When Myopia Keeps Progressing, What Worries Parents Most?
“I’m not afraid of my kid wearing glasses. I’m afraid of the prescription getting worse every year and feeling like there’s nothing we can do about it.”
That’s the sentence we hear most often at Beyond Visual Optometry. And your worry is well-founded.
Myopia is fundamentally the eyeball growing too long (axial elongation) — and once the eye elongates, it cannot shrink back. High myopia (worse than -6.00D) carries a significantly higher lifetime risk of retinal detachment, macular degeneration, and glaucoma compared to a normal eye (per public health-education materials from Taiwan’s Health Promotion Administration and ophthalmology associations). Tracking your child’s prescription trend early is the first step in protecting their vision.
Childhood Myopia in Taiwan: The Numbers
Taiwan has one of the highest myopia prevalence rates in the world:
- First grade of elementary school: roughly 5–10% myopic
- End of elementary school (sixth grade): roughly 55–65%
- High school graduation: over 85%
- High myopia prevalence (adults): roughly 20–25%
(Prevalence figures reference Taiwan’s Health Promotion Administration school-age vision monitoring and public health-education data.)
Myopia progresses fastest between ages 8 and 14 — which makes regular tracking during this window especially important.
Why Does Myopia Keep Progressing?
The root cause of myopia is an excessively long eye axis — the eyeball’s front-to-back length exceeds normal, so light focuses in front of the retina instead of on it.
Three main drivers of continued axial elongation:
- Too much near work: More than 3–4 hours daily on phones, books, or tablets keeps the ciliary muscles chronically contracted, stimulating axial growth
- Not enough outdoor time: Natural light (above 10,000 lux) is associated with dopamine release, and research has observed a relationship between outdoor time and axial development. Two hours of outdoor activity per day is a common recommendation in the ophthalmology community
- No regular tracking: If you don’t know whether the eye axis is lengthening, you can’t adjust the lens strategy at the right time
Optometrist vs. Ophthalmologist: Who Does What
Many parents are confused about who should handle their child’s myopia. Here’s the correct division of roles under Taiwanese regulations:
| Service | Licensed Optometrist (Beyond Visual) | Ophthalmologist (MD) |
|---|---|---|
| Vision and prescription assessment | ✅ | ✅ |
| Axial length measurement | ✅ | ✅ |
| Defocus lens fitting (defocus-design soft contact lenses, Zeiss MyoCare) | ✅ | ✅ |
| Regular tracking records and trend analysis | ✅ | ✅ |
| Low-dose atropine prescription | ❌ Requires a physician’s prescription | ✅ |
| Fundus examination, cycloplegic refraction | ❌ Classified as medical procedures | ✅ |
Beyond Visual Optometry’s role is regular measurement, record-keeping and tracking, and defocus lens fitting. Children who need medication are referred to an ophthalmologist — it’s a collaboration, not a turf war.
Defocus-Design Lenses: What an Optometrist Can Do
Peripheral-defocus lenses are the tools that licensed optometrists can fit and track:
| Lens | Type | Notes |
|---|---|---|
| Defocus-design soft contact lenses (daily disposable) | Contact lenses (medical device) | Require an in-person corneal and wearing-condition assessment by a licensed optometrist; for those under 15, fitting must be conducted under an ophthalmologist’s guidance |
| Zeiss MyoCare | Spectacle lenses | A spectacle-form defocus design for school-age children; daily care is the same as ordinary glasses |
Whether these lenses suit an individual child requires an in-person assessment of wearing conditions and lifestyle. Product indications follow the content approved in the MOHW license. For medication or any medical treatment, please consult an ophthalmologist.
Option 1: Defocus-Design Soft Contact Lenses (Daily Disposable)
What Are Defocus-Design Soft Contact Lenses?
These are soft daily-disposable contact lenses with a central-and-peripheral zoned optical design: the central zone corrects refractive error while the peripheral zones use a defocus structure. Contact lenses are medical devices; their product characteristics and indications follow the content approved in the MOHW license.
