Understanding the Myopia Explosion: 6 Myths and Facts

By Dr. Russel Lazarus
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The rate of myopia in the western world has doubled in the last 30 years.

This is known as the ‘myopia explosion’… 

In today’s day and age, children are spending more time indoors, often learning and playing on digital screens, and less time outdoors playing in the sun. At the same time, the rate of myopia development and progression has spiked in recent years.

Is this jump in myopia (nearsightedness) linked to the way children are spending their time? 

What’s causing the myopia explosion?

Can anything be done to help our children maintain their vision and long-term eye health?

Here are our top 6 myths and facts about the myopia explosion:

Myth #1: The only problem of myopia is blurry vision

Fact: Myopia is linked to an increased risk of sight-threatening eye conditions later in life.

1. Glaucoma

According to a study published in Value in Health (May 2015), myopia increases the risk of glaucoma significantly, with moderate myopia being twice as likely, and high myopes being three times as likely to develop glaucoma.

Myopic eyes tend to be larger than average, making the optic nerve more vulnerable to damage, causing an increased risk for glaucoma for people with high myopia.

2. Retinal detachment

Myopia has also been linked to increased risk of retinal detachment. 

Already in 1993, the American Journal of Epidemiology  found that myopia is a “clearly relevant factor for retinal detachment.”

In the study, those with mild myopia were four times more likely to develop retinal detachment, while the risk jumped 10 times in those with mild to high myopia.

3. Macular degeneration

Myopic macular degeneration (MMD) can occur as the longer length of the eyeball, results in stretching of the retina, eventually leading to retinal tears and bleeding of the retinal blood vessels.

4. Cataracts

Cataracts are a clouding of the focusing lens inside the eye and are another potentially sight-threatening eye condition linked to myopia.

Eye care professionals suspect that the increased length of the eyeball that causes myopia also hinders nutrient delivery to the lens of the eye. This nutrient deprivation is a possible cause of cataract formation as a result of myopia.

Myth #2: Outdoor play has no effect on myopia development

Fact: Researchers found that children who spent at least 14 hours per week, or two hours per day, playing outside in the sunshine were less likely to develop myopia than those who spent less time outdoors.

Many studies, including Investigative Ophthalmology and Visual Science (February 2019), show a strong link between the amount of time children spend outdoors and the development of myopia.

Myth #3: Once your child has myopia, there’s no way to slow its progression

Fact: Myopia management is a well-established area of eye care specifically dedicated to slowing down the progression of myopia.

Because myopia has been linked to heightened risk of developing sight-threatening eye conditions later in life, eye doctors have developed methods of combating it’s progression.

Myopia management methods used by eye doctors include:

Although your child may already have myopia, these methods can help slow myopia progression, reducing their chances of developing conditions such as macular degeneration, glaucoma, cataracts and retinal detachment.

SEE RELATED: Why Stronger Glasses Are Not the Solution for Worsening Myopia 

For more information on the myopia explosion and how parents can help protect their child’s eye health, contact your local eye doctor.

Find an eye doctor near you

Myth #4: There is no connection between screens and myopia development and progression.

Fact: Many leading studies on the connection between screen time and myopia progression suggested a strong possibility that they are linked.

Research published in The Lancet Digital Health (October 2021), representing one of the most comprehensive studies on the subject, suggests a strong direct link between screen time and myopia. 

Researchers from Singapore, Australia, China and the United Kingdom, studied the link between smart devices and myopia development by compiling more than 3,000 separate research articles on the subject.

They found that more than three hours a day on a smart device caused a 30 percent increase in myopia risk, which then jumped to 80 percent when taking computer usage into account.

Myth #5: The effect of screens on myopia progression is the same across all ages

Fact: A study in The British Journal of Ophthalmology (Feb 2019) found that children who spent more than three hours on screens each day were at four times the risk of developing myopia than those who spent an hour or less per day on screens.

These results varied across age and stage of development.

Children aged  6-7 who were heavy screen users were up to 5 times more likely to develop myopia than those in the same age group who were lighter screen users.

This increase was much less pronounced in the 12-13 year old group, where heavy screen usage represented a 21 percent increase in the risk of developing myopia.

Myth #6: There are no professional recommendations for how to manage screen time

Fact: The American Academy of Pediatrics (AAP) recommends a limit of 2-3 hours per day of screen time for children. 

The AAP also recommends encouraging your children to spend time outside every day, away from screens and other types of close-vision work.

Many studies on the link between screen usage and myopia development and progression note that increased screen time can often lead to other behaviors that are thought to be detrimental to a child’s health.

For example, a study in the February, 2019 issue of Investigative Ophthalmology and Visual Science links heavy screen usage with reduced time spent outdoors. The study suggests a strong link between outdoor play time and a reduced incidence of myopia.

Eye care professionals therefore recommend limiting screen time and encouraging outside play.

LEARN MORE: Guide to Myopia Management

If your child’s myopia is worsening, speak to an eye doctor near you about myopia management.

Here’s our top 6 Myths and Facts on the myopia explosion.

If your child’s myopia is increasing, eye doctors that specialize in myopia management have the solutions you are searching for.