What Is Myopia and Why Is It Increasing in Children?

Myopia (short-sightedness) is a condition where the eye grows too long from front to back (axial elongation), causing light to focus in front of the retina instead of directly on it. As a result, distant objects appear blurry while near vision remains clear.

Myopia is becoming increasingly common worldwide because children are spending more time on near work (reading, tablets, smartphones, and computers) and less time outdoors in natural daylight.

Research shows that at least two hours of outdoor time each day can help reduce the risk of developing myopia, while genetics also plays an important role. Once myopia develops, it often progresses as the eye continues to grow throughout childhood.

According to the landmark projections by Holden and colleagues, nearly 50% of the world’s population (around 5 billion people) is expected to be myopic by 2050, making myopia one of the fastest-growing public health challenges worldwide.

Key facts:

• Myopia = blurred distance vision, clear near vision.
• Caused primarily by excessive axial elongation of the eye.
• Risk increases with family history, prolonged near work, and insufficient outdoor time.
• By 2050, 1 in 2 people worldwide is projected to have myopia.
• Slowing myopia progression during childhood can reduce the lifetime risk of serious eye diseases such as retinal detachment, myopic macular degeneration, glaucoma, and cataracts.

Why Is Myopia Management So Important for Children?

Myopia usually begins in childhood and often progresses as the eyes continue to grow. The earlier myopia starts, the higher the chance it will progress to moderate or high myopia, increasing the risk of serious eye diseases later in life.

Managing myopia is not just about reducing dependence on glasses—it is about slowing excessive eye growth (axial elongation) to help protect long-term eye health.

Evidence shows that slowing myopia progression can significantly reduce the risk of vision threatening complications associated with high myopia, including:

• Retinal detachment – The retina pulls away from the back of the eye, which can cause sudden vision loss and requires urgent treatment.
• Myopic macular degeneration – Damage to the central retina (macula) caused by excessive eye elongation, leading to permanent loss of detailed central vision.
• Glaucoma – A disease that gradually damages the optic nerve, causing irreversible vision loss if left untreated.
• Early cataracts – Clouding of the eye’s natural lens that develops at a younger age than expected, resulting in blurred or reduced vision.

Starting treatment as early as possible provides the greatest benefit because the eyes grow most rapidly during childhood. Effective myopia management combines evidence based optical treatments, increased outdoor time, and regular eye examinations to monitor eye growth and prescription changes.

Key facts:

• Earlier onset = greater lifetime risk of high myopia.
• Myopia management aims to slow eye growth, not just improve vision.
• Early intervention offers the best chance of preserving lifelong eye health.
• Regular monitoring allows treatment to be adjusted as your child’s eyes develop.

What is difference between Single Vision vs. Myopia Control Lenses?

Both lens types provide clear vision, but they are designed for different purposes.

Single Vision Lenses	Myopia Control Lenses
Correct blurry distance vision.	Correct blurry distance vision and help slow myopia progression.
Have one uniform prescription across the entire lens.	Have a clear central vision zone with specially designed peripheral treatment zones.
Improve vision only.	Improve vision while reducing the stimulus for excessive eye growth.
Suitable for children and adults who only need vision correction.	Designed primarily for children with progressing myopia.
Do not slow the worsening of myopia.	Clinical studies show they can slow myopia progression by approximately upto 67%, depending on the lens design, individual response and wearing hours.

In simple terms:
Single vision lenses help your child see clearly today.
Myopia control lenses help your child see clearly today while helping protect their vision for the future by slowing the progression of myopia.

What Is the Best Age to Start Myopia Management?

The best time to start myopia management is as soon as myopia is diagnosed and confirmed to be progressing. Research shows that children who develop myopia at a younger age are more likely to become highly myopic, so early intervention provides the greatest long-term benefit.

Most children begin developing myopia between 6 and 13 years of age, but it can start earlier. Myopia management is generally most effective when started during these early years, while the eyes are still growing rapidly. Treatment is usually continued until eye growth has stabilized, often in the mid to late teenage years.