Before Wearing
Contact-lens fitting must be carried out by a licensed optometrist who assesses corneal condition, tear film, and wearing habits in person. Under Article 12 of the Optometrists Act, fitting contact lenses for anyone under 15 must be conducted under an ophthalmologist’s guidance, and it may not be performed for children under 6. Whether the lenses are suitable, and whether daily cleaning and care can be maintained, all require an in-person assessment.
Option 2: Zeiss MyoCare Spectacle Lenses
What Is MyoCare?
Zeiss MyoCare is a spectacle-lens defocus design for school-age children using C.A.R.E.® technology (Cylindrical Annular Refractive Elements) — nearly invisible concentric rings that alternate defocus and correction zones across the lens, giving the child clear vision with the same wearing experience as ordinary glasses.
No contact lenses required, so acceptance among children is high, and daily care is the same as ordinary glasses. The portfolio also includes MyoCare S, designed for younger children.
Who It Suits
- Children who refuse to wear contact lenses
- Younger children (6 and up)
- Parents who want something simple to use and easy to maintain
The Real Key: A Solution Your Child Will Actually Stick With
Even the best lens does nothing if your child won’t wear it.
What Beyond Visual Optometry cares about most is not recommending the most expensive option, but finding the combination your child will genuinely cooperate with and your family can sustain.
Choosing a Frame (for the Spectacle Option)
For children’s frames, the key isn’t the brand — it’s:
- Light and snug: silicone nose pads that don’t press on the nose bridge
- Doesn’t slip: temple curvature that fits your child’s face
- Drop- and impact-resistant: memory-material frames that hold their shape through daily use
- Correct sizing: oversized frames increase optical-center alignment error
The Regular Tracking Routine
- Measure axial length every 3–6 months
- Axial length change is the true objective indicator — it reflects eye development better than prescription numbers alone
- Adjust the plan based on tracking results; this is an ongoing program, not a one-time fitting
FAQ
Q: At what age should tracking start?
The earlier the better. The fastest-progression window is ages 6–14. For children aged 6 and up whose myopia increases by more than 0.50D per year, regular tracking is recommended. The younger you start, the more complete a picture you’ll have of axial development.
Q: Do we still need to see an ophthalmologist?
We recommend doing both. The optometrist handles lens fitting and regular tracking; the ophthalmologist handles fundus health checks and medication evaluation (such as low-dose atropine). The two roles don’t conflict — together they give your child the most complete care.
Q: How long does myopia tracking continue?
Generally until age 18–20, when axial development stabilizes. It’s not something you do for a few years and stop — the goal is continuous tracking through the growth years so your child’s prescription at 18 is as low as possible.
Q: My child is already at -5.00D. Is tracking still worth it?
Absolutely. The point of tracking is knowing the trend — where the prescription and axial length stand — so the lens plan and visual habits can be adjusted at the right time, and so an ophthalmologist has complete records whenever a medical evaluation is needed.
Q: Where can I get children’s myopia tracking in Xinzhuang?
Beyond Visual Optometry’s Xinzhuang store is our primary location for children’s myopia tracking, offering axial length measurement, prescription trend records, defocus-design soft contact lens fitting, and Zeiss MyoCare evaluation. Our licensed optometrists track progress every 3–6 months, and children who need medication evaluation are referred to an ophthalmologist. Call +886-2-2206-6700 or book online.
“It feels like I can’t keep up with the changes” — the important word in that sentence is feels.
Without records, parents have only impressions to go on, and impressions are easily dominated by whatever the last check-up said. Line up each visit’s prescription and axial length in date order, though, and the things worth worrying about separate themselves from the things that aren’t. Anything requiring medical judgement, we refer to an ophthalmologist. Keeping the data properly is the part you can leave to us.
Xinzhuang (Biyang Optometry Clinic): +886-2-2206-6700. Start the record now, then come back every three to six months to add to it.