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A new international study has produced the first standardized eye growth charts for children, giving clinicians a new tool to identify abnormal eye growth that may signal myopia risk before sight-threatening complications develop later in life.
Published in JAMA Ophthalmology, the research comes as myopia, commonly known as nearsightedness, continues to rise worldwide. Researchers estimate that about 35% to 40% of the global population currently has myopia, with that number expected to reach 50% by 2050. In some parts of East and Southeast Asia, as many as 80% of young adults are affected.
For pediatric nurses, school nurses, ophthalmology nurses, nurse practitioners, and primary care clinicians, the charts may support earlier identification of children who could benefit from closer monitoring and timely referral for eye care.
Researchers Create First Standardized Eye Growth Charts
The study, led by researchers from The University of Western Australia and international collaborators, analyzed nearly 560,000 eye measurements from 147,573 children and adolescents across Australia, Europe, and East Asia.
Using those data, researchers developed the first age-, sex-, and region-specific centile charts for eye length, similar to the growth charts clinicians use to monitor children’s height and weight.
Study co-lead Dr. Gareth Lingham, from The University of Western Australia’s Medical School, the Lions Eye Institute, and the Centre for Eye Research Ireland at Technological University Dublin, said excessive eye growth is a major driver of myopia.
“When the eye grows too long, it can weaken the structures of the eye and increase the risk of permanent, sight-threatening complications later in life,” Dr. Lingham said.
“The longer the eye, the higher the risk of these complications.”
Why Eye Length Matters
Unlike routine vision screening, measuring eye length provides insight into how rapidly a child’s eye is growing. Until now, clinicians have lacked standardized reference values to determine whether that growth falls within the expected range.
Dr. Lingham said the absence of those reference values has made it difficult to identify children at higher risk for myopia.
“A lack of reference values charting these differences has made it hard to interpret eye lengths in different groups, in turn making it difficult to confidently spot myopia risk early on,” he said.
The charts account for differences in age, sex, and geographic region, helping clinicians determine whether eye growth is progressing as expected.
Supporting Earlier Intervention
Professor David Mackey, a founding member of the Consortium for Refractive Error and Myopia in Children (CREAM-kids), said the charts are intended to support clinical decision-making rather than diagnose myopia.
“Although these centile charts are not intended to diagnose myopia, they could help clinicians identify whether a child’s eye growth is unusually rapid, how they compare with peers in their region, and whether they are at risk,” Professor Mackey said.
The charts may help clinicians identify children who could benefit from closer monitoring as their eyes develop.
Helping Families Reduce Myopia Risk
Professor Mackey also highlighted lifestyle measures families can take to help reduce the risk of myopia.
“Children should aim to spend two hours outside every day,” he said.
“To also avoid sunburns and skin cancer, they should do this when the UV index is low, in winter, early in the morning, or later in the afternoon/evening, or ensure they use sun protection if the UV index is 3 or above.”
Professor Mackey is leading additional research using children participating in the Raine Study (Gen3) and the ORIGINS study in Western Australia to further refine the eye growth charts.
The study, the largest of its kind to date, involved researchers from Australia, Ireland, the Netherlands, the United Kingdom, Switzerland, Norway, Finland, Spain, Singapore, China, and Hong Kong SAR.
