Reviewed by Dr Norazah Abdul Rahman, Paediatric Ophthalmologist, Squint & Refractive Surgeon | Last updated: August 2026
Your child’s myopia (short-sightedness) is likely to increase because their eyes are still growing. As the eye grows longer, distance vision becomes more blurred and stronger glasses are needed. A family history of myopia (genetics), prolonged near work (such as reading or screen use), limited time outdoors, and developing myopia at a younger age all increase the likelihood of faster myopia progression. Fortunately, several evidence-based myopia control treatments can slow progression and reduce the risk of future eye diseases.
What is myopia?
Myopia, also known as short-sightedness, is a common eye condition in which children can see nearby objects clearly, but distant objects appear blurred. This happens because the eye grows too long from front to back, causing light entering the eye to focus in front of the retina instead of directly on it.
Why childhood myopia matters
A child’s eye is still growing. In myopia, glasses help children see clearly, but conventional spectacles usually do not slow the excessive growth of the eye. This is why many parents notice that their child’s spectacle prescription becomes stronger every year.
Childhood myopia is common in Malaysia. A 2026 Malaysian Journal of Medical Sciences systematic review of Malaysian studies from 1990 to 2024 reported an overall pooled childhood myopia prevalence of 17.18%.
The prevalence increases with age:
- 2.5% among children aged 0–6 years
- 26.5% among children aged 7–12 years
- 42.7% among adolescents aged 13–18 years
This means that nearly one in every two Malaysian teenagers is affected by myopia.
The concern is not only thicker glasses. Higher levels of myopia are associated with a longer lifetime risk of eye problems such as retinal tears or detachment, myopic macular degeneration, cataract, and glaucoma. The global burden is increasing: a major global projection estimated that by 2050, 49.8% of the world’s population may have myopia and 9.8% may have high myopia.
Causes and risk factors
Childhood myopia usually develops from a mix of inherited risk and daily visual habits. Parents should not blame themselves or the child; the useful question is how to detect progression early and reduce modifiable risk where possible.
- Eye growth that is too fast: When the eyeball becomes longer than ideal, distant images focus in front of the retina, causing blurred distance vision.
- Family history: Children with one or both myopic parents have a higher chance of developing myopia; the International Myopia Institute Risk Factors for Myopia Report, 2021, identifies parental myopia as an important risk factor.
- Limited outdoor time: Bright outdoor light appears to help regulate eye growth; the International Myopia Institute Risk Factors for Myopia Report, 2021, states that education-related near work and time outdoors are the two major causal risk factors identified so far.
- Long near-work habits: Reading, writing, tuition, homework, and close-up device use can increase near visual demand, especially when breaks are limited.
- Digital screen exposure: A 2025 JAMA Network Open systematic review and dose-response meta-analysis reported that myopia risk increased significantly between 1 and 4 hours of daily screen time, then rose more gradually beyond 4 hours.
- Earlier onset of myopia: A child who becomes myopic at a younger age has more years for the eye to continue growing before adulthood, so closer monitoring is usually needed.
- Urban lifestyle and education pressure: More time indoors, more near work, and less daylight exposure may contribute to higher myopia risk in some children.
- Ethnicity and population risk: The 2026 Malaysian systematic review reported higher childhood myopia prevalence among Chinese children and adolescents in Malaysia, with a pooled prevalence of 44.62% for the Chinese population in the included studies.
- Uncorrected or under-corrected vision: A child who cannot see clearly may squint, move closer, or avoid distance tasks. Proper correction helps the child function, although myopia-control treatment may still be needed if progression continues.
