What is myopia?

Myopia, commonly referred to as ‘near-sightedness’ or ‘short-sightedness’, is a common eye focussing condition which causes blurred distance vision. Short-sighted people can often see reasonably clearly at short distances but will not be able to see distant objects clearly.

Myopia has become so common that by 2020, it is estimated that 2 billion people worldwide will have myopia, and by 2050, almost 50% of the world will be myopic. [1] That is five billion people.

Reducing the prevalence and impact of myopia is critical as myopia is associated with many eye health risks later in life, such as retinal detachments, glaucoma, and cataracts.

There are many causes of myopia. Genetics plays an important role but the environment in which the child evolves is believed to also be a critical factor. What has changed in our environment to explain the recent myopia epidemic is the impact of technology, resulting in less time outdoors in younger years, affecting normal eye development.

What can you do?

When should you have your child’s eyes examined?

Eye examinations can be performed on children at any age, from babies and infants up to adolescents and older teenagers. The type of examination performed depends on the signs and symptoms that the child is experiencing and is tailored to the age group of the child and the level of their development.

In babies and infants, the optometrist looks for issues such as blocked tear ducts that haven’t opened properly, congenital cataracts and childhood tumours that can form inside the eye ball, as well as crossed eyes and droopy eyelids that can cause the development of amblyopia (lazy eye).

Before starting school, children are usually able to match shapes on the letter chart so that optometrists can assess their level of eye sight (visual acuity) to detect if one or both of the eyes have reduced vision. An assessment is also made of the child’s refractive error (long sighted, short sighted, astigmatism). It is an excellent time to have the child examined as a lot of reliable data can be collected, and treatments commenced well before the child has to start school.

Between the age of five to seven years old, a examination can involve checks for higher level visual functions such as depth perception, binocular vision eye coordination, and speed and accuracy of changes in focus.

Older children need to be regularly checked for the development of myopia (short sight) and keratoconus (irregular cornea) which can greatly impact the ability to see clearly into the distance. Children with special needs such as premature babies and those with Down Syndrome often have poorer vision than the general population and need to start eye examinations at a younger age and have exams more frequently than other children.

Consider a comprehensive eye examination. By getting a checkup you can find a problem if one exists because kids will often not complain about things that they feel is normal. This is because they don’t know any different.

What will a comprehensive eye examination involve? How is it different to a vision screening?

General practitioners, child care nurses and paediatricians do not perform eye examinations but sometimes conduct a “vision screening” which is a basic test looking for a difference in vision between the two eyes. Unfortunately vision screenings fail to detect a large number of eye problems that are readily detected in a comprehensive eye examination performed by the optometrist, and screenings do not check for any eye health issues. The ideal time to have a child examined is before starting school and regularly thereafter to ensure that their visual development is proceeding normally. Depending on the child’s age group and level of development, the eye examination consists of a large number of tests that assess various aspects of vision and visual acuity, eye coordination and binocular vision, and ocular health. Some of the tests performed are distance and near visual acuity in each eye, subjective and objective measurement of the refraction (prescription) of the eye, stereopsis (3D vision), colour vision, eye coordination, accuracy of focus and ability to shift focus to different positions, and internal and external eye health. A comprehensive eye exam typically takes 30 to 45 minutes to perform.

Often a comprehensive eye examination will result in advice, not necessarily a new pair of glasses. A key component of an examination is around asking questions about habits and hobbies to get an understanding of how a child is using their eyes. An examination can often be a key opportunity to highlight behaviours that could affect the quality of vision and how to adapt these behaviours accordingly.