T
he rising prevalence of myopia, or nearsightedness, among children is becoming a growing concern worldwide, including in Malaysia. According to the World Health Organisation (WHO), cases have surged significantly, particularly after the COVID-19 pandemic.
The organisation predicts that by 2050, 50 per cent of the global population will have myopia, with 10 per cent at risk of developing high myopia. This condition can lead to serious complications, including glaucoma, retinal detachment, and permanent vision impairment.
The shift to online learning during the pandemic—a trend that continues today—has resulted in prolonged screen time for children, whether on computers, tablets, or smartphones. Beyond education, many also engage with digital devices for entertainment, including video games and streaming content.
Expressing his concerns to Bernama, ophthalmology specialist Dr Pall Singh from the Tun Hussein Onn National Eye Hospital said countries such as China, Japan, and Singapore report myopia rates exceeding 80 per cent among teenagers. He warned that Malaysia is on a similar trajectory unless preventive measures are implemented.
Citing current data, Dr Pall noted a significant rise in myopia prevalence among children, increasing from 9.8 per cent at age seven to 34.4 per cent by age 15.
A HIDDEN THREAT
According to Dr Pall, an expert in Vitreoretinal, Medical Retina, Neuro-Ophthalmology, and Orbit disorders, the rise in myopia among Malaysian children is driven by several key factors, including genetics and lifestyle habits.
"One of the main factors affecting children's eye health is the widespread use of digital devices. Children now spend more time in front of smartphones, tablets, and computers, whether for schoolwork or entertainment.
The prevalence of myopia among Malaysian children has also shown a significant increase.
“When children spend too much time in front of screens, their eyes are exposed to blue light, which emits short wavelengths that can cause eye strain. Over time, this contributes to the progression of myopia," he explained when met at his clinic.
He added that long hours of studying in school, especially in an education system that prioritises academic achievement, require children to spend extended periods reading, writing, and focusing on near objects—further increasing their risk of developing myopia.
Recent studies have proven that children who are less exposed to sunlight and spend more time on near-work activities, such as reading, writing, or using digital devices, have a higher risk of developing myopia.
"In Malaysia, the packed school schedule, including extra classes, tuition, and continuous homework assignments, indirectly reduces children's opportunities to take breaks from near-work tasks and receive natural light exposure, increasing their risk of developing myopia," he added.
Eye strain caused by prolonged screen use is worsened by the fact that children often do not follow proper rest routines. According to Dr Pall, children tend to ignore early signs of eye strain, such as watery or irritated eyes, which can lead to worsening myopia.
Thus, he emphasised the importance of parents and educators being attentive to early signs of myopia, as early detection is key to preventing more severe vision problems in the future.
"I recommend that every child undergo regular eye check-ups at optometry clinics to detect myopia at an early stage. If left unaddressed, nearsightedness can negatively impact a child’s academic performance and daily life, as they may struggle to see the whiteboard or engage in outdoor activities freely.
"Regular vision screening is a crucial first step, not only to detect vision problems but also to prevent children from facing more significant difficulties in the future," he said.
THE ROLE OF OUTDOOR ACTIVITIES AND NATURAL LIGHT
Meanwhile, Associate Professor Dr Mohd Mursyid Arshad, Director of the Co-Curriculum and Student Development Centre at Universiti Putra Malaysia, said that besides digital devices, the lack of exposure to natural light and outdoor activities also contributes to the development of myopia.
Describing this as an important factor, he noted that studies show children who spend more time outdoors have a lower risk of developing myopia compared to those who spend most of their time indoors.
He said exposure to natural sunlight plays a crucial role in preventing the progression of nearsightedness.
Assoc Prof Dr Mohd Mursyid Arshad.
According to the 2018 study The Epidemic of Myopia: Aetiology and Prevention, children who spend more time outdoors and receive natural light exposure have a lower risk of myopia because natural light signals the eyes to develop in a healthier way.
"Natural light plays a key role in slowing down the progression of myopia. It stimulates the retina to develop in a more structured manner. Children who receive less natural light, especially at a young age, are more likely to develop myopia," he explained.
He further noted that outdoor activities not only reduce the risk of myopia but also provide other benefits, such as improving children's physical and mental health. Playing outdoors helps enhance motor coordination and social development, which positively impacts overall growth.
As such, Mohd Mursyid said educational institutions must play an active role in helping children reduce their risk of myopia. Measures that can be taken include ensuring classrooms have adequate lighting and reducing reliance on digital devices for learning.
"The education system must pay more attention to the learning environment. Providing more outdoor activities and ensuring sufficient natural lighting in classrooms are among the steps that can help reduce eye strain in students," he stressed.
SUPPORT FROM EDUCATIONAL INSTITUTIONS
Elaborating further, Mohd Mursyid suggested that educational institutions adopt a more holistic and integrated approach to addressing the issue.
With digital learning increasingly dominating classrooms, eye health issues among students can no longer be ignored, as prolonged exposure to blue light and lack of outdoor activities increase the risk of myopia from an early age, he said.
School-aged children are among the main groups who need to get a comprehensive eye examination that covers overall eye health.
Some measures that could be considered include implementing staggered break schedules to give students periodic screen breaks and encouraging outdoor activities as part of the daily school curriculum.
"Mandatory outdoor activities in schools can have a positive impact on students' eye health. At the same time, educational institutions must implement comprehensive eye health policies, including training teachers and parents on children's vision care," he said.
Mohd Mursyid also emphasised the need for eye health education to become a permanent agenda in schools, in line with the increasing reliance on digital technology in modern lifestyles.
"Continuous education on eye health, adapting learning environments to be more vision-friendly, and promoting physical outdoor activities to reduce screen time and artificial lighting exposure are among the approaches that can be taken," he said.
He added that basic elements such as adequate natural lighting, limits on screen time, and appropriately sized reading materials should not be overlooked, as these factors can significantly impact students’ eye health.
At the same time, structured training for teachers and parents on proper learning posture and methods to reduce eye strain should be emphasised so that interventions can be implemented comprehensively.
He believes that only through a systematic and collaborative approach between schools, families, and the Ministry of Education can myopia among students be effectively and sustainably addressed.
COLLABORATION FROM ALL PARTIES
However, the main challenge that needs to be tackled is raising widespread awareness about the importance of early prevention. Effective education, advocacy, and communication efforts must be strengthened to ensure that all parties understand their responsibilities.
"This initiative cannot be undertaken alone," said Dr Fazliana Ismail, a senior lecturer and consultant ophthalmologist at the Department of Ophthalmology, Faculty of Medicine, Universiti Malaya.
Dr Fazliana Ismail.
She believes that all stakeholders must work together to identify early signs of myopia and take immediate preventive measures, supported by policies and special allocations from the government.
Among the suggested approaches are training educators and parents to recognise early signs of myopia, such as difficulty seeing the whiteboard, frequent squinting, excessive eye rubbing, or recurring headaches. Additionally, children should be encouraged to spend at least two hours outdoors daily to support better eye health.
Dr Pall also noted that exposure to natural light for at least two hours daily can reduce myopia risk by 30 to 50 per cent, as outdoor light is significantly brighter (10,000–100,000 lux) compared to classroom lighting (only about 500 lux).
He recommended that national education policies incorporate vision health into the curriculum and enhance collaboration between schools and parents to help reduce screen time at home.
