Nearsightedness means that your child can see fine up close, but that they might be having a hard time seeing things that are further away. The medical name for nearsightedness is myopia, and sometimes, seeing signs of it aren’t easy until it becomes a real problem. Children who have myopia will typically squint when they are trying to view things far away, and they will typically sit closer to things like the television or try to inch their way up in class to see the chalkboard.

There are times when myopia can become worse throughout childhood, becoming more of a problem from year to year. That can cause great anxiety not just for the child, but also for the parent wondering whether the damage will slow down or just continue to get worse. If it gets bad enough, many parents become concerned that there will come a time when glasses will no longer be enough to help their child see things that are in the distance. 

The good news is that while for most children, myopia develops early in childhood, by the time that they reach the age of about 20, their eyesight will begin to equalize and their nearsightedness will probably not get much worse. 

However, if it’s not addressed in childhood, the damage to your child's eyes can be disconcerting, which is why treating the progression while the child is developing is the best way to minimize the damage to their eyesight. There are four possible ways to address myopia in childhood. Determining which one is right for your child is a decision that you should make with your pediatric optometrist.

Commonly referred to as “ortho-k,” orthokeratology is a contact lens that is permeable and is used to flatten out the cornea or to reshape it. In doing so, it will typically help to limit the progression of nearsightedness. It is an excellent option for children who have a moderate amount of myopia. The lenses are worn while sleeping, and then they are taken out in the morning. 

In addition to ortho-k, many youngsters will use glasses during the daytime to see better. Usually they are just temporary, because once the lenses work to reshape the cornea, children can generally see without glasses over time. There is evidence to suggest that using ortho-k at nighttime may be enough to reduce myopia in childhood permanently, and that the lenses are typically only needed during childhood. They are often discontinued as a person becomes an adult.

Atropine is a type of medication that works to temporarily paralyze the pupil through dilating it. It helps to relax the eye’s ability to focus. Recent research indicates that nearsightedness in childhood might be linked to the eyes’ fatigue. By using atropine to relax the focusing mechanism, you might be able to minimize the progression of myopia. Not much hope has been shown for the long-term effectiveness of atropine. It typically only works for the first year of care, but it has not been shown to be very effective for any long-term control of myopia in childhood.

Research has been mixed about whether wearing multifocal eyeglasses in childhood helps to reduce nearsightedness during development. In the same way that atropine helps to reduce fatigue of the focal mechanism, having eyewear that magnifies things that are far away might help to reduce the fatigue of the eye and to slow the progression of myopia.

Recent research shows that if a child’s mother and father are also nearsighted, they had more success with wearing bifocal eyewear and the slowing of the progression of myopia. In these children the use of bifocal eyewear had better results than those who wore regular eyeglasses.

A study done at Ohio State University discovered that those children who wore multifocal Winnipeg contact lenses had a slowing in the rate of progression by as much as 50%, which is highly significant and indicates that multifocal lenses are an excellent way to address the progression of nearsightedness in children.

The best way to know if your child is experiencing myopia is to look for signs that they might not be seeing objects far away very well. But since the signs might not always be easy to spot, having an eye exam early to diagnose myopia is critical to slowing the progression of it throughout childhood.