Vision is one of our most precious senses, yet it is under threat like never before. In Bangladesh, a growing number of children are experiencing myopia, commonly known as short-sightedness, which makes it difficult for them to see distant objects clearly. Parents often respond by visiting optical shops and buying spectacles, assuming the problem is solved.
Myopia is a refractive error where nearby objects are seen clearly, but distant objects appear blurred. It occurs when the eyeball grows longer than normal or when the cornea bends light excessively, causing light to focus in front of the retina rather than on it. A child with myopia may comfortably read books but struggle to see the classroom board, road signs, or television clearly. Globally, myopia is becoming a major public health concern, with experts predicting that nearly half of the world's population could be myopic by 2050. In Bangladesh, the rising use of digital devices, limited outdoor activity, and intense academic pressure are believed to be contributing factors.
Myopia progression refers to the gradual increase in the lens power needed to correct vision, usually during childhood and adolescence while the eye is still growing. For example, a child may require ?1.00 diopter glasses at age eight, which could increase to ?2.00 diopters by age ten and reach ?4.00 diopters by age thirteen. Rapid progression significantly increases the risk of serious eye diseases later in life, including retinal detachment, glaucoma, cataract, and myopic macular degeneration. Controlling myopia progression is therefore critical.
In Bangladesh, myopia control is particularly important for children who develop myopia at an early age, whose prescription increases rapidly, or who have a family history of high myopia. Children who spend excessive time indoors studying or using digital devices are also at higher risk. A nine-year-old child whose prescription jumps from ?1.00 to ?2.00 within a year, for instance, signals significant progression and requires professional evaluation.
Detecting and monitoring myopia progression requires proper clinical evaluation. Visual acuity testing, cycloplegic refraction, axial length measurement, corneal topography, and retinal examination are commonly used by trained eye care professionals. Unfortunately, many optical shops in Bangladesh only perform basic refraction, leaving children without comprehensive evaluation. This gap highlights the need for professional standards and ethical practices in eye care.
Fortunately, modern eye care offers several scientifically proven strategies to slow down myopia progression. Specially designed spectacle lenses can control peripheral defocus and reduce eye growth, while soft contact lenses and orthokeratology lenses modify light focus on the retina. Low-dose atropine eye drops have been shown to slow progression in children.
A young child with rapid progression may benefit from a combination of atropine therapy and special spectacles, while a teenager with moderate progression may use myopia control contact lenses. Regular monitoring through eye examinations, axial length measurements, and assessment of visual comfort ensures the treatment is effective and safe. Parents must understand that myopia control is a long-term commitment, not a one-time intervention.
Myopia is no longer a simple problem that can be solved only with glasses. It has become a significant public health issue in Bangladesh and globally. Early detection, proper clinical evaluation, and evidence-based treatment strategies are essential to controlling progression and preventing long-term complications.
Equally important is the ethical responsibility of eye care practitioners and optical shop owners to provide accurate diagnosis, safe treatment, and patient-centered care. Parents should ensure that their children receive regular eye examinations from qualified professionals. With awareness, ethical practice, and modern myopia management, the burden of progressive myopia in Bangladesh can be significantly reduced. Protecting children's vision today is truly an investment in the nation's future.
The writer is Assistant Professor and Research Fellow, Management and Science University, Malaysia
