Consultant and paediatric ophthalmologist Dr Fiona Chew said most of these cases stem from refractive errors, where light is not focused properly on the eye owing to the shape of the eyeball, resulting in blurry vision.
Myopia (nearsightedness) and astigmatism (distortion of vision) are the most common refractive errors among Malaysian children – both of which are becoming increasingly prevalent.
“Nearly one in two Malaysian children is affected by refractive errors, with a local study reporting a prevalence of 47.8%,” Chew said. “Myopia, meanwhile, affects 30.2% of kids and occurs when light focuses in front of the retina, causing distant objects to appear blurry.
“Astigmatism, which affects 16.3%, is caused by an uneven curvature of the cornea, resulting in blurred vision at all distances; while hyperopia, or long-sightedness, is less common at 1.2% and occurs when light focuses behind the retina, making near objects appear blurry.”
While most of these conditions are common, they are often overlooked because children rarely complain of vision problems and tend to adapt to their limitations, leading parents to believe nothing is wrong.
“Symptoms may be subtle, such as squinting to see distant objects, frequent blinking or rubbing of the eyes, or even holding books and devices unusually close to the face,” Chew noted.
She added that while behaviours like sitting too close to the television are often mistaken for bad habits, they could indicate that a child is struggling to see clearly and may have myopia.
“Left untreated, refractive errors can lead to more serious vision problems, including lazy eye, which causes permanent poor vision, eye alignment issues, headaches from eye strain, problems with depth perception, and even difficulties in concentration.”
These risks are further compounded by modern lifestyle habits such as prolonged screen use, especially as reliance on digital devices has increased significantly over the years. As a result, more than half of Malaysian students experience headaches linked to extended periods in front of screens.
Chew said screen time should ideally be introduced to children as late as possible, preferably from the age of seven. Those over age three should have no more than an hour of screen time per day, while those under three should avoid screens entirely.
She added that spending more time outdoors can help protect children’s vision by giving their eyes a break from digital devices, allowing them to focus on varying distances and exposing them to natural sunlight, which reduces the risk of developing myopia.
Chew also encourages the adoption of the 20-20-20 rule, which is beneficial for people of all ages: taking a 20-second break every 20 minutes of near-distance work to focus on something 20 feet (6m) away.
Alongside preventive habits, she said appropriate corrective measures, including prescription glasses, are key to protecting a child’s vision, as they remain the most effective way to correct refractive errors in children.
Those who require them should wear their glasses consistently to prevent eye strain and help stabilise refractive errors.
Ultimately, routine eye screenings play an important role in maintaining children’s eye health, while incorporating nutrient rich foods such as carrots, sweet potatoes, eggs, spinach, broccoli and fish helps children develop strong, healthy vision that supports them throughout their lives.