Children's eyes are still developing well into the teen years. Good habits and proper care during these years pay off for the rest of their life — and a few specific interventions can meaningfully change the trajectory of childhood nearsightedness.
Most pediatricians do a basic visual screening at well-child visits, but those screenings catch only a fraction of eye problems. The American Optometric Association recommends a comprehensive eye exam at 6 to 12 months, again at age 3, before kindergarten, and every two years through school — yearly if the child wears glasses or contacts.
Many practitioners offer free or low-cost first exams for infants through the InfantSEE program.
Children often don't realize their vision is abnormal — it's how they've always seen the world. Watch for sitting close to the TV, squinting, frequent eye rubbing, holding books very close, complaints of headaches, an eye that turns in or out, head tilting, light sensitivity, or trouble with schoolwork that doesn't match the child's ability.
Don't wait for the school screening. School screenings miss a lot.
Rates of childhood myopia (nearsightedness) have risen dramatically over the past few decades worldwide. Higher levels of myopia carry lifelong risks — retinal detachment, glaucoma, myopic macular degeneration — so the goal isn't just glasses for now, it's slowing how nearsighted the child becomes.
Several effective myopia control treatments now exist, and the earlier you start in a progressing child, the more impact they have.
Time outdoors — at least 90 minutes a day of outdoor time meaningfully slows myopia onset in children. It's free, has only upside, and works.
Low-dose atropine eye drops — typically 0.05% or 0.025% once nightly. Strong clinical evidence for slowing progression with mild side effects.
Orthokeratology ("ortho-k") — custom rigid lenses worn overnight that temporarily reshape the cornea, giving clear daytime vision without glasses and slowing axial elongation.
Specialty soft contact lenses (MiSight, multifocal soft lenses with treatment zones) — FDA-approved options worn during the day with proven myopia-slowing effects.
Myopia control spectacle lenses (DIMS and HAL designs) — newer lens designs that show meaningful slowing of progression in children, with fewer logistical demands than contact lens-based options.
Excessive near work — including screens — is one of several factors associated with myopia progression. Practical recommendations: limit recreational screens (especially for younger kids), build in frequent breaks during homework and devices, encourage outdoor play, and don't let kids use devices in dim lighting.
Sports-related eye injuries are one of the leading causes of preventable vision loss in children. Polycarbonate sports eyewear is required for any child playing baseball, racquet sports, basketball, soccer, lacrosse, or hockey. Safety glasses for science and shop classes are required by law in most states.
Many optometrists and pediatric ophthalmologists are well-trained for children's eye care. Look for someone who's comfortable with kids, who tests visual function (not just vision charts), and who's familiar with current myopia control options. A good pediatric eye exam takes time — be wary of in-and-out visits.
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