With childhood myopia rising rapidly in India, as in the world, ophthalmologists have warned that the crisis could eventually affect not only public health but also future workforce readiness in the country, including recruitment into defence services, where sharp vision is essential.
Their concern comes amid projections that myopia could affect nearly half of the world’s population by 2050. And India will be no exception.
“If projections suggesting that nearly half the population could become myopic by 2050 come true, it may eventually affect recruitment into services such as the armed forces, Air Force and Navy, where strict visual standards are mandatory,” said Dr. JS Titiyal, ex-Chief of the RP Eye Centre, AIIMS Delhi, and Additional Director of Dr. Agarwal’s Eye Hospital.
Stressing that myopia prevention must become a national public health priority, he emphasised that the real focus should shift from merely controlling myopia after it develops to preventing its onset during the preschool years itself.
Dr. Titiyal, a leading cornea transplant surgeon from AIIMS and a Padma Shri awardee, called for compulsory eye screening before the age of five, including eye examinations during vaccination visits and annual health assessments on birthdays.
He also advised parents with a family history of myopia, particularly those who themselves wear glasses or have undergone corrective surgery, to ensure early and regular eye check-ups for their children, as such children are at a significantly higher risk of developing progressive myopia.
Agreeing with the concern, Dr. Rohit Saxena, senior paediatric ophthalmologist at RP Centre, AIIMS, Delhi, said the rising burden of myopia among children requires urgent and collective intervention.
If we do not wake up to this threat, he warned that a large-scale increase in severe myopia among young adults could potentially reduce the pool of eligible candidates needed in military services, particularly combat roles in the Army, Air Force and Navy, which often require stringent visual standards.
Dr. Rohit Saxena is also the programme director of the revised childhood myopia prevention and management guidelines issued by the All India Ophthalmological Society, which were recently released to guide ophthalmologists across the country in tackling the growing burden of myopia among children.
Drawing attention to the gravity of the issue, he said that nearly 15 per cent of the 1,200 children with myopia who visited the special Myopia Clinic at AIIMS, Delhi, last year had a refractive error of minus 5 or higher, indicating severe myopia that cannot return to normal vision naturally.
Also, Dr. Saxena said cases that were earlier seen among children aged 10 to 12 are now increasingly being detected among those aged five or six.
Eye experts said the rapid increase in screen exposure, shrinking outdoor activity and changing childhood lifestyles after the Covid-19 pandemic have transformed myopia from a simple refractive error into what many doctors describe as a growing “lifestyle epidemic”.
The guidelines strongly recommend annual eye examinations, school vision screening programmes, limiting recreational screen exposure, maintaining proper reading distance, using adequate lighting while studying, and ensuring that children spend at least two hours outdoors every day.
According to Dr. Titiyal, childhood myopia has become a serious long-term eye health concern.
“High myopia can permanently alter the structure of the eye and significantly increase the risk of retinal detachment, glaucoma, cataracts and irreversible vision loss later in life,” he said.
Studies conducted in recent years indicate a sharp rise in prevalence among school-going children, particularly after prolonged online learning during the pandemic. Ongoing surveys by the AIIMS, Delhi, along with the AIOS and a pharma firm, have shown nearly 20 per cent prevalence in urban regions compared to 6–8 per cent in rural areas.
“The lifestyle change has happened more so post-Covid because children were studying online. As a result, children are continuously glued to their tabs and phones and do not go outdoors to play,” he observed.
Ophthalmologists also warned that excessive near-work activities and prolonged digital screen exposure among toddlers and young children are accelerating the problem. Dr. Rajesh Sinha, Ophthalmologist, AIIMS Delhi, recommended that children below two years should ideally have no screen exposure, while screen time for children aged two to five should remain strictly limited and supervised.
Dr. Rohit Saxena urged parents to remain alert to early signs of myopia, including children holding books too close, sitting near television screens, squinting while viewing distant objects, and frequently experiencing headaches, watery eyes or eye strain.
The revised guidelines also discuss interventions including atropine eye drops, specialised myopia-control spectacles, orthokeratology and multifocal contact lenses. However, ophthalmologists stressed that these measures only slow progression and should be undertaken strictly under professional supervision.
Dr. Namrata Sharma, senior Ophthalmologist and Chairman of the AIOS Scientific Committee, said prevention remains the most powerful strategy.
“The prevention and management of childhood myopia require a shift from reactive treatment to proactive prevention,” she said, emphasising the need for collective action involving parents, schools, healthcare professionals and policymakers.
Dr. Kaushik Murali, Ophthalmologist at Sankara Eye Hospital, Bengaluru, said prolonged screen exposure among children not only weakens the eye but has also been found to disrupt sleep patterns, which can adversely affect their overall growth and developmental health.
