Myopia in Children A Comprehensive Management Approach

Childhood myopia is an increasing concern for the parents of school-aged children and a significant public health concern globally. This condition, which causes distant objects to appear blurry while close objects remain clear, can have a detrimental impact on a child’s life and development. Increased screen time on digital devices, including computers, tablets, gaming devices, and smartphones, has been linked to the progression of myopia, along with low levels of outdoor activity, and light exposure.¹

Defined as a spherical equivalent refraction of equal to or less than -0.50D in one or both eyes,² myopia not only impairs visual acuity but also increases the risk of severe ocular conditions later in life. By 2050, it is estimated that more than 50% of the world’s population will have myopia,³ with increasing prevalence among children. Myopia often progresses during childhood, and early onset can lead to high myopia (-6.00D or worse) in later years,⁴ which significantly increases the risk of serious eye conditions.

LOCAL PREVALENCE

In the past decade, the prevalence of myopia has surged, with children in Australia and New Zealand showing a trend towards earlier onset and higher incidence rates. A comprehensive review spanning five years of Specsavers deidentified patient records revealed that the prevalence of myopia among children in Australia rose from 24.6% in 2017 to 28.8% in 2022. Although New Zealand saw a slight decline from 32.6% to 29.8%⁵ over the same period, the overall numbers remain high and concerning.

According to a Specsavers research survey conducted in April 2024, which interviewed 468 parents of children aged 0–12 in Australia and New Zealand, it was identified that 21% of kids up to the age of 12 require some kind of vision correction.⁶ Changes in the eye become much more common as children get older, and the likelihood of developing myopia increases when one or both parents are myopic.⁷

VISION SCREENING EARLIER IN LIFE

Vision plays a crucial role in a child’s ability to understand and engage in school, with 80% of classroom learning being visual.⁸ Children with uncorrected myopia may struggle with everyday activities, as they may not be able to see the front of the room clearly, read from a distance, or participate fully in classroom activities. This visual barrier can lead to missed information, difficulty completing assignments, and ultimately hinder academic performance.

Specsavers is committed to combating the rising prevalence of childhood myopia by working to ensure all kids can have an eye test early in life. Currently, approximately 30% of Australian children and 28% of New Zealand children (aged 17 years and under) have never been to an optometrist to have an eye examination.⁹ The likelihood of the child’s first eye test increases with age, but the majority do not get an eye test until they are five years old.⁶ Prior to that, eye checks are generally booked as a reaction to noticeable signs, such as squinting, rubbing their eyes, or complaining of headaches. These symptoms may be observed by a teacher or a parent, or be a recommendation from the child’s GP.

Specsavers’ Children’s Vision Screening program is an impactful community initiative whereby local Specsavers practices organise screening days conducted by qualified optometrists at schools. Increasing access to eye care in this way is an opportunity for many children to have a basic eye check earlier than they otherwise would have. This may be the catalyst for the detection of undiagnosed vision issues. In these instances, the child is recommended to have a comprehensive eye exam with an optometrist of their choosing to ensure timely intervention and management of the condition. This clarity on the next steps after the initial school screening provides parents with peace of mind and a pathway for continued care.

Eye testing is a routine habit, and once a child has had their first eye examination, they are likely to continue to return every one to two years.6 When eye examinations become part of a child’s regular and ongoing health checks, early signs of myopia can be identified and monitored from a young age, and with treatment options and interventions, its progression can be significantly slowed.

ADVANCEMENTS IN MYOPIA MANAGEMENT OPTIONS

With research and technological innovation, eye care practitioners have access to a growing range of new, evidence-based management options to treat children presenting with myopia.

Working with our industry partners, Specsavers is making the latest myopia management options available to patients. Myopia management spectacle lenses are a mainstay of myopia management across the industry and provide a dual benefit: immediate visual clarity and long-term management of myopia progression.¹⁰ These therapeutic lenses form an important part of an optometrist’s myopia management toolkit, alongside other treatments, such as contact lenses and low-dose atropine eye drops. MiSight contact lenses have been clinically proven to slow myopia progression in children,¹¹ making them a vital part of our treatment arsenal. Similarly, low-dose atropine drops, prescribed by our professional optometrists, offer another effective method to manage myopia progression. With eye drops, spectacle lenses, and contact lenses, Specsavers optometrists have access to a comprehensive range of tools to meet the varied needs of our young myopic patients.

A PROACTIVE, HOLISTIC APPROACH

Taking a proactive approach to the increasing prevalence of childhood myopia in Australia and New Zealand is crucial. Early detection allows for interventions that can protect vision and ensure children thrive both in and out of the classroom. With advancements in myopia management technology and integrated community screening programs, Specsavers is providing a holistic approach to this issue and giving school-aged children the best possible care, from initial diagnosis through ongoing management.

We encourage the broader optometry community to adopt similar patient-centric models. By working together, we can significantly reduce the impact of myopia and improve the long-term eye health of the next generation.

Dr Joe Paul is the Head of Professional Services at Specsavers, where he provides clinical and professional support to optometrists across Australia and New Zealand. Dr Paul holds a PhD in glaucoma research and has extensive experience as a postdoctoral researcher at the Centre for Eye Research Australia. Over the past decade, he has also practised as an optometrist at Specsavers and in private practice.

References

1. The Australian and New Zealand Child Myopia Report 2022–23. Reducing the Risk to Vision. An adjunct report by the Australia and New Zealand Child Myopia Working Group, available at: childmyopia.com/for-parents/ [accessed June 2024].
2. Jong, M., Flintoff, D.I., Clinical Summary: IMI Defining and Classifying Myopia Report, International Myopia Institute; 2019. Available at: myopiainstitute.org/wp-content/ uploads/2020/09/IMI-Defining-and-Classifying-Myopia- Report_FINALv2-1.pdf [access June 2024].
3. Holden, B., Fricke, T., Resnikoff, S., et al., Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016; 123(5):1036–1042.
4. Shiley Eye Institute, Myopia (webpage). Available at shileyeye.ucsd.edu/eye-conditions/pediatric-conditions/ myopia [accessed May 2024].
5. Specsavers ANZ Patient Outcomes Database. [Data file]. Specsavers, Melbourne, 2024. [accessed 19 May 2024].
6. Research conducted by FiftyFive5, part of Accenture Song, on behalf of Specsavers. April 2024. [accessed 19 May 2024].
7. Lim, L.T., Gong, Y., Yu, S. et al., Impact of parental history of myopia on the development of myopia in mainland China school-aged children. Ophthalmol Eye Dis. 2014. June 24; 6:31–5.
8. Dudovitz, R.N., Izadpanah, N., Chung, P.J., Slusser, W., Parent, teacher and student perspectives on how corrective lenses improve child wellbeing and school function. Matern Child Health J. 2016 May; 20 (5):974–983.
9. Myopia in Australia and New Zealand: 2022 Consumer Perceptions Survey, commissioned by CooperVision Australia & New Zealand and conducted online by YouGov Research between 16–24 June 2022. Available at childmyopia.com/wp-content/uploads/ANZ-Myopia- Report-and-Key-Media-Statistics_221020F.pdf [accessed 19 May 2024].
10. Hoya, MiyoSmart (webpage) Available at: hoyavision.com/au/vision-products/miyosmart/ [accessed 26 May 2024].
11. Chamberlain, P., et al., A three-year randomized clinical trial of MiSight lenses for myopia control. Optom Vis Sci. 2019; 96(8):556-567.