Singapore ranks first globally as childhood myopia surges

Mount Elizabeth now uses atropine MiSight lenses and near-work devices to slow progression in children.

Singapore’s rise in childhood myopia is increasing concern over future retinal complications, especially after pandemic lockdowns kept children indoors and increased screen time.

Speaking at the Asia-Pacific Myopia Management Symposium (APMMS) in Tokyo, Niall Crosby, Consultant Vitreoretinal Surgeon at Mount Elizabeth Medical Centre, Singapore, said myopia has risen steadily over the past 50 years, with Singapore now one of the most affected markets for childhood myopia. The post-COVID increase has sharpened concern because less outdoor time and more near work can accelerate progression.

“We did see, particularly after the COVID lockdowns, a big increase in childhood myopia, because children were spending much less time outdoors,” Crosby said. Outdoor time remains important in prevention, whilst near work and screen exposure can drive myopia.

The concern is that myopia is often treated as a routine need for glasses rather than a disease that can affect the retina. High myopia can raise the risk of serious retinal complications later in life, making early intervention important for children and families.

Mount Elizabeth Medical Centre has incorporated several options to slow myopia progression. These include atropine at various concentrations, MiSight contact lenses, orthokeratology and newer near-work devices. Crosby said MiSight lenses correct refractive error and have been shown in randomised controlled trials to slow myopia progression.

The newer devices aim to reduce effective near-work exposure while children read or do homework. They use mirrors or cameras to make the eye respond as if nearby material is farther away, reducing strain linked to myopia progression.

“We're seeing really good results from these different treatment modalities,” Crosby said.

The biggest challenge remains education. Crosby said families need to understand that myopia is “not just a refractive error and it's not just an inconvenience,” but a condition with implications for the retina.

The priority is to help parents act earlier through prevention, monitoring and treatment, before childhood myopia progresses into higher-risk disease.