A child in a Saudi classroom struggles to read the board. Previously, the solution was straightforward: measure their eyes, prescribe glasses, and return when the prescription changed. Today, that same visit may mark the beginning of something more deliberate.
Myopia, or nearsightedness, is no longer viewed solely as a refractive error. It is now recognized as a long-term eye health concern requiring early attention and ongoing management. This shift stems from evidence linking higher levels of myopia to increased risks of serious eye diseases later in life, including retinal detachment, glaucoma, and macular degeneration.
Global data shows myopia affected 22.9% of the world’s population in 2000, with projections estimating 49.8% by 2050. High myopia alone could increase from 2.7% to 9.8% over the same period. While East Asia has dominated discussions due to its rapid rise in prevalence, the Middle East is now part of this conversation.
In Saudi Arabia, a 2022 study of 3,678 schoolchildren in Taif revealed 33.2% of examined eyes were myopic, with rates increasing from 26.8% in children aged 7–9 to 43.8% in those aged 16–18. A 2024 study in Jordan, involving 542 children, found 11% with myopia, though rates varied by age—8% in six-year-olds compared to 18% in 15-year-olds.
A meta-analysis of 737,000 children across 19 African countries showed childhood myopia prevalence nearly doubled between 2000–2010 and 2011–2021. The findings indicate myopia is not limited to high-prevalence markets in Asia but is a growing concern across diverse populations.
Myopia’s hidden risks demand early action
Each additional diopter of myopia carries measurable risks. Studies link higher levels to a 58% increase in myopic maculopathy, a 30% rise in retinal detachment, and greater odds of glaucoma and cataracts. The goal is not to eliminate myopia entirely but to slow its progression and reduce long-term complications.
Earlier onset of myopia worsens these risks. A study of 928 children in Singapore found younger age at diagnosis correlated with higher levels of myopia later in childhood. A prescription addresses current vision but does not predict future progression.
This changing perspective was formalized in 2025 by the International Myopia Institute, which distinguished between myopia correction (addressing immediate vision) and myopia control (interventions to slow progression). The broader term, myopia management, now includes prevention, risk assessment, lifestyle guidance, and ongoing monitoring.
For decades, eye care operated reactively—children received glasses when vision blurred and returned when it worsened again. The new approach is proactive, focusing on when myopia began, its progression, and steps to manage it over time. The emphasis has shifted from correcting vision to protecting it for decades.
Regional eye care faces uneven progress barriers
Ophthalmologists lead diagnosis and medical oversight, but optometrists, orthoptists, and opticians play essential roles in refraction, education, and follow-up. The challenge lies in ensuring continuity across the region, where healthcare systems, professional scopes, and technology access vary widely. Children may see multiple providers over the years, requiring records to follow them.
Optometrists in Saudi Arabia now incorporate axial length measurements into routine exams to track eye growth beyond refractive error. A 2022 study in Taif found children with axial lengths exceeding 26 millimeters, an early sign of rapid progression, were nearly twice as likely to develop high myopia by age 16. Standardizing these measurements remains difficult, as equipment and training levels vary. Urban centers in Riyadh and Dubai have adopted portable optical biometry devices, but rural areas often rely on manual keratometry, limiting precision.
Jordan’s 2024 school-based screening program trained teachers to recognize early myopia signs using pocket vision charts. While the program identified 11% of children with myopia, only 38% of flagged cases returned for cycloplegic refraction. Logistical barriers, including transportation and parental work schedules, disrupted continuity. A hematologist in Amman noted families often prioritize acute illnesses over routine eye exams, viewing myopia as a minor issue rather than a long-term risk.
Risk tiers and tech reshape myopia management
The International Myopia Institute’s 2025 definitions are reshaping clinical workflows. In the UAE, optometrists now categorize patients by risk tiers: low-risk children receive annual check-ups, while those with fast-progressing myopia or family histories of retinal detachment are scheduled every three months. This mirrors Singapore’s model, where axial length growth rates guide intervention thresholds. However, in Egypt, where optometry regulations are less standardized, many practitioners still focus solely on spectacle prescriptions, missing early management opportunities.
Lifestyle interventions are now integrated into management plans. A photographer who switched from single-vision glasses to multifocal contact lenses in 2023 reported reduced myopia progression, aligning with studies showing outdoor light exposure and reduced near-work time can slow advancement. Schools in Qatar have introduced “20-20-20” breaks, though compliance varies. An optician in Abu Dhabi observed parents often resist behavioral changes, preferring simple lens adjustments over lifestyle modifications.
Technology is advancing the transition, but access remains uneven. In South Africa, a pilot program using smartphone-based autorefractors in township clinics achieved 92% accuracy in detecting myopia, though results were not yet linked to electronic health records. High-end myopia-control lenses are primarily available in urban clinics, leaving rural children dependent on basic single-vision corrections. Urban prevalence exceeds rural rates by up to 15 percentage points in some studies, highlighting equity concerns.
Axial length monitoring has exposed infrastructure limitations. A pediatric ophthalmologist in Morocco described cases where children’s records were lost between public and private providers, forcing repeat measurements. Saudi Arabia’s King Khaled Eye Specialist Hospital is adopting digital health records, but interoperability between systems remains fragmented. Without unified databases, long-term trends, such as declining myopia onset ages, risk being obscured by inconsistent data collection.
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