Childhood myopia is increasing across New Zealand, and early management can significantly slow its progression and reduce the risk of sight-threatening complications in adulthood. Myopia, commonly known as short-sightedness, causes distant objects to appear blurred while close objects remain clear. While corrective lenses restore clear vision, they do not address the underlying progression of the condition. Children who develop myopia at a young age face longer periods of progression, potentially leading to higher prescriptions and increased risk of serious eye conditions such as retinal detachment, glaucoma and myopic macular degeneration later in life. Modern myopia management strategies focus on slowing progression during childhood when the eyes are still developing, offering parents access to evidence-based treatments that can make a meaningful difference to their child's long-term eye health.
Why Myopia Is Increasing in New Zealand
Lifestyle and environmental changes are influencing eye development in children across New Zealand and internationally. The rise in childhood myopia correlates with observable shifts in how children spend their time, particularly the balance between near work activities and outdoor exposure.
Increased near work and screen use place sustained demands on children's focusing systems throughout their school day and leisure time. Reading, homework, digital devices and close-up hobbies require the eyes to maintain focus at short distances for extended periods. While screens themselves are not solely responsible for myopia development, the combination of prolonged near work and reduced time spent looking at distant objects appears to influence how eyes grow during childhood.
Reduced outdoor time among New Zealand children coincides with rising myopia rates. Research indicates that time spent outdoors, particularly in natural daylight, may have a protective effect against myopia development and progression. The mechanisms behind this protection remain under investigation, but current evidence suggests that outdoor exposure benefits eye development in ways that indoor activities, even when not focused on screens, cannot replicate.
Earlier onset of myopia leads to longer progression periods and typically results in higher final prescriptions. Children who develop myopia at age six or seven have more years of eye growth ahead of them compared to children who develop the condition at age twelve or thirteen. This extended progression window increases the likelihood of reaching moderate to high myopia levels, which carry greater risks for eye health complications in adulthood.
Early Signs of Myopia Parents Often Miss
Children rarely recognise or report vision changes because they lack a reference point for what clear distance vision should look like. A child who has always seen distant objects as blurred assumes this is normal and does not know to complain about it. This means parents and teachers must watch for behavioural signs rather than waiting for children to articulate visual problems.
Sitting closer to screens or books than siblings or classmates may indicate a child is compensating for blurred distance vision by bringing objects nearer. Children with developing myopia often position themselves at the front of classrooms, move closer to television screens, or hold books and devices unusually close to their face. These adjustments happen gradually and may seem like preference rather than necessity.
Squinting or eye rubbing frequently occurs when children attempt to see distant objects more clearly. Squinting temporarily improves focus by reducing the amount of light entering the eye, creating a pinhole effect that sharpens vision. Persistent eye rubbing, particularly after activities requiring distance vision, may signal eye strain or fatigue from sustained effort to focus.
Complaints of headaches or tired eyes, especially after school or screen time, can indicate that a child is working harder than necessary to maintain clear vision. The constant effort to focus on blurred images creates eye strain and fatigue that manifests as physical discomfort. Children may not connect these symptoms to vision problems and instead express general tiredness or reluctance to continue reading or homework.
Declining concentration or reading confidence during the school year sometimes reflects undiagnosed myopia rather than learning difficulties or behavioural issues. Children who cannot see the classroom board clearly struggle to follow lessons, copy notes accurately, or engage with visual materials presented at a distance. This disconnect between effort and results can affect confidence and academic performance before parents or teachers identify the underlying vision problem.
Factors That Influence Myopia Progression
Myopia progression is influenced by multiple factors, some of which parents can modify and others that remain beyond direct control. Understanding these influences helps parents make informed decisions about lifestyle adjustments and management strategies that may slow progression during the critical years of eye development.
Genetics and family history play a significant role in determining whether a child develops myopia and how rapidly it progresses. Children with one myopic parent face approximately double the risk of developing myopia compared to children with no myopic parents, while children with two myopic parents face an even higher risk. Genetic predisposition does not guarantee myopia development, but it does increase the importance of early and regular eye examinations to detect changes promptly.
Screen habits and close work contribute to myopia progression through sustained near-vision demands that may influence eye growth patterns. The issue extends beyond total screen time to include the intensity and duration of continuous near work without breaks. Children who engage in prolonged reading, device use, or close-up activities without regular distance viewing may experience faster myopia progression than children who balance near and distance tasks throughout the day.
Limited outdoor time appears to accelerate myopia progression in children who have already developed the condition. While the protective mechanisms of outdoor exposure remain under study, current evidence suggests that children who spend less than ninety minutes outdoors daily progress faster than those who spend more time in natural daylight. This relationship exists independently of physical activity levels, indicating that light exposure itself, rather than exercise, provides the protective benefit.
