Starting primary school is a new and exciting journey for every child. It’s also a significant time in their overall development, and good vision forms a crucial part of this. Depending on the country, most children must undergo some form of school entry examination. This “test” usually includes an assessment of the child's visual ability. If any abnormalities are detected during this examination, it is recommended to consult an eyecare practitioner. The specialist will conduct a more thorough examination of the child's eyes and visual ability and may, for example, diagnose nearsightedness (myopia) and decide, together with the parents, whether the child needs visual aids such as glasses.

When it comes to nearsightedness, early detection is key, so it’s most beneficial for the child if this is diagnosed as early as possible. Therefore, an optometrist, ophthalmologist or other local specialist should always be consulted if the child shows abnormalities, even at a preschool age. The earlier measures are taken against nearsightedness, the better.

Progressive myopia is a special form of nearsightedness that gets worse over time. Above all, it is important to slow down or stop the progression of myopia through appropriate measures to prevent high myopia. This is important because it helps to improve the child's quality of life, but it also reduces the risk of further eye health issues.

Certain steps can be taken to limit the progression of myopia. When eye care specialists implement myopia management treatment/s, the goal is to protect children from high levels of nearsightedness and potential long-term health consequences for their eyes. A healthy lifestyle can also help. Studies have shown that spending at least two hours outdoors and reducing near work have a positive impact on the eye development of children.¹

Newborn babies are generally farsighted.² As they age, their eyes elongate and the lens's refractive power develops so that a state of normal vision (emmetropia) is achieved by around the age of 10 (under normal circumstances).^3,4 This natural process is known as emmetropization.

In addition, visual acuity develops over time. Newborn babies don’t have sharp vision yet, but visual acuity improves quickly and increases until around the age of six to ten years.⁵ That means when a child starts school and their vision develops normally, they will have visual acuity similar to that of an adult with normal vision. When children are emmetropic (they have normal vision), they can then see objects clearly and in focus at near and far distances. This development is crucial as it supports reading, writing, and interaction with the world. Additionally, spatial perception continues to develop during primary school years, and children learn to estimate the depth and distance between objects. This plays a significant role in sports, riding a bike, or playing in the park. Good depth perception helps children to move confidently in their environment and promotes motor skills at the same time.

During a child’s early developmental phase, it is crucial to pay attention to any signs of vision problems. Frequent squinting, headaches, or difficulty with reading and writing can be indicators. If there are any concerns, parents should let their child be examined by a specialist to assess vision.

If vision correction is necessary, it can make a big difference in the child's academic and social life. Although children are often masters at hiding minor or major vision problems, research shows that academic success and overall quality of life depend on good vision.⁶

To prevent myopia in children, experts recommend reducing the amount of time children spend on smartphones, tablets, or other activities that require constant near vision.

Children should take regular breaks to go outside. Studies have shown that spending more time outdoors reduces the risk of myopia and slows down the progression of this vision impairment in children who are already affected.⁷

Experts therefore recommend that children spend at least two hours outdoors in daylight every day, regardless of their age.

However, it is important to know that the risk of developing (high) myopia is higher when the first signs of myopia appear before the age of seven.⁸ Based on various studies, the ZEISS Myopia Management Guide states the following: If a child still has a far refraction greater than +0.75 diopters at the age of six, or a far refraction greater than +0.5 diopters between the ages of seven and ten, the development of their eye length growth can be considered normal. If the value is below this or even in the minus range, the child is at risk of myopia.⁹

If an primary school child shows any signs of myopia, it’s important to pick up on this as early as possible. The school entrance examination is crucial, and both teachers and parents should carefully observe if any difficulty is experienced during class or when doing homework. At this stage it’s important to determine through regular examinations and tests whether the myopia is progressing within normal limits or if the increase is occurring rapidly, indicating progressive myopia.

If progressive myopia is diagnosed, the child should be treated. To slow down the progression of myopia in children and adolescents, various options are available, including medical eye drops, specialised contact lenses (which may not be suitable for children of that age), or specialised eyeglass lenses that can slow down the elongation of the child's eye.