Childhood Myopia Is Rising in the U.S.: What Parents Should Know About Prevention and Treatment

Why Childhood Myopia Is a Growing Concern in the U.S.

More children in the United States are being diagnosed with myopia, also called nearsightedness. Myopia makes it hard to see clearly at a distance—like reading the board at school or road signs while riding in a car.

On its own, mild myopia can usually be corrected with glasses or contact lenses. But higher levels of myopia are linked to greater lifetime risk of serious eye problems, including retinal detachment, glaucoma, and myopic macular degeneration, according to the National Eye Institute (NEI).

That long-term risk is why pediatric eye specialists and public health experts are paying close attention. The goal is not just to help kids see clearly now, but to reduce the chance of vision-threatening disease decades later.

What the Data Show About Trends and Risk

Federal agencies including the Centers for Disease Control and Prevention (CDC) and NEI describe myopia as common and increasing in children and adolescents. U.S. survey data over past decades show that a substantial share of teenagers are now nearsighted, and experts expect that number to continue rising.

Researchers point to several factors that appear to influence risk:

Family history: Children with one or both parents who are myopic are more likely to develop it.
Limited outdoor time: Multiple studies suggest children who spend more time outdoors are less likely to develop myopia.
High near-work demands: Activities that require prolonged close focus—reading, homework, and screen use—are associated with myopia.

It’s important to separate association from cause. Screen time is often blamed, but research shows it is linked with myopia rather than proven to be the sole cause. Myopia likely develops from a mix of genetics and environment.

Why Outdoor Time and Near Work Matter

Outdoor time is one of the most consistent protective factors identified in research. Observational studies and some interventional trials have found that children who spend more time outdoors—often around two hours a day in study settings—are less likely to develop myopia.

Researchers believe bright outdoor light may stimulate dopamine release in the retina, which can slow eye elongation. Myopia develops when the eye grows too long from front to back, causing distant images to focus in front of the retina instead of directly on it.

Near work, including reading and digital device use, is associated with higher myopia rates. However, the evidence does not show that screens alone cause myopia. Public health guidance generally focuses on balance: regular breaks from near work and daily outdoor activity.

What Actually Works to Slow Myopia Progression

Once a child becomes myopic, the next question is whether progression can be slowed. Several approaches have been studied. None reverse myopia, and none are appropriate for every child, but some can reduce the rate of worsening.

Low-Dose Atropine Eye Drops

Low-dose atropine has been evaluated in randomized controlled trials, including studies published in journals such as JAMA Ophthalmology. These trials show that low concentrations (often 0.01% to 0.05%) can slow myopia progression in many children.

Important details:

Higher concentrations tend to work more strongly but may cause more light sensitivity or near blur.
Optimal dosing is still being studied.
Atropine for myopia control in the U.S. is typically prescribed off-label, meaning it is not specifically FDA-approved for this indication.

Parents should discuss risks, benefits, and follow-up needs with a pediatric ophthalmologist or optometrist experienced in myopia management.

Specialty Soft Contact Lenses

Some soft contact lenses are designed specifically to slow myopia progression. At least one daily disposable lens has received FDA approval for myopia control in children within a defined age range. Clinical trials supporting approval showed reduced progression compared with standard lenses.

These lenses require careful hygiene and follow-up. They are not appropriate for every child, especially those unable to manage contact lens care safely.

Orthokeratology (Overnight Corneal Reshaping)

Orthokeratology uses specially fitted rigid contact lenses worn overnight to temporarily reshape the cornea. Studies suggest it can slow eye elongation in some children. However, it carries a small risk of infection, particularly if hygiene is poor.

Orthokeratology is FDA-approved to temporarily correct vision, but its use specifically for slowing myopia progression is considered a management strategy rather than a cure.

Glasses vs. Myopia Control: What’s the Difference?

Standard glasses and regular contact lenses correct blurry distance vision. They do not typically slow the underlying eye growth that drives myopia progression.

Myopia-control therapies—such as low-dose atropine, specialty soft lenses, or orthokeratology—aim to reduce how quickly the prescription worsens. The American Academy of Ophthalmology (AAO) emphasizes that these treatments slow progression; they do not eliminate myopia.

Not every child with myopia needs active control therapy. Decisions depend on age, rate of progression, prescription strength, family history, and family preference.

When to Schedule an Eye Exam

School vision screenings can catch some problems, but they are not a substitute for a comprehensive eye exam.

The CDC and pediatric specialty groups recommend routine vision screening in childhood, with referral for a full eye exam when concerns arise. Children with a family history of myopia or early signs of nearsightedness may need closer monitoring.

Parents should schedule a comprehensive exam if a child:

Squints or sits very close to screens.
Complains of headaches or blurry distance vision.
Has declining school performance linked to vision concerns.

Early detection allows families to discuss whether simple correction or active myopia management makes sense.

Costs, Insurance, and Access Issues

Standard glasses for children are often covered under vision plans or pediatric essential health benefits. Myopia-control treatments are different.

Low-dose atropine, specialty contact lenses, and orthokeratology are frequently paid out of pocket. Insurance coverage varies widely and may not include these therapies because they are considered elective or specialized.

Costs can include:

Medication or specialty lens fees.
Frequent follow-up visits.
Replacement lenses or supplies.

Families should ask providers about total expected costs, follow-up schedules, and whether payment plans are available.

What Researchers Are Still Studying

Researchers continue to study:

The best atropine dose for balancing effectiveness and side effects.
How long treatment should continue.
Which children benefit most from early intervention.
The long-term safety of newer lens designs.

Most studies show slowing progression during treatment, but questions remain about what happens after therapy stops.

What This Means for Parents

Childhood myopia is becoming more common in the United States, and higher prescriptions are linked to greater lifetime risk of serious eye disease.

Encourage daily outdoor play when possible.
Promote regular breaks from close-up work.
Schedule comprehensive eye exams—even if school screening was normal.
Discuss evidence-based myopia-control options with a pediatric eye care professional if your child is diagnosed.

Myopia control is not about quick fixes. It’s about informed, individualized decisions that balance benefits, risks, and costs. For many families, small daily habits—like more outdoor time—are a practical first step.

Sources

This article is for general informational purposes only and is not medical advice. Research findings can be early, limited, or subject to change as new evidence emerges. For personal guidance, diagnosis, or treatment, consult a licensed clinician. For current outbreak or public health guidance, follow your local health department, the CDC, or another relevant public health authority.