Key facts:

• Start treatment as soon as myopia is diagnosed—don’t wait for the prescription to become stronger.
• Children who become myopic before age 10 have the highest risk of developing high myopia.
• Earlier treatment provides the greatest opportunity to slow eye growth and reduce future eye health risks.
• Regular follow up examinations are essential to monitor progression and adjust treatment when needed.

Can Teenagers and Young Adults (16–25 Years) Still Benefit From Myopia Management?

Yes. Although myopia progresses most rapidly during childhood, many teenagers and young adults continue to experience worsening myopia into their late teens and early twenties. If progression is still occurring, myopia management may help slow further eye growth and reduce the risk of developing high myopia.

Recent studies show that myopia progression can continue in 16–25-year-olds, particularly in students and individuals who spend long hours on near work such as reading or computer use. While treatment is generally more effective when started earlier, it may still provide meaningful benefits if the prescription is continuing to increase.

Key facts:

• Myopia can continue to progress into the late teens and early twenties.
• Treatment may still be beneficial if your prescription is still increasing.
• Early treatment remains the most effective, but it’s never too late to assess whether myopia management is appropriate.
• Regular eye examinations can determine whether your myopia is stable or still progressing.

Is It Ever Too Late to Start Myopia Management?

No—but the earlier treatment begins, the greater the benefit. Myopia management is most effective when started in childhood, before significant eye elongation has occurred. However, if your prescription is still increasing during the teenage years or early adulthood, treatment may still help slow further progression.

If your myopia has already stabilized, myopia management treatments are unlikely to reduce your existing prescription or shorten the eye. However, regular eye examinations remain important to monitor eye health and detect complications associated with moderate or high myopia.

Key facts:

• It is never too early to start, and often not too late if myopia is still progressing.
• The greatest benefit is achieved when treatment begins soon after myopia develops.
• Myopia management slows progression—it does not reverse existing myopia.
• An eye examination can determine whether your myopia is still progressing and whether treatment is likely to be beneficial.

How Long Should Myopia Control Lenses Be Worn?

Myopia control lenses should be worn every day for as many waking hours as possible to achieve the best effect. Most children continue wearing them until their myopia has stabilized, which is often between 16 and 18 years of age, although some continue to progress into their early twenties.

For treatment to be effective, the lenses should be worn consistently as the primary pair of glasses. Studies show that longer daily wear is associated with better myopia control, while wearing them only occasionally may reduce their effectiveness.

Once eye growth has stabilized, your eye care professional may recommend transitioning to conventional single vision lenses if myopia is no longer progressing.

Key facts:

• Wear myopia control lenses every day as your main glasses.
• Aim for full-time wear during waking hours for maximum benefit.
• Most children wear them until myopia has stabilized, typically around 16–18 years, but sometimes into the early twenties.
• Regular eye examinations help determine when it is appropriate to stop myopia management.

Will Myopia Return If My Child Stops Wearing Myopia Control Lenses?

No. Myopia will not “return” because it never disappears in the first place. Myopia control lenses do not cure or reverse myopia—they help slow the rate at which it progresses while the eyes are still growing.

If treatment is stopped before myopia has stabilized, the eyes may begin to elongate more quickly again, and the prescription may continue to increase. This is why eye care professionals usually recommend continuing treatment until eye growth has largely stopped. Current evidence suggests that modern spectacle myopia control lenses have little or no clinically significant rebound effect when discontinued appropriately, although continued monitoring remains important.

Key facts:

• Myopia control lenses slow progression—they do not eliminate existing myopia.
• Stopping treatment too early may allow myopia to continue progressing if the eyes are still growing.
• Once myopia has stabilized, treatment can often be discontinued with guidance from your eye care professional.
• Regular follow-up examinations help determine the safest time to stop treatment and ensure the prescription remains stable.

Do More Hours Outdoors Really Help Reduce the Risk of Myopia?

