The younger the age when myopia or nearsightedness begins, the greater the likelihood that a child will experience progression to vision threatening levels of myopia. Eye care professionals and parents should be active in monitoring both myopia onset and progression at as early an age as possible.
No formal protocols have yet been identified that recognize those patients at risk of myopia development before the actual changes in refractive error occur that ultimately leads to a myopia diagnosis at the optometrist's office. However, it is clear, that Chinese children living in urban regions of Asia, who are immersed in an intensive education environment and have two myopic parents, have a much greater risk for onset and development of significant myopia than a Caucasian living in a rural environment in the United States with no myopic parents.
Not all children who are young at myopia onset will experience progression to high myopia, but age of onset is the current best determinant for identifying children at risk of progression.
While noting the risk of high myopia is greatest in those with early onset, doctors and parents should also be aware that the condition of some patients, with later onset of myopia (11 years or older), may also progress to higher degrees of myopia, where the rate of increasing myopic change is high. This would indicate that even older children whose prescriptions are getting worse every year may progress to high myopia.
Eye care providers and parents should be vigilant in identifying and treating those at risk of rapid progression, regardless of age of onset.