Childhood Myopia

Slowing the Progression of Nearsightedness in Children

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Myopia -- also called nearsightedness -- can interfere with your child’s schoolwork, sports, and daily activities. Left untreated, the inability to see distant objects clearly can rapidly worsen with age. Duke pediatric optometrists aim to intervene in myopia progression by identifying and managing the condition as early as possible. We offer new FDA-approved and other novel treatment approaches beyond corrective lenses. Controlling the advancement of your child’s myopia can improve their long-term vision and eye health and may reduce their risk for more serious eye conditions -- including retinal detachment, glaucoma, and macular disease -- when they are adults.  

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Understanding Myopia

Myopia occurs when developing eyes grow too long from front to back or the curvature of the front part of the eye does not match the size of the eyeball. This prevents the eye from focusing correctly. As a result, distant objects appear blurry, while close-up objects typically remain clear. 

Watch this video to learn about new treatment options for nearsightedness and other ways children with myopia can practice good eye hygiene and care for their eyes.

Signs of Myopia

Your child may have myopia if they have trouble seeing the details of faraway objects -- like writing on the board at school or letters on street signs. They may complain about blurry vision, headaches, or end-of-day eye strain, or you may notice them squinting or moving closer to distant objects to see them better.

Risk Factors for Myopia

Myopia runs in families, so children with a parent who is nearsighted are more likely to be myopic. Spending significant time reading or using a computer or handheld devices and not enough time outdoors are also risk factors.

Duke Eye Center

Learn about Duke Eye Center so you can prepare for your child's appointment.

Pediatric Myopia Assessment

Prescription glasses and single-vision contact lenses can help your child see better, but it’s likely that a stronger prescription will be needed each year to correct their vision. Duke pediatric optometrists use the latest advances to correct your child’s vision and manage myopia progression. We also identify other eye conditions that may be related to their worsening myopia.

Myopia Consultation

You and your child will meet with a pediatric optometrist to review your family’s eye history and environmental factors that may be contributing to your child’s myopia. Myopia consultations are longer than typical eye appointments to allow enough time for a thorough evaluation and to discuss appropriate treatment options and expectations. 

Eye Exam and Testing 

Your child’s eye doctor will test their visual acuity and eye health to determine if they are a candidate for treatment to slow myopia progression. If necessary, several eye measurements, including length of eyeball, retinal photos, and a 3D map of their cornea will be created. This information can be used during treatment to monitor your child’s eye health and the effectiveness of the myopia control. Finally, your child’s eyes will be dilated to help their doctor determine the most accurate prescription needed to correct their vision.

Treatment for Myopia 

If your child is a candidate for myopia treatment, they may receive one of these options.

Multifocal Soft Contact Lenses 

Multifocal soft contact lenses worn during the day can slow the eye elongation responsible for myopia. The center of each lens corrects nearsightedness, and the outer portions bring peripheral light rays into focus. Young children can wear multifocal soft contact lenses but will require help inserting and removing them. We will fit your child with contact lenses, teach you how to care for them, and practice inserting and removing them.  

Prescription Eyedrops

A low-dose prescription eyedrop given before bedtime can slow the progression of myopia in children. Atropine drops are compounded at a special pharmacy and mailed to your home. We will show you and your child how to administer and store the drops.

Out-of-Pocket Costs

Medical insurance and vision plans may cover the costs of a basic eye examination but currently do not pay for more extensive testing or treatments for myopia. If your child is a candidate, we will recommend a specific treatment plan, and all costs will be fully discussed so that you can decide if myopia management is the best choice for your child and your family.

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Why Choose Duke

Trained to Care for Children

Pediatric eye specialists at the nationally ranked Duke Eye Center are experienced in evaluating and caring for infants and children. We use the latest advances in pediatric ophthalmology to optimize your child’s vision and eye health. Our child-friendly waiting rooms and clinical spaces are designed to reduce stress for the whole family.

Access to Advanced Eye Care

If your child needs specialized care, they will have access to a range of providers trained in the medical and surgical management of childhood eye conditions, including amblyopia and strabismus, glaucoma, cataracts, and prematurity-related eye problems, among other rare conditions. If your child requires multiple visits for different eye conditions, we make every effort to coordinate their care and maximize your convenience.

Best Eye Hospital in North Carolina

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our ophthalmology program is ranked seventh in the nation and is the highest-ranked program in North Carolina, according to U.S. News & World Report for 2023–2024.

This page was medically reviewed on 09/20/2023 by