Myopia in children – causes, diagnosis and treatment

Myopia, also known as “short-sightedness” or “axial myopia”, is an eye condition in which near objects are seen clearly, while distant objects appear blurry. This is one of the most common vision problems and can affect people of all ages. Myopia occurs when the shape of the eyeball is too elongated or the cornea (the transparent layer on the surface of the eye) is too curved. This causes the light to focus in front of the retina, not directly on it, which leads to clear vision only at short distances.

Myopia in children is similar to myopia in adults, but there are some significant differences regarding the development, progression and management of the disorder.

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1. Myopia in children, risk factors, causes
2. Myopia in children – manifestations and symptoms
3. Myopia in children – correction methods
4. Complications of myopia in children

Myopia in children, risk factors, causes

• Genetics: myopia in children tends to be hereditary. If one or both parents have myopia, the child’s risk of developing this condition is higher.
• Environment: activities that require a close look at close objects, such as reading or excessive use of digital devices, can contribute to the development of myopia in children.
• Early onset: myopia in children usually appears at a young age, often between 6 and 14 years. The earlier it appears, the more likely it is to progress quickly.
• Rapid progression: myopia in children can progress more quickly than in adults. Children’s eyes are growing and changing, which can contribute to worsening myopia as the eyeball elongates.

Myopia in children – manifestations and symptoms

Symptoms:

• blurred vision of distant objects;
• the need to squint to see clearly;
• headaches caused by eye strain;
• eye fatigue;
• myopia in children can affect school performance, because children can have difficulties in seeing the text written on the blackboard or other objects at a distance;
• children with myopia may avoid activities that require clear distance vision, such as sports or outdoor games.

Eye development : children’s eyes are in full development, which makes myopia in children progress faster. In adults, myopia tends to stabilize, because eye development stops at a certain point.

Myopia in children – correction methods

The correction of myopia in children involves several methods, each with the aim of ensuring clear vision and slowing the progression of myopia. Here are the most common and effective correction methods for myopia in children:

1. Eyeglasses

Glasses are the most common correction method when it comes to myopia in children. Concave (negative) lenses help focus light correctly on the retina, allowing children to clearly see distant objects.

• Advantages: they are easy to use and adjust, offer additional eye protection and various aesthetic options.
• Disadvantages: they can be uncomfortable for some physical activities, they can break or scratch easily.

2. Contact lenses

Contact lenses are an alternative for myopia in children, for those who are responsible enough to handle and maintain them properly.

• Advantages: it offers more natural visual correction, without peripheral distortions, they don’t fog up and don’t break.
• Disadvantages: they require rigorous care and hygiene, because there is a risk of eye infections if they are not properly maintained.

3. Orthokeratology (Ortho-K)

Orthokeratology involves wearing gas-permeable rigid contact lenses at night, which temporarily reshape the cornea to improve vision during the day.

• Advantages: provides temporary correction of myopia without the need for glasses or contact lenses during the day, and can slow the progression of myopia.
• Disadvantages: it requires constant wear to maintain the effects, the costs are higher, and the respective lenses require regular monitoring by a specialist.

4. Multifocal contact lenses

These lenses have several focus areas, which help not only to correct myopia, but also to slow down its progression.

• Advantages: they can be worn throughout the day, provide a clear view at various distances and can slow down the progression of myopia.
• Disadvantages: they require adjustment and accommodation, they can be more expensive than conventional contact lenses.

5. Atropine drops

Atropine in low concentrations is used to slow the progression of myopia, when it comes to myopia in children. The drops are administered daily in the eyes.

• Advantages: they are effective in slowing the progression of myopia, studies supporting the long-term beneficial effects.
• Disadvantages: they have possible side effects such as photophobia (sensitivity to light) and can create difficulties with close vision, require prescription and medical monitoring.

6. Progressive or bifocal lenses

Glasses with progressive or bifocal lenses have different correction zones for distance and near, which can help slow the progression of myopia.

• Advantages: they can be used continuously, because they correct both distance and near vision.
• Disadvantages: they may require an adjustment period, and glasses with such lenses may be more expensive than those with conventional lenses.

7. Time spent outdoors

Although it is not a correction method in itself, increasing the time spent outdoors is associated with a reduction in the risk of myopia progression in children.

• Advantages: offers additional benefits for general health and physical development.
• Disadvantages: requires commitment from the family to encourage outdoor activities.

Complications of myopia in children

Myopia in children, especially when it is not properly corrected and monitored, can lead to a series of long-term complications. These complications are more frequent and more severe in cases of advanced myopia. Here are some of the major complications associated with myopia in children:

1. Rapid progression – myopia in children

Myopia in children can progress rapidly, leading to an increase in the severity of the disorder. The more severe the myopia, the more the risk of ocular complications that are more difficult to manage increases.

2. Vision problems

• Retinal detachment: the risk of retinal detachment increases significantly in people with severe myopia, because the elongated eye can strain the retina.
• Glaucoma: children with severe myopia have a higher risk of developing glaucoma, a disease that affects the optic nerve and can lead to vision loss.
• Myopic macular degeneration: this is a condition in which the center of the retina (the macula) degrades, affecting central vision and clarity.
• Cataracts: if myopia in children worsens, the risk of premature development of cataracts, which affect the clarity of the lens, may increase.

3. School and social problems

• School performance: children with uncorrected myopia may have difficulty seeing the blackboard or other educational materials clearly, which can lead to poor school performance.
• Daily activities: myopia in children can limit participation in sports and recreational activities, affecting their physical and social development.

4. Eye fatigue and discomfort

• Asthenopia: children may experience eye fatigue, headaches and eye discomfort due to the effort to clearly see distant objects.

5. Risk of amblyopia (lazy eye)

• Amblyopia: if myopia in children is manifested by very different degrees of damage to the vision of the two eyes, there is a risk of amblyopia, where the brain favors the eye with clearer vision and ignores the information from the other eye, which leads to a weakening of its vision.

6. Psychological and emotional impact

• Loss of self-confidence: myopia in children can make them aware of the differences between themselves and their peers and they can feel a decrease in self-esteem or even anxiety related to wearing glasses.
• Social isolation: vision difficulties can contribute to feelings of isolation and difficulties in social interactions.

7. Financial costs

• Optical correction: the constant need to change glasses or contact lenses as myopia in children progresses can involve significant costs.
• Medical treatment: in severe cases, the costs related to surgical treatments or management of eye complications can also be considerable.