Myopia, The Silent Crisis In Children's Vision

Eye specialists are sounding the alarm. They warn that children are spending too much time indoors, exposed to artificial light and fixed on screens and close-up activities—all contributing factors to the explosion of myopia cases or nearsightedness. Moreover, the progression of the condition is also accelerating — the power of glasses is increasing rapidly.

Myopia is a common vision condition in children where they have difficulty seeing distant objects clearly. It occurs when the eyeball is too long or the cornea is too curved, causing light to focus in front of the retina instead of directly on it. These results in blurry vision for distant objects, while close-up vision remains clear, explain ophthalmologists.

Poor posture, inadequate lighting, improper sleep, and even the child’s height are minor but compounding influences. The COVID-19 lockdowns have only worsened the situation. Now, with record-breaking summer heat forecast likely to become a new normal in the coming months and years, indoors activities and screen time are all set to skyrocket—leading to even more stress on developing eyes.

In India, like in the world, doctors are seeing children as young as three requiring prescription lenses, and projections suggest that by 2050, half the global population could be myopic. The causes are preventable, but time is running out, warn the ophthalmologists.

“We are seeing children as young as three or four developing myopia—something that used to appear during early adolescence,” says Dr. Radhika Tandon, senior ophthalmologist and head of the Dr. Rajendra Prasad Centre for Ophthalmic Sciences at AIIMS, Delhi.

“We are raising a generation of children who may struggle to see the world beyond their screens—literally. Myopia, is no longer a minor inconvenience corrected by glasses. It's a rapidly growing vision disorder with lifelong consequences like retinal detachment, glaucoma, cataracts, and myopic macular degeneration."

“While myopia often stabilises in young adulthood, early-onset cases can lead to lifelong complications. The faster and earlier the eye elongates, the greater the risk of serious disorders later in life.”

Talking about the symptoms, Dr. Tandon said, children may experience, including eye fatigue, pain, loss of concentration, sleep disturbances, headaches, and irritability.

Dr. Digvijay Singh, head of ophthalmology at Madhukar Rainbow Children’s Hospital, echoes her concern. "Today, every classroom has children wearing glasses—more so as students progress from junior to senior levels. My clinic sees a growing number of patients under five with newly diagnosed myopia. The pandemic accelerated this shift as kids were glued to screens and deprived of outdoor activity.”

“The risk increases dramatically with higher prescription levels,” warns Dr. Singh. “That’s why intervention during early childhood is critical.” A study by AIIMS found that one in eight school children in Delhi wears corrective glasses. Other studies in South and Northeast India report rates as high as one in three.

Yet, awareness remains a major issue. A University of Michigan Health study revealed that only half of parents recognize screen time as a major factor impacting their child’s vision. While the condition is manageable, there’s no single guaranteed cure. Management includes prescription glasses or contact lenses, including specialized lenses that slow progression, diluted atropine eye drops, which can help slow eye growth, regular eye checkups, especially for kids under five or with a family history of myopia, protective measures outdoors, like sunglasses and wide-brimmed hats to guard against UV damage followed by healthy diet rich with vitamin A.

Dr. Mahipal S. Sachdeva, Chairman of Centre for Sight, cautions that while these interventions help, results vary widely. “Early detection remains our best defense,” he says while Dr. Tandon stresses on key prevention tips including those suggested by the World Health Organisation (WHO).

“Follow the 20-20-20+2 rule: Every 20 minutes of screen time, take a 20-second break to look at something 20 feet away, and spend at least two hours outside daily,” she suggests. At the same time, Dr. JS Titiyal, former chief of the RP Centre at AIIMS, takes it a step further as he calls for a legislation to ban smartphones for children under age three. “Parents must take an active role in monitoring screen usage and promoting outdoor activities.”

In view of surge in cases, AIIMS has established a dedicated Myopia Clinic, prioritizing care for children under 15 with rapidly worsening vision.

No doubt, in the age of smart classes, digital toys, and streaming screens, controlling myopia is a challenge—but not impossible. What it demands is early action, consistent awareness, and a collective push from parents, educators, and health experts. The eyesight of the next generation may very well depend on it.

The most important thing is to catch it early and on time to enable timely treatment so I always recommend to parents to get their child's vision screened at least once at the age of 4-5 years and even earlier if there is a strong family history of myopia, says Dr. Sachdeva.

Top eye experts from Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, Delhi calls for more researches in the context of India which though seeing surge in Myopia cases, not being given due importance due to a paucity of scientific literature in Indian set ups.

“Prospective cohort-based studies are necessary to understand the natural history, progression, genetic influences, regional differences, and various effects of interventional measures. In addition, standardized methodology including case definition, sampling strategy and measurement protocols are to be followed to prevent potential bias,” said top ophthalmologists including Dr. Amar Pujari, Dr. Sujeeth Modaboyina, Dr. Divya Agarwal, Dr. Gunjan Saluja, Dr. Rajeswari Thangavel, Dr. Vaishali Rakheja, Dr. Rohit Saxena, Dr. Namrata Sharma, Dr. Jeewan S Titiyal, and Dr. Atul Kumar in their review article published last year in journal Clinical Ophthalmology.

Prevention or Management of Myopia

Using eyewear to minimize risks to children’s eyes

Protect little eyes from intense sunlight: In fact, when children are outdoors, they should wear sunglasses or wide-brimmed hats to decrease the risks of ultraviolet radiation damage, which can contribute to eye problems in older age, Clark says.

Regular eye checks to detect problems early

Last but not the least: “Follow the 20-20-20+2 rule: for every 20 minutes of screen time, take a 20-second break, look at something 20 feet away or more, and spend at least 2 hours outside each day, throughout the day.”

The WHO recommends no more than 2 hours of recreational screen time per day for children ages 5 to 17.