Yes. Strong scientific evidence shows that spending more time outdoors can reduce the risk of children developing myopia. Exposure to bright natural daylight is thought to slow excessive eye growth, even on cloudy days.

Research suggests that children should spend at least 2 hours outdoors each day (around 14 hours per week) to help lower their risk of becoming myopic.

While outdoor time is highly effective at reducing the risk of developing myopia, it is less effective at slowing progression once myopia has already developed. For children who are already myopic, outdoor time should be combined with evidence-based myopia management treatments, such as myopia control lenses, and regular eye examinations.

Key facts:

• At least 2 hours of outdoor time each day is recommended for children.
• Bright natural daylight helps reduce the risk of developing myopia.
• Outdoor time alone cannot replace myopia control treatment in children whose myopia is already progressing.
• A combination of more outdoor time, healthy visual habits, and myopia management provides the best long-term protection for children’s vision.

How Much Screen Time Is Too Much for Children With Myopia?

There is no scientifically proven daily screen time limit that directly causes myopia. However, prolonged near work without regular breaks—whether on smartphones, tablets, computers, or books—is associated with an increased risk of developing and progressing myopia.

Rather than focusing only on the number of hours, experts recommend healthy visual habits. Children should take regular breaks during near work, hold screens at a comfortable viewing distance (at least 30–40 cm), avoid using devices for long periods without interruption, and spend at least 2 hours outdoors each day.

The 20-20-20 rule is a simple habit: Every 20 minutes, look at something at least 20 feet (6 metres) away for 20 seconds.

Key facts:

• There is no exact screen time limit proven to cause myopia.
• Continuous near work is a greater concern than total screen time alone.
• Follow the 20-20-20 rule during reading and screen use.
• Keep screens 30–40 cm away and encourage at least 2 hours of outdoor time daily.
• Good visual habits combined with evidence-based myopia management provide the best protection for children’s vision.

Is a Combination of Myopia Control Lenses and Atropine More Effective?

Yes, for some children. Combining myopia control lenses with low-dose atropine eye drops may provide additional benefit in children whose myopia continues to progress despite using a single treatment alone.

Research suggests that combining low-dose atropine (typically 0.01–0.05%) with evidence-based myopia control spectacle lenses or contact lenses can slow myopia progression more than either treatment alone in some children. However, the additional benefit varies between individuals, and combination therapy is generally reserved for fast progressors or children at high risk of developing high myopia.

Your eye care professional will consider your child’s age, rate of progression, family history, prescription changes, and axial eye growth before recommending combination therapy.

Key facts:

• Combination therapy may be more effective than a single treatment for some children.
• It is often recommended for rapidly progressing myopia or children at high risk of high myopia.
• Low-dose atropine (0.01–0.05%) is commonly used alongside myopia control lenses.
• Not every child requires combination treatment—therapy should be individualized and monitored with regular eye examinations.

Do Atropine Eye Drops Alone Solve the Problem of Childhood Myopia?

No. Low-dose atropine eye drops can slow the progression of myopia, but they do not correct blurred vision, cure myopia, or stop it completely. Children who use atropine still need properly prescribed glasses or contact lenses to see clearly.

Clinical studies have shown that low-dose atropine (0.01–0.05%) is an effective treatment for slowing myopia progression in many children. However, because atropine does not provide vision correction, it is often used together with spectacles or contact lenses. For children with rapidly progressing myopia, combining atropine with myopia control lenses may provide greater benefit than either treatment alone.

Key facts:

• Atropine slows myopia progression but does not cure or reverse myopia.
• Children still need glasses or contact lenses for clear vision.
• Combination treatment with myopia control lenses and low-dose atropine may provide additional benefit in some children.
• Regular eye examinations are essential to monitor treatment effectiveness and adjust therapy if needed.

Are There Any Side Effects of Atropine Eye Drops? Why Do They Cause Blurred Vision and Light Sensitivity?

Yes. Atropine eye drops can cause side effects, but these are usually mild and depend on the concentration used. Lower concentrations (such as 0.01–0.05%) are generally much better tolerated than higher concentrations.