Staging and classification
Myopia is usually classified by severity and by whether it is stable or progressing. For parents, the most practical question is not only “What is the power now?” but also “How quickly is it changing, and is the eye getting longer?”
| Stage | What It Means | Key Concern |
|---|---|---|
| Pre-myopia / At-risk | Not yet short-sighted; risk factors present – family history, heavy near work, limited outdoor time, or borderline eye measurement | Likely to develop myopia without intervention |
| Mild myopia | Distance blur present but manageable with glasses | Progression likely if the child is still young |
| Moderate myopia | Dependent on glasses for school, sports, and daily activities | Further progression remains possible |
| High myopia | Significantly elevated prescription; eye is often longer than average | Higher lifetime risk of retinal and optic nerve complications |
| Progressive myopia | Prescription or axial length is increasing over time – can occur at any severity level | Rate of worsening, not just current level |
Signs and symptoms
What only an eye care professional can detect
A comprehensive eye examination by an ophthalmologist, optometrist, or orthoptist can identify important findings that cannot be detected at home, including:
- The child’s exact spectacle prescription following a detailed refraction
- Whether cycloplegic eye drops are needed to temporarily relax the eye’s focusing muscles for an accurate measurement
- Whether the child has pseudomyopia, a temporary focusing spasm that can mimic true short-sightedness
- Whether one eye is significantly more myopic than the other (anisometropia)
- Whether the eye is becoming longer by measuring axial length, an important indicator of myopia progression
- Whether there are early retinal changes associated with moderate or high myopia
- Whether other vision problems are present, such as squint (strabismus), lazy eye (amblyopia), or focusing disorders
- Whether the child is a suitable candidate for contact lens-based myopia control, such as orthokeratology or soft myopia-control contact lenses
What parents and teachers may notice
Children often do not realize that their vision is becoming blurred because the change happens gradually. Parents, caregivers, or teachers may notice signs such as:
- Squinting to see the whiteboard, television, road signs, or distant objects
- Sitting very close to the television or holding books and digital devices very near the face
- Complaining that the writing on the classroom board looks blurred
- Frequent headaches or tired eyes, especially after reading or schoolwork
- Rubbing the eyes or blinking excessively
- Losing interest in outdoor games or activities that require clear distance vision
- A decline in school performance because it is harder to see classroom materials
- Needing stronger glasses more often than expected
- One eye occasionally turning in or out, particularly when tired
- Closing or covering one eye to see more clearly
If you notice any of these signs, arrange a comprehensive eye examination. Early detection allows timely treatment and better long-term visual outcomes.
Treatment options
The goal of treatment is twofold: first, to help the child see clearly now; second, if the child is progressing, to consider myopia-control options that may slow worsening. No treatment can guarantee that myopia will stop increasing.
| Treatment | How It Works | Best For |
|---|---|---|
| Standard glasses/ contact lenses | Focuses light onto the retina for clear distance vision | All children requiring vision correction |
| Outdoor time & visual-habit changes | Daylight exposure and regular near-work break to reduce modifiable risk | At-risk children or early progressors |
| Myopia-control spectacle lenses (e.g. DIMS, HALT) | Peripheral defocus zones signal the eye to slow elongation while correcting central vision | Children needing spectacles who are suitable for lens-based control |
| Low-dose atropine eye drops (0.01%-0.05%) | Pharmacological agent that slows ocular growth signals; glasses still required | Progressive childhood myopia; specialist-assessed cases |
| Orthokeratology (Ortho-K) | Overnight rigid lenses temporarily reshape the cornea for daytime glasses-free vision | Progressive myopia in motivated children with strong hygiene compliance |
| Soft multifocal / dual-focus contact lenses (e.g. MiSight) | Defocus zones slow axial elongation while correcting vision; worn during waking hours | Mature children with parental support for contact lens hygiene |
| Combination therapy (e.g. atropine + optical) | Two or more strategies used together for additive effect | High progressors or those unresponsive to single-modality treatment |
| Refractive surgery (LASIK, SMILE Pro 2.0, TransPRK, ICL) | Surgical correction of refractive error once prescription is stable in adulthood | Adults with stable refraction and suitable ocular measurements |
Screening
No treatment guarantees a child will not develop myopia or that the prescription will not increase. Earlier detection allows earlier action.
A screening visit typically covers vision testing, refraction, eye alignment, binocular vision, and axial-length measurement — the most objective marker of physical eye growth, independent of glasses power.
Helping to reduce the risk of myopia progression
Healthy visual habits can complement medical treatment and may help slow the progression of myopia.
