A focus on children with myopia

More and more children are experiencing nearsightedness or myopia. There is a lot that is not well understood about myopia or how to treat it, but there is general agreement on one thing – the younger the age of onset of myopia, the greater the likelihood that a child will progress to vision threatening pathology as they grow.

“I am seeing young children in my clinical practice more and more frequently who suffer from myopia and am asked by parents what can be done to help,” says Tawna Roberts, OD, PhD, assistant professor of ophthalmology. “We need to learn more about myopia, including better ways to control and slow the progression – to prevent more serious eye disease later on in life. That is why I am excited that we have launched a new myopia initiative at Stanford focused on children.”

Today, about 2.5 billion people worldwide suffer from myopia, which is rapidly on the rise. By 2050, it’s projected that 50% of the world’s population will have myopia (10% with pathologic or “high myopia”), an astonishing number. The problem is especially serious in Asian populations. For example, in urban areas of Singapore, China, Taiwan, Hong Kong, Japan and Korea, 80 to 90% of high school graduates are myopic. There has also been a sharp rise in myopia amongst children in the United States.

Myopia occurs when a child’s developing eyes grow too long from front to back. Instead of focusing images on the retina—the light sensitive cells at the back of the eye—images of distant objects are focused at a point in front of the retina. Near vision is good but distance vision is poor.

High myopia occurs when a prescription reaches at least -5 diopters, the unit of focusing power correction needed to optimize distance vision.  Studies have shown that high myopia can lead to glaucoma, retinal detachment, myopic macular degeneration, and other serious and sight-destroying eye diseases.

"This is an area of high local and international need, and we have to take a multimodal approach."

The causes of myopia are unclear but evidence suggests that close-up work, such as screen time and less time spent outdoors during early development, are contributing factors. Genetics also plays a role. If both parents have myopia, there is a high likelihood that their children will be myopic.  Currently, scientists and doctors are unable to predict precisely who will develop high myopia. “We need more research to better understand who is at risk of developing more extreme myopia and we need better treatments for those patients,” says Ann Shue, MD, clinical assistant professor of ophthalmology.

Typically eye glasses will be prescribed but glasses do not slow down the underlying progression or prevent pathologic damage. Thankfully, new treatments are pushing the field forward.  “In recent years there have been new discoveries on how to control the progression of myopia so the earlier we diagnose the problem, the sooner we can use interventional treatments. The problem is that insurance in the US does not cover these treatments and many children are not getting the care they need,” says Roberts.

“This is an area of high local and international need, and we have to take a multimodal approach,” says Jeffrey Goldberg, MD, PhD, professor and chair of the Department of Ophthalmology. “Having this team focus on patient treatment, laboratory and clinical research, and education outreach, has allowed us to broaden our efforts in understanding the causes and improving treatments–something that’s long overdue.”