Refractive errors occur when the optics of the eye-ball are not in perfect focus.
Generally, when a child sees, the light rays from different objects should be focused on the retina.
 Most children are hyperopic, or long-sighted when they are born.
The eyeball is small, and images are focused behind the retina. However, the child is able to ‘focus’ or ‘pull the image forward’ to achieve a clear image.
Most hyperopic children do not need glasses, unless the power is extremely high (eg greater than 4D). Hyperopic power tends to decrease over time as the eyeball grows.
 Myopia or short-sightedness occurs when the eyeball becomes too big or long. Distance images fall in front of the retina. Only Near objects are focused on the retina. Myopia increases further as the eyeball grows.
Astigmatism occurs when the shape of the eyeball is not perfectly round (ie. more like an egg, than a ping-pong ball). Some parts of the image may be in focus whilst others parts are not, resulting in blurred, distorted vision.
Children with astigmatism (>1.5D) often need to wear glasses.
“There has been a heated debate in the Forum pages of the Straits Times regarding the treatment of myopia in children. This is a subject of considerable concern to many anxious parents. I believe it is time to put things into perspective, and clearly distinguish between facts, theories and myth.”
- Dr Vivian Balakrishnam, Honarary Senior Consultant, SNEC
| FACTS |
MYTHS (Untruths) |
Myopia is worsening in Singapore
Currently about 10% of primary 1, 60% of primary 6, and 80% of 18 year olds are myopic. These figures continue to increase over time.
Myopia is more common in those who do more near work
Studies show that children who read more books per week have a increased risk of myopia.
True myopia is irreversible
Myopia increases as the eyeball grows. Once the eyeball has grown, it will not get smaller.
Myopia increases with age
Atropine eye drops decrease the rate of myopic progression
Studies show that atropine is effective in controlling myopic progression. Short-term, it is quite safe. However, because long-term effects are unknown, this medication is reserved for those children whose myopia is rapidly increasing. |
Myopia is reduced by:
- avoiding the use of glasses
- reducing the power of glasses*
- contact lens wear*
- bifocal spectacles*
- dietary supplements including vitamin A
- eye exercises, accupressure, vision training
* There is now good scientific evidence that these modalities do NOT cause significant reductions in myopia progression
Myopic children should have laser surgery
Laser surgery should best be considered after the eyeball has stop growing, usually in early twenties. |
 When reading, place the book 30cm away make sure there is sufficient lighting- When watching television sit at least 2-3m away make sure there is some background lighting
- After 30-40 minutes of close work, rest your eyes by looking at a distant object (eg. out of the window) for 2-3 minutes
- Encourage daily outdoor activities
- Encourage child to sleep early
- Maintain a healthy balanced diet
Myopia Research is on-going at the Singapore Eye Research Institute (tel: 65-63224500).
Please contact Dr Chua WH, Sr Peck CF, Ms Jocelyn Hee, Ms Marlina Tay, Ms Angeline Tang or MsDaphne Chan if you require more information, or are willing to volunteer for clinical trials.
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