Myopia Prevalence Among Children in Hong Kong

The prevalence of myopia among Hong Kong schoolchildren increases with age, doubling from 6.3% among preschoolers to 18.3% at age 6, and climbing to 61.5% by age 12. Among adults aged 21–30, the rate of myopia reaches as high as 84.7%.

If it progresses to high myopia, the risk of developing various eye diseases later in life—such as retinal detachment, cataracts, glaucoma, and macular degeneration—will increase significantly.

The goal of orthokeratology for children is not to completely halt the progression of myopia, but to slow down the rate of myopia progression.

Prevention of Myopia

If a child's myopia progresses by 100 degrees per year, this is considered rapid progression, and treatment may be considered. For children, the ideal progression rate is within 50 degrees per year.

Low-dose atropine eye drops have become a commonly used first-line treatment among ophthalmologists in recent years to slow the progression of myopia in children.

Research from the Chinese University of Hong Kong indicates that this method can effectively slow the progression of myopia in children by up to 60%, with rare side effects.

Additionally, a pair of "Multi-Zone Positive Optical Defocus" (DIMS) lenses designed by The Hong Kong Polytechnic University has been proven to slow the progression of myopia by up to 60% in participating children.

The lens comprises a "central optical zone" designed to correct refractive errors, along with a "multi-zone progressive myopic defocus" extending from the central zone to the periphery of the lens.

When the wearer views objects at different distances, DIMS lenses provide clear vision and myopic defocus to correct vision and help slow the progression of myopia.

Finally, children may choose to wear orthokeratology lenses (OK lenses).

It utilizes specially designed rigid orthokeratology contact lenses and the surface tension of tears to alter the curvature and shape of the cornea.

Children undergoing orthokeratology simply need to wear the reshaping lenses while sleeping at night, with the benefit of not needing glasses in the morning.

The only concern is that children may unconsciously rub their eyes during sleep, potentially causing corneal damage or infection. Therefore, this method is only suitable for children aged 8 and above who possess a higher level of self-care ability.

What is pseudomyopia?

Once a child develops myopia, parents become extremely anxious and often ask, "Does a child being diagnosed with a prescription mean they have true myopia?"

We know that the eye's ability to focus on distant and near objects is primarily due to the adjustment of the ciliary muscle and the lens, which allows images to be focused onto the retina, enabling us to see objects clearly.

We should be aware that the primary symptom of myopia is blurred vision when looking at distant objects.

However, if this situation occurs suddenly after excessive eye strain, don't rush to get new glasses right away, as you may be experiencing pseudomyopia.

Prolonged close-up viewing causes excessive contraction of the ciliary muscles. When shifting focus to distant objects, the muscles cannot relax immediately, causing the focal point to shift and resulting in blurred vision.

Pseudomyopia commonly occurs in schoolchildren because children's ciliary muscles possess stronger accommodative capabilities.

Additionally, the most prominent feature is fluctuating vision, particularly when shifting focus from near objects to distant ones, which then appear blurred.

Furthermore, myopia is less likely to be accompanied by astigmatism.

Fake Myopia Eye Drops to Distinguish Between True and False Myopia

If pseudomyopia is treated as true myopia and corrective lenses are prescribed, the patient's eyes will experience significant discomfort because the factors causing the ciliary muscle to contract and adjust have not been alleviated.

Finally, the doctor will use cycloplegic eye drops to dilate the pupils and relax the ciliary muscles, thereby distinguishing between true and false myopia.

How to improve pseudomyopia?

However, parents need not be overly concerned, as this situation is temporary.

With timely diagnosis and treatment, coupled with eliminating factors contributing to pseudomyopia—such as paying attention to reading distance, writing posture, and duration, frequently looking into the distance to allow the ciliary muscles to relax and adjust—the increased myopia can still be reversed.

It is worth noting that today's students are constantly glued to their tablets and smartphones, causing the ciliary muscles to remain in a state of prolonged tension. This can even lead to premature degeneration and weakness, rendering them unable to contract and adjust focus—thus turning "fake into real."

Therefore, if you notice any vision problems in your children, you should take them for an eye examination as soon as possible.

As parents, we naturally worry about our children's eye health.

Five Key Methods for Eye Protection

Statistics show that newborns have approximately 250 degrees of hyperopia, and they can only perceive black-and-white images before reaching six months of age.

Therefore, it is best to place high-contrast black-and-white patterns to help stimulate your baby's visual development.

Additionally, soft natural light is crucial for supporting the visual development of infants and young children.

It is recommended to keep curtains open during the day to expose your baby to light stimulation, but remember to avoid direct exposure of bright light to the infant's eyes.

Since infants under one year old are still developing their vision and their pupils do not constrict quickly, overly bright light can harm their eyes. Therefore, please turn off the flash when taking photos.

After infants reach six months of age, parents can hold brightly colored patterns about 12 inches (30 cm) in front of the child's eyes and gently wave them back and forth.

This helps develop eye coordination and train focusing ability in young children.

Vision screening can be done at home in Hong Kong

If you suspect your baby has poor vision, you may want to try some simple self-tests at home.

First, an infant's gaze typically follows light sources. Additionally, parents can cover one of the infant's eyes with a clean gauze cloth and observe whether the infant's waking behavior exhibits any abnormalities.

If an infant uses their weaker eye to see objects and experiences blurred vision that differs from their usual state, they may become anxious and restless, crying incessantly. In such cases, further examination should be conducted promptly.

Causes of Myopia

Additionally, any form of close-up work can induce myopia.

Prolonged close-up focusing work places increased strain on the ciliary muscles, causing the eyeball to elongate.

The American Academy of Pediatrics has issued guidelines advising against screen time for children under two years of age. For children aged two and older, screen time should ideally not exceed two hours per day, though adjustments should be made based on the child's learning needs.