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Pediatric Nearsightedness Cases on the Rise

Image of Pediatric Nearsightedness Cases on the Rise. U.S. Air Force Lt. Col. Derek Melton, an optometrist with the 181st Intelligence Wing, examines a patient's eyes in Owyhee, Nevada, May 23, 2023. Regular exams are important to identify problems with eye health, especially in children. (credit: U.S. Air Force Tech Sgt. Amy Lovgren/133rd Airlift Wing)

Myopia, otherwise known as nearsightedness, is the leading cause of visual impairment in children worldwide, according to the National Institutes of Health.

“Myopia is the ability to see things up close but not far away,” said Dr. Michael D. Pattison, readiness, and operations optometry program manager for the Defense Health Agency’s Vision Center of Excellence. “Myopia is often diagnosed early in childhood, frequently a result of reported difficulty seeing at a distance in the classroom.

Pediatric Myopia is on the Rise

Nearsightedness affects one in three people ages 12 to 54 in the United States. Its prevalence has been rising worldwide according to the World Health Organization. Experts predicted that nearly 50% of the world’s population will become myopic by 2050, and about 10% of these near-sighted people have severe cases.

Juvenile-onset myopia, the most common type, typically starts during elementary school and the late-onset type is frequently showing up in teens.

In a recent U.S. study, it’s estimated that 36% of youth have myopia, with 41% of those located in urban areas and almost 16% in rural areas, according to the National Institutes of Health.

“The exact cause of myopia remains unclear, but experts found that genetic predisposition and environmental causes contribute significantly to the development and progression of near-sightedness in children,” said U.S. Navy Cmdr. (Dr.) Hong Gao, aerospace optometrist with the Medical Service Corps.

Pattison said that myopic parents are more likely to have nearsighted children. Kids with two myopic parents have three times or more higher risk of becoming near-sighted in comparison to kids without myopic parents.

According to Gao, an increase in screen time, lack of exposure to sunlight, and excessive near activity are significant risk factors.

Near work is considered work that requires close visual focus to a worker’s eyes, like heavy use of computer screens, working on a puzzle, or even reading.

She said preventive measures for myopia can vary.

“Some interventions are shown to be effective in delaying the onset or controlling progression of myopia in children. For instance, increasing time spent outdoors and decreasing the duration of near work may prevent against developing myopia or myopia progression,” she said.

“Some studies show there is an association between physical activity and outdoor activity to the point that a lot of eye care providers are now recommending that children try to spend at least two hours a day outside doing something other than looking at devices,” said Pattison. “It’s good for children to play outside when possible.”

Why This Matters to the U.S. Military

“Warfighters with a functional unaided vision have significant advantage on the battlefield or in other operational environments,” said Gao.

Service members with better vision have “less dependence on visual aids and better marksmanship performance,” Gao said.

Determining why these rates are trending upwards is important to the Department of Defense to ensure its future pool of warfighters are mission ready.

During calendar year 2019, approximately 20% of the active duty service members had substantial refractive errors that require fulltime spectacle correction, according to an article published in a DHA Medical Surveillance Monthly Report.

According to this report, 24% of U.S. armed forces active duty service members required some sort of spectacle correction, with almost 15% in the U.S. Coast Guard.

Gao said that the “vision standard for appointment, enlistment, or induction into the military services has not changed for decades. Medical waiver for higher nearsightedness is available for some military duties.”

“If a candidate’s vision can be corrected with glasses to a level at which they can read regularly sized print, then their vision will likely not prevent their enlistment or commission,” said Pattison.

Most cases of myopia fall within the acceptable range of military vision standards,” he said. “Even with the increase in the incidence of myopia in this country, it is unlikely to be an issue in terms of future numbers of individuals meeting the vision requirements to enlist in the military.”

There are a few specific occupations in the military, principally those dealing with aircraft and ships, that require a higher standard of visual function.<

Tips for Protecting Your Child’s Vision

The Centers for Disease Control and Prevention

  • Eat well: Eating a healthy diet rich in fruits and vegetables can help protect your child’s vision.
  • Limit screen time: Increased screen time can make uncorrected vision problems worse. Taking frequent breaks is also a good habit to have when doing other kinds of near-vision activities, such as reading, writing, or drawing.
  • Get enough sleep: Not getting enough sleep can affect how well your child’s eyes heal from everyday eye strain and irritants in the environment—like dry air, allergens, and pollutants.
  • Spend time outdoors: Just like other muscles in the body, the muscles in the eyes need time to relax. Going outdoors allows their eyes to look at objects in the distance, which gives their eyes a chance to recover from eye strain and fatigue.
  • Wear sunglasses: Exposure to the sun’s ultraviolet rays over time can be harmful to the eyes. For the best protection, make sure your child wears sunglasses that have 100% UV protection.
  • Use protective eyewear: About 90% of eye injuries can be prevented with protective eyewear. If your child is involved in sports or other activities, make sure they wear protective eyewear to avoid serious eye injuries.
  • Get regular eye exams: When your child gets regular eye exams, their eye doctor can follow their vision at every stage of development. If anything changes, the doctor will be able to treat and manage your child’s vision quickly.

“Overall, the prevalence of nearsightedness is expected to be higher in the United States as young children nowadays are exposed to excessive near activity and more screen time earlier in life,” said Gao. “Prevention and control among school age children have the most significant benefit, which may prevent eye diseases, increase warfighter performance, reduce unaided visual disability, and decrease cost in the U.S. military.”

Like for any ailment, regular exams at every age are key to staying healthy and catching problems early.

For information on TRICARE eye exam coverage, visit: www.tricare.mil/EyeExams.

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Children's Health

The Department of Defense recognizes the important role military children play in the armed forces community.

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Last Updated: August 09, 2023
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