Atropine works by temporarily relaxing the eye’s focusing (accommodation) muscle and enlarging the pupil. As a result, some children may experience blurred near vision because the eye cannot focus as well on close objects, and increased sensitivity to bright light (photophobia) because a larger pupil allows more light to enter the eye.

Most children using low-dose atropine experience little or no noticeable blurring or light sensitivity. If these symptoms occur, they are often manageable with photochromic or sunglasses outdoors and, if needed, reading glasses for prolonged close work. If side effects are significant, your eye care professional may recommend adjusting the atropine concentration or considering an alternative treatment.

Key facts:

• Low-dose atropine is generally safe and well tolerated.
• It can cause blurred near vision by temporarily reducing the eye’s ability to focus at close distances.
• It can cause light sensitivity because the pupil becomes larger and lets more light into the eye.
• Side effects are less common and milder with lower concentrations (0.01–0.05%).
• If symptoms are troublesome, speak with your eye care professional—the treatment can often be adjusted without stopping myopia management.

How Long Can a Child Safely Use Atropine Eye Drops??

Current evidence suggests that low-dose atropine eye drops can be used safely for several years when prescribed and monitored by an eye care professional. Most children use atropine for 2–5 years, or until their myopia has stabilized, which is typically around 16–18 years of age.

Long-term clinical studies have shown that low-dose atropine (0.01–0.05%) has a good safety profile, with very few serious side effects. Regular follow-up examinations are important to monitor myopia progression, check for side effects, and determine the appropriate time to reduce or stop treatment.

Stopping atropine too early may allow myopia to begin progressing again if the eyes are still growing. For this reason, many eye care professionals gradually reduce treatment or monitor closely after discontinuation to minimize the chance of further progression.

Key facts:

• Low-dose atropine has been shown to be safe for long-term use, often 2–5 years or longer if needed.
• Treatment is usually continued until myopia has stabilized, often during the mid to late teenage years.
• Regular eye examinations are essential to monitor effectiveness and safety.
• The decision to stop treatment should be based on eye growth and prescription stability, not simply on age.

Blue Light Glasses: What Does the Evidence Say?

Current scientific evidence does not support the use of blue light glasses for preventing or slowing myopia. While blue light filtering lenses may improve visual comfort for some people during prolonged screen use, they have not been shown to reduce the risk of developing myopia or slow its progression in children.

Research has also found no convincing evidence that blue light from digital devices causes permanent damage to the retina during normal everyday use.

Instead of relying on blue light glasses, experts recommend evidence-based strategies such as increasing outdoor time, taking regular breaks from near work, and using proven myopia management treatments when appropriate.

Key facts:

• Blue light glasses do not prevent or slow myopia progression.
• There is no strong evidence that blue light from screens damages the retina during normal use.
• Some people may find blue light filters more comfortable during prolonged screen use, but this varies between individuals.
• For myopia prevention and control, outdoor time, healthy visual habits, and evidence-based myopia management are far more effective than blue light glasses.

Why Are High-Index Lenses Thinner and Lighter? Do They Provide More Precise Vision?

High-index lenses are made from materials with a higher refractive index, meaning they bend light more efficiently than standard lens materials. Because they bend light more effectively, less material is needed to produce the same prescription, making the lenses thinner, lighter, and more comfortable, especially for stronger prescriptions.

High-index lenses do not automatically provide sharper or more precise vision than standard-index lenses. When manufactured accurately, both can provide excellent vision correction. The quality of vision depends more on the lens design (e.g., aspheric or freeform), manufacturing precision, anti-reflective coatings, and accurate fitting than on the refractive index itself.

However, high-index lenses often offer additional advantages:

• They reduce edge thickness in minus (myopic) prescriptions and centre thickness in plus (hyperopic) prescriptions.
• They are lighter, improving comfort for higher prescriptions.
• Aspheric high-index lenses can reduce peripheral distortions and improve cosmetic appearance by making the eyes look more natural through the lenses.

