An unseen health condition is sweeping the world. Myopia (or nearsightedness) is projected to affect nearly 40% of children by 2050. Its prevalence has been steadily growing in the past 30 years. Affecting children and adolescents disproportionately, this condition has to be taken more seriously, researchers warn.
East Asians are twice as likely to be affected by it, say researchers, while the most affected countries are Japan, Korea, Russia, Singapore, and China.
Nearsightedness hinders the ability to see distant objects clearly. While it can be managed with corrective lenses or surgery, the long-term consequences of widespread myopia are concerning. High myopia, a severe form of the condition, increases the risk of serious eye diseases such as retinal detachment, glaucoma, and cataracts. As myopia rates continue to rise, so too will the incidence of these potentially blinding conditions.
In 1990, the global prevalence of myopia among children and adolescents was estimated at 24.32%. By 2023, that number had risen to 35.81%, a major increase, according to a new study published in the British Journal of Ophthalmology. According to the same study, myopia prevalence is expected to reach 36.59% by 2040 and a whopping 39.80% by 2050. That’s more than 740 million children and adolescents worldwide affected by this condition by mid-century.
Stunning numbers in East Asia
The study is essentially a meta-analysis (a study of studies) that involved more than 5 million participants across 50 countries. It showed that although the numbers are increasing in most places around the world, they’re not increasing the same everywhere.
East Asia, particularly in countries like China, Japan, South Korea, and Singapore, has seen a surge in childhood myopia. In some urban areas, the prevalence of myopia among adolescents has reached staggering levels. According to the study, nearly 90% of high school graduates in some East Asian cities suffer from myopia. In Japan, for example, myopia affects 85.95% of children and adolescents, making it the country with the highest prevalence worldwide.
Adolescents, in general, are particularly susceptible to myopia. The meta-analysis found that 47% of adolescents aged 13–19 were myopic, compared to 21% of children aged 6–12. High school students, in particular, face increased pressure to succeed academically, leading to more time spent on close-up activities like reading, writing, and screen use. This, combined with reduced outdoor time, creates a perfect environment for myopia to develop.
Gender also appears to be a significant factor in the prevalence of myopia. Girls are more likely to develop myopia than boys, especially during adolescence. Studies suggest that this gender gap is linked to lifestyle factors, with girls often spending more time engaged in academic activities and less time outdoors compared to boys. In addition, girls tend to enter puberty earlier, which may contribute to faster eye growth during a critical period.
What’s driving this surge?
There are several contributors to this myopia surge, particularly in regions like Asia. One key factor is the intense academic pressure in these countries. Students are forced to spend long hours indoors engaged in near work activities. Combined with a lack of outdoor exposure — a known protective factor against myopia — these environmental conditions create a perfect storm for the development of nearsightedness.
Urbanization further exacerbates the issue. Children living in urban areas are significantly more likely to develop myopia than those in rural regions. The study found that urban children have a myopia prevalence of 28.55%, compared to lower rates in rural populations. This urban-rural divide can be explained by differences in lifestyle, including reduced time spent outdoors and greater exposure to digital screens in cities.
The COVID-19 pandemic has further intensified the myopia crisis. With schools closed and students confined to their homes during lockdowns, screen time skyrocketed as children shifted to online learning. Outdoor activities, which have been shown to protect against myopia by encouraging the eyes to focus on distant objects, were severely limited. The study highlighted the pandemic’s negative impact on eye health, noting that the global prevalence of myopia increased more rapidly in the years following the pandemic.
This phenomenon was particularly pronounced in countries like China, where strict lockdown measures kept children indoors for extended periods. A separate study involving over 1 million students in southern China found that the prevalence of myopia had increased significantly during the pandemic. These findings underscore the urgent need for public health interventions to mitigate the long-term effects of increased screen time and reduced outdoor activity on children’s vision.
Can we stop myopia?
Given the alarming projections for the future, scientists urge urgent action to curb the myopia epidemic. Several strategies seem to be working, particularly in children.
Increasing outdoor activity is one of the most well-supported interventions. Studies have shown that spending more time outdoors, particularly in sunlight, helps prevent the elongation of the eyeball—a key factor in the development of myopia.
School-based initiatives can also play a crucial role. Reducing the academic pressure placed on students and encouraging regular breaks from near work activities could help alleviate some of the risk factors associated with myopia. For instance, the Chinese government has implemented measures to limit the amount of homework assigned to young students and reduce the number of hours spent on screens.
Technological innovations are also emerging as promising solutions. Orthokeratology (Ortho-K) lenses, for example, are specialized contact lenses worn overnight to reshape the cornea temporarily. This method has been shown to slow the progression of myopia in children and could become a valuable tool in managing the condition. Additionally, new pharmaceutical treatments, such as low-dose atropine eye drops, have demonstrated efficacy in slowing myopia progression in clinical trials.
Ultimately, however, any strategy has to start with awareness.
Awareness and action
Many parents may not be aware of the environmental factors that contribute to myopia or the importance of early detection. Regular eye exams for children, particularly before they enter school, can help identify vision problems early and prevent more severe myopia from developing later in life.
Schools and healthcare providers should work together to implement vision screening programs and provide resources for parents and educators on how to reduce the risk of myopia. Simple measures, such as ensuring children take breaks during long periods of reading or screen time, can make a significant difference in protecting eye health.
With the prevalence of myopia expected to approach 40% by 2050, there is a pressing need for comprehensive prevention strategies that address the environmental and lifestyle factors contributing to this epidemic. From increasing outdoor activities to reducing screen time, there are concrete steps that can be taken to slow the progression of myopia and protect the vision of future generations.
The study “Global prevalence, trend and projection of myopia in children and adolescents from 1990 to 2050: a comprehensive systematic review and meta-analysis” was published in the British Journal of Ophtalmology.
