I am short-sighted and I'm worried that my child might also develop similar vision problems. What can we do to prevent this?
We often have parents asking us about myopia prevention for their children. Myopia prevention is different from myopia control — myopia prevention refers to strategies of avoiding or delaying the onset of myopia in a child with normal vision, and myopia control are methods of slowing progression for a child who is already short-sighted.
REGULAR EYE TESTS
Arguably the best way of preventing myopia onset is for your child to have professional eye tests regularly from a young age. If there are known risk factors of myopia such as family history, regular eye tests even more important as children's eyes can change rapidly and often without them noticing or complaining. Delays in diagnosing and managing myopia will lead to greater progression.
We recommend all children have a comprehensive eye examination by the age of 3, and then every year while they are at school. While children will have basic vision screening tests by their maternity nurse, screening tests are not designed to detect subtle problems and can sometimes be unreliable.
Having a baseline eye examination at 3 and then annually will help us identify development trends in your child''s eyes and we can use this information to predict the risk of developing short-sightedness. Children are usually mildly long-sighted (hyperopic) when young — this is part of normal eye development. A 5 year old will typically be +1.00 or +1.50 long-sighted — this doesn't mean he or she needs glasses, as most young children can compensate for this naturally very well without symptoms. If we identify that your 5 year old child is only +0.50 long-sighted or perhaps has no long-sightedness, then your child is at much greater risk of becoming short-sighted.
There is much current evidence and news in mainstream media promoting the benefits of spending more time outdoors as prevention against myopia onset. While the exact mechanism of how this works is not yet clear, it is believed that the much higher levels of ambient light outdoors helps to modulate eye growth.
Our recommendation is for all kids to spend at least 90 minutes outdoors each day. It doesn't matter if they are playing sport, walking the family dog, in the school playground or riding their bike, it's the total outdoor time that counts. Of course, with spending more time outdoors kids will need appropriate UV protection such as sunglasses, sunscreen and hats.
With near work, we understand your child's education and schooling is important. Our recommendations for near work are: holding a book or tablet at least an elbow's distance away from your eyes, not too close; take plenty of regular breaks from intense close-up activities, such as homework, iPad, laptop and smartphones — the 20/20/20 is a good guide. This means after every 20 minutes of near work, spend 20 seconds to look at something in the distance over 20 metres away.
Wearing glasses for some, but not all, children can help prevent myopia onset. Children who naturally have eye teaming difficulties or more prone to focusing discomfort at near may benefit from using bifocal or progressive lenses that provide relief with close-up work and help reduce prolonged eyestrain that can lead to myopia development. A comprehensive eye examination with a children's optometrist will identify kids who require additional help with their near focusing.
ATROPINE EYE DROPS
Very few studies have been published in relation to using atropine eye drops for myopia prevention in children with normal eyesight. There is indication that atropine does work to delay onset of myopia in pre-myopic children, but due to insufficient clinical data at this point, this practise is not a routine one. If you are interested in using low-dose atropine for your child to prevent myopia onset we can evaluate this on a child-by-child basis.
The Singapore National Eye Centre (SNEC), which has previously done amazing research work into atropine treatment for childhood myopia in their ATOM1 and ATOM2 studies, recently announced their next study, ATOM3, which will investigate the effectiveness of atropine treatment on pre-myopic children.
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