Nuance Audio: Smart Hearing Glasses
18/12/2025
Pre myopia is a relatively new concept in paediatric eye care. It describes a stage where a child’s eye is developing in a direction that increases their future risk of becoming myopic, even if they do not yet meet the traditional criteria for myopia.
A child may be considered pre-myopic if they:
In recent years, myopia (short-sightedness) has become one of the fastest growing eye health concerns worldwide. With children spending more time indoors, focusing on screens, and getting less outdoor daylight exposure, the rates of myopia are rising at an unprecedented pace. However, what many parents don’t realise is that myopia doesn’t simply appear overnight. There is a stage known as pre-myopia, during which changes in a child’s eye can indicate a high likelihood of developing myopia later on. The good news? With the right monitoring tools – particularly axial length measurements – eye care professionals can identify risks early and take proactive steps to slow or even prevent myopia progression.
Pre myopia is a warning sign, telling us that although vision may still be clear, the eye is growing in a way that may lead to myopia in the near future. Early identification allows for timely intervention, which is crucial because once myopia begins, it typically progresses each year during childhood.
While many people see myopia as a simple need for glasses, the condition is much more than that. The higher the myopia, the longer the eye becomes, which stretches and thins the internal structures. This increases the lifetime risk of serious eye diseases, including:
Thus, preventing or slowing the onset of myopia is not just about vision correction – its about long-term eye health.
The most accurate way to assess pre myopia and monitor myopia progression is through axial length measurement – a quick, painless scan that measures the length of the eyeball from front to back.
Unlike traditional vision tests, axial length measurement does not rely on a child’s responses. This makes it highly reliable, especially for young children.
Increases in axial length often occur before refractive changes are noticeable on a standard eye test. This allows practitioners to identify myopia risk long before vision becomes blurry.
Axial length should grow slowly in childhood. A faster-than-normal growth pattern signals that intervention may be needed.
Myopia-control treatments – such as orthokeratology, atropine eye drops, and myopia-control soft lenses – are more effective when progress is monitored through precise axial length data.
In pre-myopic children, the eye may already be elongating at a faster rate than average. Measuring axial length at regular intervals provides a personalised growth chart, similar to height measurements during childhood development.
By comparing a child’s results to population-norms, practitioners can determine:
This approach allows intervention to begin before the child becomes myopic, potentially delaying the onset or reducing the eventual degree of myopia.
Parents play a vital role in reducing myopia risk. Even for children identified as pre-myopic, small lifestyle changes can make a significant difference:
With early monitoring and simple behavioural changes, many children can maintain healthier eye growth patterns.
Pre myopia presents an opportunity – not a diagnosis. By identifying risk factors early and carefully tracking eye growth, optometrists can guide families with personalised strategies that protect long-term vision. Axial length measurement is transforming the way practitioners monitor children’s eye health, making it possible to intervene earlier than ever before.
As awareness grows and technology improves, early detection through axial length monitoring will play an increasingly pivotal role in managing the global rise of myopia. For parents and clinicians alike, this tool offers clarity, precision, and peace of mind. Book your child in for an eye test today.
