Vision problems are becoming increasingly common among Malaysian children, yet many cases remain undiagnosed until they begin to affect behaviour, school performance, or overall development. A recent study revealed that 22.3% of Malaysian children have some form of visual impairment, with more than half of these cases linked to treatable causes. According to Dr Fiona Chew Lee Min, Consultant Ophthalmologist, Paediatric Ophthalmologist and Strabismus Surgeon at Sunway Medical Centre Velocity (SMCV), most of these issues stem from refractive errors. A condition in which light is not focused properly on the eye due to the shape of the eyeball, resulting in blurry vision. She explains that myopia, or nearsightedness, and astigmatism, which causes distortion of vision, are the most common refractive errors among Malaysian children, and both are becoming increasingly prevalent.
With August marking Children’s Eye Health and Safety Awareness Month, Dr Fiona reminds parents to make regular vision checks a priority, even in the absence of obvious symptoms. Refractive errors affect nearly one in two Malaysian children, with studies reporting a prevalence of 47.8%. Myopia affects 30.2% and occurs when light focuses in front of the retina, causing distant objects to appear blurry. Astigmatism, which affects 16.3%, results from an uneven curvature of the cornea, leading to blurred vision at all distances. Hyperopia, or long-sightedness, is less common at 1.2%, occurring when light focuses behind the retina, making near objects appear blurry.
These conditions often go unnoticed because children rarely complain of vision problems, instead adapting to their limitations. Parents might misinterpret subtle signs such as squinting, frequent blinking, rubbing of the eyes, or holding books and devices unusually close to the face as mere habits, when in fact they may indicate underlying issues. Untreated refractive errors can result in more serious complications, including lazy eye, eye alignment problems, headaches, depth perception difficulties, and poor concentration. The risks are further heightened by modern lifestyle habits, especially prolonged screen time, which has become increasingly common in recent years.
The shift towards remote learning during the pandemic greatly increased daily screen exposure for children, with over half of Malaysian students experiencing headaches related to extended screen use. Prolonged exposure is also linked to increased eyeball length, a major factor in developing refractive errors. Dr Fiona advises that children above the age of three should limit screen time to one hour a day, while those under three should avoid screens entirely, ideally introducing them only at the age of seven or later. She also stresses the importance of outdoor activities, which allow children’s eyes to rest from near work, adjust to varying distances, and benefit from natural sunlight. All factors shown to reduce the risk of myopia. She encourages practising the 20-20-20 rule, where every 20 minutes of close-up work is followed by a 20-second break to look at something 20 feet away.
Corrective measures remain crucial in managing refractive errors, with prescription glasses being the most effective option for children. Wearing the correct prescription consistently helps reduce eye strain and stabilise the condition. Dr Fiona dispels the myth that glasses weaken eyesight, noting instead that they ensure the eye focuses properly. For older children aged 10 to 12, contact lenses can be an alternative, provided strict hygiene is maintained. Routine eye screenings are equally vital, starting at birth and followed by a formal assessment at the age of three, or earlier if warning signs appear. Early detection can significantly improve treatment outcomes and enhance a child’s quality of life.
Nutrition also plays an essential role in eye health, though it is often overlooked. Chow Yu Fei, Registered Dietitian at SMCV, explains that a balanced diet during early childhood supports visual development, eye muscle coordination, and overall eye function. Key nutrients such as vitamin A, lutein, zeaxanthin, and omega-3 fatty acids are crucial in maintaining healthy vision and protecting the retina from harmful light exposure. Deficiencies in these nutrients can impair low-light vision, reduce the retina’s natural defence against blue light, and hinder the retina’s development and function. Foods rich in these nutrients include carrots, sweet potatoes, eggs, spinach, broccoli, corn, salmon, mackerel, and local favourites like ikan tenggiri, ikan kembung, and ikan patin, as well as walnuts and chia seeds.
By combining early detection, healthy lifestyle habits, proper screen management, and nutrient-rich diets, parents can take an active role in safeguarding their children’s eyesight. With timely intervention and the right care, many childhood vision problems can be successfully managed or even prevented, giving children the best possible foundation for a lifetime of healthy vision. Sunway Medical Centre Velocity remains committed to raising awareness and providing expert care in protecting children’s eye health.