The Current State of Childhood Myopia: A Health Issue That Cannot Be Ignored
As smartphones and tablets become part of daily life, the prevalence of myopia among Korean children and adolescents is rising rapidly. According to the Korean Ophthalmological Society, the proportion of students diagnosed with vision abnormalities in 2024 ranged from 30.8% among first-graders in elementary school to 74.8% among first-year high school students.
Myopia that begins at an early age is accompanied by axial elongation, in which the eyeball grows abnormally long. This significantly raises the risk of serious sight-threatening conditions in adulthood, including glaucoma, retinal detachment and macular degeneration. That is why myopia is now recognized not as a simple vision problem but as a progressive disease that affects lifelong eye health.
Is Myopia Hereditary?
"Will my child need glasses if I wear them?" This is one of the most common questions parents of young children ask in the clinic. Myopia is considered a classic hereditary condition. Though estimates vary across studies, genetic factors account for 60% to 80% of all myopia cases. Children whose parents are both myopic face a higher risk of developing myopia than those whose parents both have normal vision. Some studies have reported the risk increases by up to 11.4-fold.
Advances in genomic research have identified specific genes associated with myopia. More than 400 myopia-related genetic loci have been discovered to date, and a polygenic risk score (PRS) that integrates these findings to predict an individual's myopia risk has been developed. Children with higher PRS scores show a greater likelihood of developing myopia, underscoring the significant role of genetic predisposition.
Environmental Factors Are Equally Crucial
The explosive rise in myopia prevalence in recent years cannot be explained without considering environmental factors. A lack of outdoor activity and increased near-work tasks involving smartphones and tablets are identified as key drivers of myopia. Studies have shown that even children with myopic parents can significantly lower their risk of developing myopia by spending an average of two or more hours outdoors per day.
This means the genetic "trigger" requires environmental pressures — such as increased near-work and insufficient outdoor activity — to be pulled. Myopia is ultimately a multifactorial disease in which genetic predisposition and environmental factors act together. While parental vision can serve as an important predictor of a child's myopia risk, the progression can be sufficiently slowed and healthy vision maintained through lifestyle management and early screening.
Rapidly Advancing Treatment Options
Pediatric myopia suppression therapies are evolving quickly. Clinically, various methods are used, including orthokeratology — commonly known as "Ortho-K" or "dream lenses" — low-dose atropine eye drops, functional spectacles and light therapy.
The Korean Association for Pediatric Ophthalmology and Strabismus (KAPOS) recommended in its myopia management consensus published last year that treatment efficacy be evaluated using changes in axial length as a primary indicator. Combination strategies using multiple treatments simultaneously are also expanding. Research has confirmed that using Ortho-K lenses together with low-dose atropine produces a stronger myopia suppression effect than either treatment alone.
Ages 7 to 9: The Golden Window for Intervention
The golden window for myopia management is between ages seven and nine. Because myopia progresses most rapidly during this period, active intervention can effectively prevent the development of high myopia.
Recently, preemptive treatment has gained traction, with low-dose atropine therapy being initiated for children at the pre-myopia stage — those who have no vision problems yet but are highly likely to develop myopia as they grow — to prevent or delay the onset of myopia altogether.
Accurate diagnosis is the first step in treatment. Children have strong accommodative ability, which often makes them appear myopic when they are not — a condition known as pseudomyopia. It is therefore important to measure the precise refractive error through a cycloplegic refraction test, which fully relaxes the eye's accommodation.
Prevention Remains the Best Approach
The most ideal myopia management strategy is prevention. The International Myopia Institute emphasizes that spending two or more hours outdoors per day is the most reliable way to prevent myopia onset. Natural sunlight is known to stimulate dopamine release in the retina, which suppresses abnormal growth of the eyeball.
When near-work tasks are unavoidable, the distance between the eyes and monitors, smartphones or books should be maintained at 30 centimeters or more. Taking a 10-minute break every 30 minutes to look at distant objects also helps. Above all, regular ophthalmological checkups are essential for myopia management.
Thanks to advances in medicine, a wider range of therapeutic options is now available to effectively suppress and manage myopia progression. Through a combination of the latest medical treatments and healthy lifestyle habits, children can maintain clear and healthy vision for life. Rather than simply watching a child's eyesight deteriorate, parents should intervene actively to protect their lifelong eye health.