Key facts:

• High-index lenses are thinner and lighter because they bend light more efficiently.
• They do not inherently provide clearer or more accurate vision than standard-index lenses.
• Lens design and manufacturing quality have a greater impact on visual performance than lens index alone.
• High-index lenses are especially beneficial for moderate to high prescriptions, where they improve comfort, appearance, and reduce lens thickness.

What Is the Difference Between Spheric, Aspheric and Freeform Lens Designs? Which Is Best?

The design of a lens has a greater impact on vision quality than the lens material or refractive index. Modern lenses generally fall into three categories:

Spheric Lenses	Aspheric Lenses	Freeform HD Lenses
Traditional lens design with a constant surface curvature.	Flatter, more advanced design with gradually changing curvature.	Digitally designed and individually surfaced for each prescription and frame.
Thicker and heavier, especially for stronger prescriptions.	Thinner, lighter and more attractive.	Optimized for the wearer’s prescription, frame shape and fitting position.
Good central vision but more peripheral distortion in higher prescriptions.	Better peripheral optics and less distortion than spheric lenses.	Widest clear field of view with the least peripheral distortion.
More magnification/minification of the eyes.	More natural eye appearance.	Most natural vision and cosmetic appearance.
Most economical option.	Better visual performance and appearance.	Premium lens offering the highest level of optical performance.

Which Design Is Best?

For most people, Freeform HD lenses provide the best overall vision because they are manufactured using advanced digital surfacing technology. Unlike conventional lenses, each lens is individually optimized for the wearer’s prescription, frame size, fitting position, and viewing angles. This produces sharper vision across a larger area of the lens, especially in stronger prescriptions.

Aspheric lenses are an excellent choice for people wanting thinner, lighter lenses with improved optics and appearance at a more affordable price.

Spheric lenses still provide good vision for lower prescriptions but are generally thicker, heavier, and produce more peripheral distortion than modern lens designs.

Key facts:

• Spheric: Traditional design with good central vision but more distortion and thicker lenses.
• Aspheric: Thinner, lighter, flatter lenses with improved optics and appearance.
• Freeform HD: Individually customized digital lenses offering the widest clear field of view, least peripheral distortion, and highest precision vision.
• For the best visual performance, Freeform HD lenses are generally the gold standard, particularly for moderate to high prescriptions or anyone seeking the sharpest, most comfortable vision.

What Are Anti-Reflective (AR) Coatings and How Do They Help?

Anti-reflective (AR) coatings are ultra-thin transparent layers applied to the surface of eyeglass lenses. They reduce unwanted reflections from the front and back of the lens, allowing more light to pass through the lenses and reach your eyes. This results in clearer vision, improved comfort, and better-looking glasses.

How Do AR Coatings Help With Night Driving?

At night, bright headlights, streetlights, and reflections can create glare and halos, making it more difficult to see. A high-quality AR coating reduces these reflections, helping to:

• Improve contrast and clarity in low-light conditions.
• Reduce glare from oncoming headlights and wet roads.
• Make night driving more comfortable by reducing eye strain.

It’s important to note that AR coatings reduce reflections from your lenses—they do not eliminate glare caused by eye conditions such as cataracts or dry eyes.

How Do AR Coatings Help With Digital Screens?

Computers, tablets, and smartphones produce reflections on the lens surface that can reduce visual comfort. AR coatings help by:

• Reducing reflections from screens and indoor lighting.
• Improving contrast and making text appear clearer.
• Decreasing visual fatigue during prolonged screen use.
• Making your eyes more visible during video calls by minimizing lens reflections.

AR coatings improve visual comfort, but they do not prevent digital eye strain or slow myopia progression. Healthy screen habits, such as the 20-20-20 rule, regular breaks, and proper viewing distance, remain essential.

Key facts:

• AR coatings allow more light to pass through your lenses, improving clarity.
• They reduce reflections and glare, especially during night driving.
• They improve comfort when using computers, tablets, and smartphones.
• They make lenses almost invisible, improving the appearance of your glasses and making eye contact easier.
• Premium AR coatings often include scratch-resistant, water-repellent, oil-resistant, and easy-to-clean properties for greater durability and convenience.

