Myopia in Children and Adults: Causes, Risks, and Management
- The Straits Eye Centre
- Sep 19
- 4 min read
Introduction: Why Myopia Matters Today
Myopia, commonly known as nearsightedness, is one of the fastest-growing eye conditions in the world. In Singapore, the numbers are especially striking: by the age of 12, over half of children already develop myopia, and many progress into high myopia as adults. This condition not only affects daily life, from classroom learning to driving but also carries long-term risks such as retinal detachment, glaucoma, and myopic macular degeneration.
Early detection, regular monitoring, and safe management strategies are key to reducing complications. This guide will walk you through the causes, risks, and management options for myopia in children and adults, giving you clarity on what to expect and how to protect your family’s vision.
What Is Myopia?
Myopia occurs when the eyeball is too long, or the cornea is too curved, causing light rays to focus in front of the retina instead of directly on it. As a result, distant objects appear blurry, while near vision remains relatively clear.
Key facts about myopia:
It often develops in childhood, between ages 6 and 12.
Progression is fastest during school years when visual demands are high.
Adults with untreated or high myopia are at higher risk for serious eye complications.
Causes of Myopia in Children and Adults
Myopia arises from a mix of genetic and environmental factors.
Genetics: Children with one or both parents who are myopic have a significantly higher chance of developing the condition.
Lifestyle: Excessive near work, such as prolonged reading or screen time, is strongly linked to myopia progression.
Outdoor Time: Reduced exposure to natural light is associated with faster myopia onset and progression.
Symptoms of Myopia
Both children and adults may experience:
Blurred distance vision (difficulty reading the whiteboard or road signs).
Frequent squinting or eye strain.
Headaches linked to visual effort.
Needing to sit closer to screens or books.
Risks of Untreated Myopia
Myopia is more than just a need for glasses. High or progressive myopia increases the risk of serious, sight-threatening conditions:
Retinal Detachment: The stretched retina is more prone to tears and detachment.
Glaucoma: Higher incidence in individuals with high myopia.
Myopic Macular Degeneration: Damage to the central retina, affecting fine vision.
Cataracts: Myopia can accelerate cataract formation.
Myopia in Children: Early Intervention Matters
Childhood is a critical period for managing myopia. Once the eyeball elongates, it cannot be reversed, but progression can be slowed with proper care.
Screening and detection:
Vision screening should begin in preschool and continue throughout school years.
Children at risk (family history, heavy screen use) may need earlier or more frequent checks.
Management options:
Customised spectacles for myopia control.
Soft contact lenses designed for slowing progression.
Orthokeratology (Ortho-K): Special contact lenses worn overnight to reshape the cornea.
Low-dose atropine eye drops: Clinically proven to reduce myopia progression rates.
Myopia in Adults: Ongoing Care and Risks
Adults with myopia face different challenges compared to children:
Stabilised Myopia: Most adults’ prescriptions stabilise, but high myopia requires ongoing monitoring.
Workplace Demands: Prolonged screen exposure may worsen symptoms of eye strain.
Surgical Options: Adults may be candidates for refractive surgeries such as SMILE, PRK, or ICL, which reduce dependency on glasses but do not cure myopia itself.
Monitoring for complications like glaucoma, cataracts, or retinal issues is crucial in adulthood.
Safe Management Options for Myopia
For Children
Regular screening and follow-up.
Specialist-led prescriptions for spectacles or contact lenses.
Lifestyle modifications: more outdoor time, screen breaks.
For Adults
Regular eye health checks to monitor for complications.
Considering refractive surgery for visual freedom.
Management of dry eye or ocular surface issues linked to prolonged screen time.
Lifestyle and Prevention Strategies
Encourage children to spend at least 2 hours outdoors daily.
Follow the 20-20-20 rule: every 20 minutes of near work, look at something 20 feet away for 20 seconds.
Maintain good reading posture and lighting.
Reduce unnecessary screen time, especially before bedtime.
Frequently Asked Questions
1. Can myopia be cured?
No. Myopia cannot be reversed, but progression can be slowed, and vision corrected with glasses, lenses, or surgery.
2. At what age does myopia usually start?
It often begins in early school years (ages 6–12) and may worsen through adolescence.
3. What’s the difference between low, moderate, and high myopia?
Low: less than -3.00 dioptres. Moderate: -3.00 to -6.00. High: greater than -6.00, which carries higher risks.
4. Is too much screen time a cause of myopia?
Excessive near work, including screen time, is linked to faster progression, especially in children.
5. How often should children have their eyes screened?
The Health Promotion Board recommends screenings in preschool and primary school. Children with symptoms should be reviewed earlier.
6. What are the safest myopia control options for kids?
Low-dose atropine, Ortho-K, and specially designed myopia-control lenses, under specialist supervision.
7. Can adults with myopia undergo refractive surgery?
Yes, many adults are suitable for procedures like SMILE, ICL, or PRK, depending on eye health.
8. What happens if high myopia is left unmanaged?
Risks include retinal detachment, glaucoma, and vision-threatening degeneration. Regular monitoring is essential.
Meet Our Specialist
At The Straits Eye Centre, your vision care is in the hands of a dedicated team of experienced ophthalmologists. Each of our doctors brings unique expertise and a shared commitment to delivering thorough, patient-focused care for all ages. Whether you need advanced cataract surgery, paediatric eye management, or treatment for complex eye conditions, our team works together to provide the same attentive care we would want for our own families.
Dr Audrey Pang
Consultant Eye Surgeon
Special interest: Paediatric Ophthalmology, Myopia Control, Amblyopia, Strabismus Trained at the University of Cambridge and fellowship-trained in the UK, Dr Audrey Pang specialises in children’s eye care and adult strabismus. She has held roles at Tan Tock Seng Hospital and serves as Visiting Consultant at TTSH and NUH, offering gentle, evidence-based care for patients of all ages.
Cost, Medisave, and Insurance
Many procedures at The Straits Eye Centre are eligible for Medisave claims under MOH guidelines, and certain insurance plans may cover part or all of your treatment costs. Our patient care team will guide you through eligibility, claim limits, and paperwork, so you can focus on your recovery. For more details, refer to our Medisave & Insurance Guide.
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