- Encourage outdoor play.
The International Myopia Institute (IMI) recommends that children spend at least two hours outdoors each day, particularly during the preschool and primary school years. Regular exposure to natural daylight has been shown to reduce the risk of developing myopia.
- Promote healthy screens and near-work habits.
Reading, studying, and using digital devices are part of everyday life, but prolonged near work without breaks may increase the risk of myopia progression. A 2025 JAMA Network Open meta-analysis found that the risk of myopia increased with longer daily screen time, particularly between 1 and 4 hours per day. Rather than eliminating screen use, parents should encourage healthy habits such as maintaining a comfortable viewing distance, taking regular breaks (for example, the 20-20-20 rule), and balancing screen time with outdoor activities.
Children who need closer monitoring
Some children have a higher risk of developing rapidly progressive myopia and may require more frequent eye examinations. These include children with:
- A strong family history of myopia
- Myopia that develops at a young age
- Rapidly increasing spectacle prescription
- Moderate or high myopia
- Squint (strabismus)
- Lazy eye (amblyopia)
Your eye specialist will recommend the most appropriate follow-up schedule based on your child’s age, spectacle prescription, axial length measurements, and rate of myopia progression.
FAQ
Your child’s myopia may be getting worse because the eye is still growing longer. Genetics, limited outdoor time, long near-work habits, heavy screen exposure, and younger age of onset can all contribute. Some children progress even with good habits, which is why monitoring and myopia-control treatment may be discussed.
Myopia-control treatment may slow progression, but it cannot guarantee that the power will stop increasing completely. The aim is to reduce the rate of worsening and lower the chance of the child reaching higher levels of myopia. Treatment response varies between children.
Normal glasses are important because they help your child see clearly, but they may not slow the eye growth that causes progression. If your child’s power keeps increasing, the doctor may discuss myopia-control spectacle lenses, low-dose atropine, orthokeratology, soft multifocal contact lenses, or a combination approach.
Screen time is one factor, but it is not the only cause. Myopia usually comes from a combination of family history, near work, indoor lifestyle, education demands, and reduced outdoor time. A 2025 JAMA Network Open review found that myopia risk increased with higher daily digital screen time, especially between 1 and 4 hours per day, but parents should interpret this as a risk association rather than proof that screens alone caused the problem.
The International Myopia Institute Risk Factors for Myopia Report, 2021, states that 2 hours per day outdoors during daylight hours is justified by available evidence, especially in preschool and early primary school years. This does not replace eye checks or treatment if myopia is already progressing, but it is a useful habit for eye and general health.
Bring your child for an eye check if they squint, sit close to the TV, complain that the school board is blurry, get headaches with reading, need frequent changes in glasses, or have one eye turning in or out. You should also arrange an assessment if either parent has high myopia, if a school screening is abnormal, or if your child’s prescription is increasing quickly.
References
- Brustad, N., Buchvald, F., Jensen, S. K., & et al. (2025). Burden of infections in early life and risk of infections and systemic antibiotics use in childhood. JAMA Network Open, 8(1), Article e2453284. https://doi.org/10.1001/jamanetworkopen.2024.53284
- Tan, E. S. Y., Agarwal, P., & Teng, C. L. (2026). Prevalence of myopia in children and adolescents: A systematic review of Malaysian prevalence studies. Malaysian Journal of Medical Sciences, 33(1), 14–26. https://doi.org/10.21315/mjms-08-2025-592
- Morgan, I. G., Wu, P. C., Ostrin, L. A., Tideman, J. W. L., Yam, J. C., Lan, W., Baraas, T. L., Resnikoff, S., Sankaridurg, P., & Saw, S. M. (2021). IMI Risk Factors for Myopia Report. Investigative Ophthalmology & Visual Science, 62(5), Article 3. https://doi.org/10.1167/iovs.62.5.3
Medical Disclaimer
This article is written for general educational purposes and does not constitute medical advice. It is not a substitute for professional consultation with a qualified ophthalmologist. Individual clinical situations vary, and management decisions should always be made in partnership with your treating specialist.
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