Modern Myopia Management Options Available at Gates Eyewear
Modern myopia management treatments aim to slow progression during childhood rather than simply correcting vision with standard lenses. These evidence-based approaches work by influencing how the eye grows, addressing the underlying elongation that causes myopia to worsen. Treatment selection depends on the child's age, prescription, lifestyle and individual response to therapy, guided by comprehensive professional assessment and ongoing monitoring.
Orthokeratology Lenses for Overnight Correction
Orthokeratology lenses, often called ortho-k, are rigid contact lenses worn during sleep that temporarily reshape the cornea to provide clear daytime vision without glasses or contact lenses. Children remove the lenses upon waking and experience clear vision throughout the day without correction. Beyond providing freedom from daytime eyewear, ortho-k lenses have demonstrated effectiveness in slowing myopia progression in children. This dual benefit makes ortho-k particularly appealing for active children who participate in sports or prefer not to wear glasses during school. Treatment requires commitment to nightly lens wear and regular follow-up appointments to monitor corneal health and myopia progression.
Daily Soft Contact Lenses Designed for Myopia Control
Specialised daily disposable soft contact lenses incorporate optical designs that address peripheral vision in ways that may slow eye elongation. These lenses correct central vision for clarity while simultaneously managing peripheral focus to influence eye growth patterns. Children wear these lenses during waking hours, disposing of them each evening and using a fresh pair the following day. This modality suits children who prefer daytime lens wear or who may not be suitable candidates for ortho-k due to corneal shape or other factors. Daily disposable lenses eliminate cleaning routines and reduce infection risk compared to reusable lenses.
Advanced Spectacle Lenses for Myopia Management
Modern spectacle lenses designed specifically for myopia control use innovative optical zones that provide clear central vision while managing peripheral focus to slow eye growth. These lenses suit younger children who may not yet be ready for contact lenses or families who prefer a non-invasive management approach. Children wear these glasses throughout the day, just as they would standard prescription glasses, with the added benefit of progression control technology. Spectacle-based myopia management offers a straightforward option that requires no additional routines beyond wearing glasses consistently.
Low-Dose Atropine Eye Drops
Low-dose atropine eye drops represent a pharmaceutical approach to myopia control that works through mechanisms distinct from optical interventions. Children instil one drop in each eye daily, typically in the evening. The low concentrations used for myopia control minimise traditional side effects associated with higher-dose atropine, such as light sensitivity and near vision blur, while maintaining effectiveness in slowing progression. Atropine therapy can be used alone or combined with optical treatments for children experiencing rapid progression or requiring additional intervention.
Combination Therapy Tailored to Individual Needs
Some children benefit from combining multiple myopia management approaches to achieve optimal progression control. A child might use ortho-k lenses in conjunction with atropine drops, or wear myopia control spectacles while also increasing outdoor time. Treatment combinations are determined based on the child's rate of progression, response to initial therapy and practical considerations such as lifestyle and compliance.
When to Review Eyewear and Eye Care for Children with Myopia
Regular reviews are essential once myopia is diagnosed because childhood myopia is a progressive condition that requires ongoing monitoring and management adjustment. The frequency and focus of these reviews depend on the child's age, rate of progression and current management strategy, but all children with myopia benefit from more frequent professional assessment than those without vision problems.
Monitoring prescription changes through regular eye examinations allows practitioners to track progression rates and evaluate the effectiveness of current management strategies. Children with myopia typically require eye examinations every six to twelve months, with more frequent reviews recommended for younger children or those progressing rapidly. These examinations measure prescription changes, assess eye health and determine whether adjustments to treatment are necessary.
Adjusting management strategies as children grow ensures that myopia control approaches remain appropriate and effective throughout childhood. A child who begins with spectacle lenses at age seven may transition to contact lenses as they mature and become capable of lens handling. Similarly, a child experiencing rapid progression despite initial treatment may benefit from adding atropine therapy or switching to a different optical approach. Regular professional review creates opportunities to modify treatment based on response and changing needs.
Reviewing eyewear fit and lens suitability maintains comfort, vision quality and compliance throughout the growth years. Children's facial features change as they grow, affecting how frames fit and lenses align with their eyes. Poorly fitting glasses reduce optical effectiveness and comfort, potentially leading to inconsistent wear that undermines myopia control efforts. Regular eye examinations at Gates Eyewear include assessment of eyewear fit and lens condition, ensuring that corrective and myopia control functions remain optimised.
Book a comprehensive eye exam for your child at Gates Eyewear. Discover which evidence-based management options suit your child's needs and receive ongoing support throughout their treatment journey.