Safal Khanal, O.D., Ph.D., and his team have launched a study that hopes to answer why childhood myopia has increased in recent years. Myopia, commonly known as nearsightedness, is a global health concern that affects over 2 billion people globally, with cases continuing to rise at an alarming rate. As more children become nearsighted, researchers are working to understand why myopia develops in some children and progresses faster in others.
Safal Khanal, O.D., Ph.D., and his team at the University of Alabama at Birmingham School of Optometry are seeking answers to the increase in childhood myopia in recent years.
Hoping to answer longstanding questions about childhood myopia, Khanal has launched a study to examine how children’s visual experiences influence eye growth and why the condition progresses more rapidly in some children than in others.
The study will use VEET, or Visual Environmental Evaluation Tool, glasses to measure children’s visual experiences in their daily lives. The glasses will log data that could help understand the user’s visual environment. With these research sensor glasses, researchers will examine how visual experiences relate to changes in the structure, optics and function of the eyes over time.
While genetics contribute to developing myopia, genetics alone cannot fully explain the rapid rise in myopia over the past decades. Researchers believe environmental factors are also influencing how children’s eyes grow.
Khanal says aspects of the modern visual environment are likely disrupting the eye’s growth control mechanism and causing the eye to grow excessively, leading to myopia. Many children today spend less time outdoors and more time using digital devices or doing schoolwork on screens. Khanal hopes the VEET glasses will capture real-world environmental data that will give insight into children’s visual experiences in the modern world.
“Our goal is to move beyond simply documenting that a child’s myopia is getting worse and to begin understanding why it is happening,” Khanal said. “Ultimately, this knowledge could help us identify children at risk earlier, develop more personalized approaches to myopia management, and reveal new environmental targets for prevention and treatment.”
The research findings could help eye care providers identify children who have the greatest risk of developing myopia or experiencing rapid progression and help determine the environmental and biological factors that contribute to that risk.
Risks beyond blurry vision
Myopia affects approximately 36 percent of children and adolescents. It causes distant objects to appear blurry and requires glasses or contact lenses to see properly. The long-term impacts of myopia include an increased risk of serious, sight-threatening conditions later in life.
Myopia occurs when the eye grows excessively long for its optical system. This elongation stretches tissues at the back of the eye and causes blurred vision when viewing objects at a distance.
As myopia progresses, the elongation of the eye can increase the risk of serious conditions such as retinal detachment, glaucoma, cataracts and myopic macular degeneration. Treating myopia earlier in childhood may also prevent it from worsening in adulthood, reducing the risk of complications.
“This is why slowing excessive eye growth during childhood could have benefits that extend well beyond reducing dependence on glasses,” Khanal said.
What parents should know about myopia
Children with myopia may have difficulty seeing distant objects clearly, squint frequently, sit closer to screens or classroom boards, or experience eyestrain or headaches.
“Importantly, some children may not complain at all, which is another reason routine eye examinations are important,” Khanal said.
Khanal says parents should understand that myopia is more than a vision problem that can be corrected by glasses or contacts.
“Parents often think of myopia primarily as an optical condition that can easily be fixed with glasses or contact lenses. However, many are unaware that myopia develops due to the eye’s getting physically longer, which predisposes the eye to significant risks of developing sight-threatening diseases later in life. Regular glasses, contact lenses or refractive surgeries may help achieve clear vision; but they do nothing to slow myopic eye growth to reduce these risks.”
Khanal says the goal is not to alarm families, but to encourage early awareness, appropriate monitoring and timely treatment, when necessary, to help slow progression.
Why understanding childhood myopia matters
“Childhood is when myopia most commonly develops and progresses. The earlier the age of onset, the faster the progression, and the more time there is for it to progress. Once a child becomes myopic, the child is at lifelong risk of vision loss from myopia-related ocular complications,” Khanal said.
“The condition can continue to worsen as the eye grows during childhood. That makes childhood a particularly important window for understanding what causes myopia and for identifying opportunities to intervene to prevent it from progressing to higher levels and to reduce the risks of sight-threatening diseases in later life.”
Identifying risk factors could lead to more personalized approaches to myopia management and potentially help prevent some cases before they begin.
“The long-term goal is to slow myopia after it develops and to understand whether we can prevent or delay its onset in the first place.”
The project is part of an open science initiative in which three grant recipients will collaborate and share data to accelerate discoveries. Study partners include Reality Labs Research, SIXTY-D, the American Academy of Optometry and Global Light Commons.
“Solving a problem of this scale requires a global collaborative effort,” Khanal said. “By working with researchers around the world and building rich, openly available datasets, we aim to identify the aspects of children’s visual environments that matter most for myopia. Ultimately, that knowledge could point us toward better ways to predict, prevent and treat the condition.”
Children ages 7 to 13 are eligible to participate in the study. Families interested in learning more can contact the research team at 205-975-3881 or click here to email them.