Is Your Child Squinting? What Parents Need to Know About Childhood Myopia

If your child came home from a school vision screening with a note saying they need glasses, you might have wondered: is this going to get worse? The short answer is — it might. And for many children, it does. But the longer answer is more encouraging: there are now proven treatments that can slow the progression of nearsightedness, and they work best when started early.

Here is what every parent in the Hackensack area should know about childhood myopia and what you can do about it.

What Is Myopia and Why Does It Worsen in Children?

Myopia — the clinical term for nearsightedness — occurs when the eye is slightly too long from front to back, causing light to focus in front of the retina instead of directly on it. The result is blurry distance vision, while near objects remain clear.

In children, the eye is still growing. For most kids, the eye reaches its adult size by the mid-to-late teens. But if the eye is already myopic, this growth phase often makes the prescription worse — sometimes significantly — year after year. This is not just about needing a stronger glasses prescription. It is about the eye elongating in ways that create real health risks later in life.

Why Progression Matters Beyond the Prescription

Each additional diopter of myopia increases the risk of serious eye diseases in adulthood. Specifically:

• The risk of retinal detachment increases by about 3x for every 3 diopters of myopia
• High myopia (above -6.00) increases the risk of myopic macular degeneration, a leading cause of permanent central vision loss
• Glaucoma risk increases significantly with higher degrees of myopia
• Cataracts tend to develop earlier in highly myopic eyes

This is why optometrists increasingly view myopia management not just as a cosmetic convenience, but as a genuine public health issue. Keeping a child’s prescription from reaching -6.00 or higher could meaningfully reduce their lifetime risk of vision-threatening disease.

Signs That Your Child May Be Myopic

Many children do not realize their distance vision is blurry because they have never experienced it any other way. Signs that may indicate myopia include:

• Squinting to see the board at school or the TV across the room
• Sitting unusually close to screens
• Complaining of headaches, especially after activities requiring distance vision
• Losing interest in sports or activities that require good distance vision
• A teacher noting that the child seems to have difficulty seeing the board

If you notice any of these signs, schedule a comprehensive eye exam promptly. Vision screenings at school are not comprehensive exams — they miss a significant percentage of refractive problems and provide no information about eye health.

The Three Main Myopia Management Options

Standard glasses and contact lenses correct vision in the moment but do nothing to slow the underlying progression. Myopia management treatments are designed to do both.

Orthokeratology (Ortho-K)

Ortho-K lenses are custom-designed rigid contact lenses worn only while sleeping. They gently reshape the cornea overnight so the child has clear unaided vision throughout the school day — no glasses, no contacts during waking hours. Beyond the convenience, Ortho-K has one of the strongest evidence bases for slowing axial elongation, the physical growth of the eyeball that drives myopia progression. Studies have consistently shown 40 to 60 percent reduction in progression compared to standard correction.

Soft Multifocal Contact Lenses for Myopia Control

Certain soft contact lenses — specifically those designed with a peripheral defocus profile — have been shown to slow myopia progression. MiSight 1-day lenses are FDA-approved for myopia control in children and are a popular option for kids who are ready for daily contact lens wear. They are worn during the day and discarded each evening, eliminating cleaning and storage concerns.

Low-Dose Atropine Eye Drops

Applied once nightly in very small concentrations (typically 0.01% to 0.05%), low-dose atropine drops have been shown in multiple large clinical trials to slow myopia progression. They are often used alongside optical interventions, particularly in children with more aggressive progression. Side effects at these low doses are minimal, though some children experience mild light sensitivity.

When Should You Start?

The earlier, the better. Myopia management is most effective when the eye is still actively growing. A child diagnosed at age 7 with a moderate prescription has many more years of potential progression ahead than a 15-year-old whose prescription has recently stabilized. If your child has been diagnosed with myopia — especially if it has increased by 0.50 diopters or more in the past year — now is the time to ask about management options.

Children with two myopic parents are also at significantly elevated risk and may be good candidates for early intervention even before significant prescription changes are observed.

What Parents Often Ask Us

Can my child really wear contact lenses?

Yes, often younger than parents expect. The key factor is not age but the child’s maturity, motivation, and ability to follow lens care instructions. Many children handle contacts successfully starting around age 8 to 10. We assess each child individually and will give you an honest opinion about readiness.

Will myopia management eliminate glasses entirely?

Not necessarily. The goal of myopia management is to slow progression — not reverse existing myopia. A child who starts Ortho-K at -2.00 may not need glasses during the day, but they will still be -2.00 if they stop wearing the lenses. The long-term goal is that they end up at, say, -3.00 at age 18 rather than -6.00.

Does screen time cause myopia?

The evidence increasingly points to time spent outdoors — not screen use per se — as the most important environmental factor. Children who spend 90 minutes or more per day outdoors have significantly lower rates of myopia onset and progression. Bright outdoor light is thought to trigger dopamine release in the retina, which regulates eye growth. Encourage outdoor time, regardless of which management approach you choose.

Schedule a Myopia Management Consultation at Bergen Optometry

If your child has been diagnosed with myopia, or if you are concerned about their distance vision, we would be happy to discuss your options. Bergen Optometry in Hackensack, NJ offers comprehensive myopia management evaluations, Ortho-K fitting, MiSight contact lens consultations, and low-dose atropine programs for children throughout Bergen County.

Call us at 201-482-1216 or book a consultation online. The sooner you start, the more of your child’s vision you can protect.