularly, usually every 6 to 12 months, to see if the myopia is changing.

• Play outside: aim for at least 2 hours outdoors every day. Daylight helps protect children's eyes [5].
• Take breaks from close work: follow the 20-20-20 rule (every 20 minutes, look at something 6 metres away for 20 seconds).
• Keep books and screens at a sensible distance, and limit leisure screen time.
• Get your child's eyes checked, especially if a parent is short-sighted.

Where to get help in Brunei

You can walk in to any Community Eye Clinic at your health centre. No referral is needed.