Are There Different Types of Anti-Reflective (AR) Coatings? How Do They Differ?

Yes. Not all anti-reflective (AR) coatings are the same. They vary in optical performance, durability, ease of cleaning, and resistance to scratches, water, and smudges. Higher-quality AR coatings generally provide clearer vision, longer durability, and better overall value.

Common Types of AR Coatings

Standard AR	Premium AR	Ultra-Premium AR
Reduces basic reflections.	Superior reflection reduction with higher light transmission.	Maximum light transmission with the lowest residual reflections.
Basic scratch resistance.	Enhanced scratch resistance and durability.	Advanced scratch resistance for longer lens life.
May smudge more easily.	Hydrophobic (water-repellent) and oleophobic (oil-resistant) coatings.	Superior resistance to water, fingerprints, dust, and smudges.
Suitable for everyday use.	Better for frequent computer users and regular drivers.	Best for night driving, demanding environments, and premium eyewear.

How Do They Differ?

The biggest differences are not just in glare reduction, but in how well the coating lasts over time.

Premium AR coatings typically offer:

• Better night driving performance by reducing more reflections.
• Higher light transmission, allowing more light to reach your eyes for clearer vision.
• Greater scratch resistance, helping lenses last longer.
• Hydrophobic coatings that repel water.
• Oleophobic coatings that resist fingerprints, skin oils, and smudges.
• Anti-static properties that attract less dust.
• Easier cleaning with less frequent wiping.

Is a Premium AR Coating Worth It?

For most people, yes. Since AR coatings are used every day, investing in a premium coating often means:

• Better visual comfort.
• Improved night driving.
• Cleaner lenses with less maintenance.
• Greater durability and longer-lasting performance.

Key facts:

• All AR coatings reduce reflections, but premium coatings perform better and last longer.
• Premium coatings improve night driving, computer use, and overall visual comfort.
• Higher-quality coatings are more resistant to scratches, water, oils, and dust.
• A quality AR coating can be just as important as choosing a high-quality lens, as it directly affects both vision and the lifespan of your glasses.

“How Often Should Children Have an Eye Examination?

Children should have regular comprehensive eye examinations, even if they do not complain of vision problems. Many eye conditions, including myopia, can develop gradually and may not be obvious to children or parents.

For children with myopia, an eye examination every 6–12 months is generally recommended to monitor prescription changes and eye growth. Children undergoing myopia management may require more frequent reviews (every 6 months) to assess treatment effectiveness and adjust management if needed.

Children with no vision concerns should still follow the eye examination schedule recommended by their eye care professional, as early detection is essential for healthy visual development.

Key facts:

• Regular eye examinations are important, even if your child seems to see well.
• Children with myopia should usually be examined every 6–12 months.
• Children receiving myopia management are often reviewed every 6 months to monitor progression and treatment effectiveness.
• Early detection and timely treatment can help preserve lifelong vision and reduce the risk of high myopia and its complications.

Does Alberta Health Cover Children’s Eye Examinations?

Yes. Under the Alberta Health Care Insurance Plan (AHCIP), children and youth 18 years of age and younger are eligible for one routine comprehensive eye examination per benefit year (July 1 to June 30). Additional examinations may also be covered if they are medically necessary.

The last routine eye examination covered by Alberta Health is while your child is 18 years old. Once they turn 19, routine eye examinations are no longer covered by Alberta Health (unless the examination is medically necessary because of an eye disease, injury, or another covered medical condition).

Key facts:

• Alberta Health provides coverage for one routine eye examination each benefit year for children and youth up to and including 18 years of age.
• Coverage renews every July 1.
• The last routine Alberta Health-covered eye exam is before the child’s 19th birthday.
• After turning 19, routine eye examinations are generally paid privately or through private insurance, unless they are medically necessary.