Myopia — short-sightedness — has become one of the fastest-growing health conditions in children worldwide. By 2050, it's estimated that half the global population will be myopic.1 In the UK, rates have doubled in children over the past few decades.2 As an optometrist, this is one of the most important conversations I have with parents.
Why Are We Seeing So Much More Myopia?
The increase can't be explained by genetics alone — our DNA hasn't changed that quickly. The evidence increasingly points to changes in how children spend their time.
Two key environmental factors stand out:
1. Reduced time outdoors
Multiple large studies have found that children who spend more time outdoors have lower rates of myopia and slower progression.3 The leading theory is that bright outdoor light stimulates the release of dopamine in the retina, which helps regulate eye growth. Two hours of outdoor time per day appears to be the threshold at which a protective effect is observed.
2. Increased near work
Close-up tasks — reading, tablets, phones, gaming — are now a much larger part of childhood than they were a generation ago. While the exact mechanism is still being studied, sustained near focus appears to be a risk factor for both the onset and progression of myopia.4
What Actually Happens in a Myopic Eye?
In a myopic eye, the eyeball has grown slightly too long from front to back. This means that light from distant objects focuses in front of the retina rather than directly on it, causing blurred distance vision.
This isn't just a focusing problem. A longer eye means the retina, macula, and optic nerve are all stretched more thinly over a larger surface. Higher levels of myopia — particularly above -6.00 D — are associated with significantly increased risks of:5
- Retinal detachment
- Glaucoma
- Myopic maculopathy (a form of vision loss)
- Cataracts (developing earlier)
This is why slowing progression during childhood isn't just about avoiding thick glasses — it's about protecting your child's long-term vision.
What Are the Warning Signs?
Children don't always tell you when their vision has deteriorated. They often adapt, assuming that everyone sees the world the way they do. Things to watch for:
- Sitting closer to the television
- Squinting to see the board at school
- Complaints of headaches, particularly after school
- Losing interest in sports or activities requiring distance vision
- Holding books or devices very close
If your child is school-aged and hasn't had an eye test recently, it's worth booking one — NHS sight tests are free for children under 16.
Myopia Control: What Options Are Available?
Standard single-vision glasses or contact lenses correct the blur but don't slow the underlying progression. Myopia control treatments aim to do both.
At Spectacle, we offer three evidence-based options:
Hoya MiyoSmart Spectacle Lenses
MiyoSmart uses D.I.M.S. (Defocus Incorporated Multiple Segments) technology. The central zone provides clear distance correction while the surrounding zone creates a myopic defocus signal that slows eye growth. Clinical trials show an average of 52% reduction in progression compared to standard lenses.6 These are spectacle lenses — ideal for younger children or those not yet ready for contact lenses.
MiSight 1-Day Contact Lenses
MiSight are daily disposable soft contact lenses with dual-focus optics. They correct distance vision while simultaneously creating peripheral defocus that inhibits axial eye growth. FDA-approved for myopia control, clinical data shows an average of 59% slowing of progression over three years.7 Children as young as 8 can typically wear contact lenses successfully.
Orthokeratology (Ortho-K)
Ortho-K involves wearing specially designed rigid gas-permeable lenses overnight. While you sleep, the lenses gently reshape the cornea so that by morning, you can see clearly without any lenses during the day. Beyond the convenience, ortho-K produces a peripheral defocus effect that slows myopia progression. Studies suggest a 57% reduction compared to standard contact lenses.8
When Should Treatment Start?
The earlier, the better. The rate of myopia progression is fastest in younger children — between ages 7 and 12.9 Starting myopia control early, before significant progression has occurred, gives the best chance of limiting the final prescription.
We recommend a myopia control consultation if:
- Your child has been diagnosed with myopia, particularly if they're under 12
- One or both parents are myopic (a significant risk factor)
- Your child's prescription has increased by -0.50 D or more in the last year
- You're concerned about screen time and outdoor time habits
What Happens at a Myopia Control Consultation?
At Spectacle, we carry out a full assessment including axial length measurement — measuring the physical length of the eye — alongside a standard refraction. Tracking axial length gives us a more objective measure of progression than prescription change alone.
We'll discuss your child's lifestyle, risk factors, and which treatment option best suits them. We also provide guidance on outdoor time and near work habits, which remain important alongside any optical intervention.
You can also use our myopia risk calculator to get an initial sense of your child's risk level and projected progression.
Danish Sheikh BSc(Hons) MCOptom DipTp(IP) is an independent prescribing optometrist at Spectacle, Claygate, Surrey, with a specialist interest in myopia management.
Footnotes
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Holden BA, et al. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology. 2016;123(5):1036–1042. ↩
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McCullough SJ, et al. Six Year Refractive Change among White Children and Young Adults. PLOS ONE. 2016;11(8). ↩
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He M, et al. Effect of Time Spent Outdoors at School on the Development of Myopia Among Children in China. JAMA. 2015;314(11):1142–1148. ↩
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Huang HM, et al. The Association between Near Work Activities and Myopia in Children — A Systematic Review and Meta-Analysis. PLOS ONE. 2015;10(10). ↩
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Flitcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Prog Retin Eye Res. 2012;31(6):622–660. ↩
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Lam CSY, et al. Defocus Incorporated Multiple Segments (DIMS) spectacle lenses slow myopia progression. Br J Ophthalmol. 2020;104(3):363–368. ↩
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Chamberlain P, et al. A 3-year randomized clinical trial of MiSight lenses for myopia control. Optom Vis Sci. 2019;96(8):556–567. ↩
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Charm J, Cho P. High myopia — partial reduction orthokeratology (MPORA) clinical study. Cont Lens Anterior Eye. 2013;36(4):164–170. ↩
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Donovan L, et al. Rates of myopia progression in schoolchildren. Invest Ophthalmol Vis Sci. 2012;53(10):6180–6186. ↩