As childhood myopia rates continue to climb, eye health professionals are drawing attention to the long-term risks associated with high levels of short-sightedness, urging families to consider proactive management rather than relying solely on stronger prescriptions.
While glasses and standard contact lenses correct blurred distance vision, they do not slow the structural changes occurring inside the eye. Increasingly, optometrists are framing myopia as a public health issue rather than a simple refractive inconvenience.
Gary Rodney, creator and founder of Smart Vision Optometry, a Master of Optometry, Behavioural Optometrist and Fellow of the International Academy of Orthokeratology and Myopia Control (FIAOMC) with more than 30 years of experience, said awareness around ocular risk is still developing among parents.
“Myopia involves elongation of the eyeball,” Rodney said. “As axial length increases, the retina becomes more stretched and vulnerable. Higher levels of myopia are associated with increased risk of retinal detachment, glaucoma and myopic maculopathy later in life.”
Understanding the Structural Changes
In myopia, the eye grows too long from front to back. This causes light to focus in front of the retina rather than directly on it, resulting in blurred distance vision.
However, Rodney emphasised that the concern goes beyond clarity.
“The structural integrity of the eye changes as elongation progresses,” he said. “Even if vision is corrected with glasses, the anatomical risk remains.”
Research indicates that each additional dioptre of myopia increases the likelihood of future ocular complications. Reducing final prescription levels, even modestly, may significantly lower long-term risk.
Earlier Onset, Greater Lifetime Progression
Optometrists report that children are developing myopia at younger ages than in previous decades. Earlier onset is often associated with higher overall progression by adulthood.
Jacquie Gattegno, principal senior optometrist at Eyes InDesign Smart Vision Optometry Bondi and an experienced Behavioural Optometrist and Orthokeratologist, said early assessment is critical.
“If myopia begins at six or seven years of age, there are many years of potential progression ahead,” Gattegno said. “That’s why we encourage families to look at management strategies early rather than waiting for prescriptions to increase each year.”
Lifestyle factors such as increased screen time, sustained near work and reduced outdoor activity are widely considered contributors.
Moving Beyond ‘Stronger Glasses’
Traditional practice involved updating spectacle prescriptions annually as vision changed. Today, many practitioners are adopting a preventative approach aimed at slowing progression.
Rodney said technological advances have expanded treatment options.
“We now have tools that directly influence how light focuses across the peripheral retina,” he said. “That peripheral defocus plays a key role in signalling eye growth.”
One of the most established methods is Orthokeratology, which uses custom-designed overnight lenses to reshape the cornea temporarily.
More information about Orthokeratology can be found at:
https://smartvisionoptometry.com.au/orthokeratology/
“Orthokeratology not only provides daytime freedom from glasses,” Rodney said, “but has been shown in multiple studies to slow axial elongation in many children.”
Personalised Myopia Management
In addition to Ortho-K, specialised spectacle lenses and soft contact lenses designed for myopia control are available.
Further information on prevention strategies is available at:
https://smartvisionoptometry.com.au/myopia-prevention/
Gattegno said individual assessment determines the most appropriate option.
“We consider age, prescription level, corneal shape, lifestyle and family history,” she said. “Some children respond best to Orthokeratology, while others may benefit from advanced spectacle lens designs combined with behavioural guidance.”
Regular monitoring, including axial length measurements and corneal mapping, allows practitioners to track progression objectively.
Addressing Parental Concerns
Safety is a common question when discussing contact lens-based treatments for children.
Rodney said careful fitting and structured follow-up are essential.
“With appropriate education and hygiene compliance, Orthokeratology has a strong safety profile,” he said. “Professional monitoring is key.”
Gattegno noted that children often adapt quickly to overnight lens routines.
“Most children are highly motivated once they understand the daytime benefits,” she said. “Parents are involved throughout the process to ensure proper care.”
Encouraging Outdoor Balance
Beyond optical interventions, optometrists continue to encourage practical lifestyle measures. Research suggests that spending at least two hours outdoors daily may reduce the risk of myopia onset.
“Outdoor exposure provides protective benefits,” Rodney said. “Balancing screen time with outdoor activity supports both general and visual health.”
Gattegno added that small behavioural adjustments can complement clinical treatment.
“Encouraging regular breaks from near work and maintaining appropriate viewing distances can reduce visual stress,” she said.
A Preventative Health Perspective
As understanding of myopia evolves, many practitioners now frame management as a preventative health strategy rather than a reactive correction plan.
Rodney believes the conversation is shifting.
“Parents are increasingly aware that myopia is progressive,” he said. “The goal is not just clearer vision today, but healthier eyes decades from now.”
Gattegno agreed that early dialogue empowers families.
“When families understand the long-term implications, they feel more confident exploring management options,” she said.
With rising rates of childhood short-sightedness across Australia, optometrists are encouraging families to seek comprehensive assessments and discuss evidence-based strategies tailored to their child’s needs.
If you’d like to learn more about how Ortho-K might benefit your child — or explore our approach to myopia management and custom lens fitting — we’re here to help.Book an appointment, or call the Bondi clinic on (02) 9365 5047 or the Mosman clinic on (02) 9969 1600. We are always happy to discuss whether Ortho-K might be a good fit for your family.
