Myopia Control – What should you be doing to help your child?
Why should you consider bringing your child to our Myopia Control Clinic? Simply put, myopia is becoming more common in children across the globe. Rates in Europe have doubled in last 20 years and rates of myopia are expected to jump to around 50% of UK children by 2050. In parts of East Asia over 90% of 18 years old’s are now myopic. As a result of such increases myopia is now recognised by the World Health Organisation as a potential global public health problem.
One the major issues surrounding myopia is that of public perception. It is often viewed as nothing more than a need for spectacles to see clearly in the distance. When an increase in myopia represents an increase in risk of retinal detachment, myopic maculopathy, glaucoma, and cataracts. For the first time in my career we have the opportunity to slow the progression of myopia in your child using Myopia Control measures (also referred to as myopia management) such as MiyoSmart spectacles lenses or contact lenses such as MiSight 1 day or OrthoK.
Myopia Control – What should you be doing to help your child?
Myopia Control Tip 1: Get Outdoors
Your child should ideally spend 1.5 – 2 hours per day outdoors. Many children do not get anywhere near this amount of outdoor play. This issue is further compounded by the COVID-19 crisis and the resultant lockdowns which mean children are spending less time outdoors. But even before the emergence of COVID children were spending significantly less time outdoors than previous generations. A 2016 survey found that 75% of UK children spent less time outdoors than prison inmates, with 20% never playing outdoors on a regular basis.
Being outdoors in the presence of sunlight appears to be protective against myopia. The exact reasoning for why is not yet fully understood. It is thought to be a combination of the brightness of the light, looking at long distances (rather than being glued to a smart phone) and in some way related to exposure to UV light on the eye and retina.
Myopia Control Tip 2: Do not hold devices and books too close!
Recent evidence suggests that your child holding reading material, whether a book, game or digital device too close requires more focussing effort and this may cause a change in the length of the eye (axial length) which can cause an increase in myopia. We should instead be encouraging children to holding reading material further away, ideally using the distance from the knuckle to their elbow (this is called the Harmon distance) or simply the elbow rule.
Encourage your child to keep an elbow-to-wrist distance between anything they are viewing up close whether book or tablet between the object and their eyes. Try this yourself, and then show your child this at home. Make a fist and sit your fist gently against your eyes. The distance to your elbow is then the minimum distance your child should view the object from.
Myopia Control Tip 3: Take regular breaks from close work and digital device use.
Holding devices further away is important. Equally as in important is encouraging your child to take regular breaks from close work. Use the 20/20/20 rule. Encourage your child to look at 20 metres, for 20 seconds every 20 minutes. This allows the eye muscles that turn in when reading to relax. Strain and fatigue of these muscles is thought to be one of the factors related to myopia progression.
Taking a 10–15-minute break every hour has also been shown to improve concentration and task performance as well as relaxing the eye muscles. This is particularly important when children are being home-schooled using digital devices. There is no differentiation between schoolwork, homework and revision as children are often sat in the one place with their laptop or tablet for 9 hours per day.
Myopia Control Tip 4: What Can I do about screen time?
Here are three tips to improve your child’s screen time habits:
- Lead by example.
Be a good screen time role model yourself! Set screen time timers and check and monitor your own screen time habits. The results may shock you. The average adult in the UK spends 6 hours 25 minutes on their phones, laptops, and TV per day. Setting up screen-free time for the family – for example meals times, breakfast, lunch, and dinner. Setup screen free rooms for the family can also be useful.
- Set screen timers.
Most smart phones and tablets have this function built in. The recent Apple iOS and Android updates both contain such features. You can customise which apps are controlled by the timer. Once the app reaches its time limit a passcode is required to override the timer.
- Signup for the MyopiaApp.
This app was developed by an international partnership of optometrists and scientists to help modify a child’s screen behaviour. The app measures how closely a device is being held and darkens the screen if it is held too close. Once the child moves the device further away to a more appropriate viewing distance the screen reveals itself again. CLICK HERE for the MyopiaApp https://myopia.app/en/
Myopia Control Tip 5: Screen time recommendations.
Screen time recommendation advice goes beyond simply protecting your child from myopia. Screen time can have an adverse effect on your child’s general development. It is a struggle for every family at present due to COVID-19, the resultant lockdowns and home-schooling. You are not alone in this! I have a daily challenge with my 3-year-old son.
- Children under the age should have no screen time.
Every minute an under-2 spends watching a screen is a minute not spent in active play or learning, reduced opportunities for language development, development of the full range of eye movement, and hand eye coordination. Screen-time can negatively influence attention span.
- Children aged 2-5 years should have a maximum of 1 hour of screen time per day.
With the exception of sleeping, infants, toddlers and pre-schoolers should not be inactive or sedentary for more then one hour at a time. Within this age group excessive screen use leads to less activity, less outdoor play and less creative play and is associated with an increased risk of myopia, an increased risk of being overweight, poor social skills and poor language development.
- Children of school age aged 5-17 years should be limited to 2 hours of sedentary recreational screen time per day.
It is important to break-up long periods of screening use and sitting where possible. Encourage your child to use the 20/20/20 rule to give the eyes a break and try to take a 10–15-minute break for every hour of work.
Myopia Control Tip 6: Sleep is also important.
Sleep is also so important to children. Screen time unfortunately competes for sleep time. A recent study has suggested sleep as a potential component in myopia. Lack of sleep seems to be linked with increases in the progression of myopia. A good routine can help, with appropriate bed and wake-up times being set and applied daily. Reducing screen time before bed and removing screens from the bedroom can also be useful.
- Children aged from 5-13 years should have an uninterrupted 9 – 11 hours of sleep per night.
- Children aged 14 – 17 years should have a minimum of 8 – 10 hours of sleep per night.
Myopia Control Tip 7: Speak to an expert in myopia control.
I have been involved in myopia management since 2010, with our practice Peter Ivins Eye Care setting up Scotland’s first dedicated Myopia Management Clinic in 2013. Despite the wealth of scientific research and proven studies that show the progression of myopia can be significantly slowed, myopia management or myopia control is still not widespread and mainstream in the UK.
If you or your child is myopic and myopia management strategies have not been discussed by your optometrist, visiting a practice like ours that specialises in myopia control would be worthwhile. Please feel to email me at firstname.lastname@example.org if you have any questions. We would be delighted to welcome you to our myopia clinic or recommend another specialist closer to home if you are further afield.
Myopia Control Tip 8: Consider a myopia control strategy.
There are variety of options available to our myopia management specialists. We have the groundbreaking Hoya MiyoSmart spectacle lenses CLICK HERE to learn more about MiyoSmart. We have a variety of contact lens options including MiSight 1 day, NaturalVue 1 day, SEED 1dayPure EDOF, Mylo and Orthokeratology.
How do I book an appointment for a myopia control assessment?
Simply call our reception team on 0141 943 3300 or CLICK HERE to use our online appointment diary to make an appointment with our myopia control specialist optometrist. They will be able to assess your child and guide you through the options available to you. If you have any questions in the meantime please feel free to email me at email@example.com and I will be more than happy to answer queries.
About the author
Craig McArthur qualified as an optometrist in 2008. He is an optometrist and director of Peter Ivins Eye Care, an award winning optometric practice in Bearsden near Glasgow. Craig has a special interest in specialty contact lenses fitting, dry eye and myopia management. He lectures throughout the UK, Europe and the far East on the topic of myopia management and has published numerous articles on the subject. He is a key opinion leader and consultant to a number of contact lens companies and pharmaceutical companies.