Why Myopia Does Not End With LASIK: What Near-Sighted Parents Need to Know About Child Myopia Control and LASIK Eye Surgery
If you’re a parent who was once nearsighted — and especially if you had LASIK years ago — there’s a good chance you don’t think much about myopia anymore. You wake up, you see clearly, and life moves on.
But here is the important truth: LASIK corrected your vision. It did not erase your myopia. And it certainly did not erase the genetic risk for your child.
This blog is for parents who once struggled to see the board at school, wore thick glasses or contacts, maybe had LASIK in their 20s or 30s — and now have children growing up in a world far more visually demanding than the one they experienced.
First, A Reality Check: LASIK Does Not Cure Your Myopia
Procedures like LASIK reshape the cornea to correct how light focuses on the retina.
They improve vision remarkably well. But they do not:
Shorten the elongated eyeball — which is the true structural cause of myopia
Reduce the lifetime risks associated with higher myopia
Remove your genetic predisposition to becoming nearsighted
If you were −4.00 or −6.00 before surgery, your eye is still physically a myopic eye. You simply no longer need glasses. And your child may still inherit that same tendency.
Myopia Is Far More Than “Just Needing Glasses”
Many parents remember myopia as inconvenient but manageable. What is often forgotten is that the myopic eye is structurally elongated — and that extra length stretches and thins the retina and other delicate internal structures.
This structural change does not disappear with glasses, contact lenses, or LASIK. The eye remains elongated, and that elongation carries real, lifelong health consequences.
Higher levels of myopia significantly increase the lifetime risk of serious ocular conditions, including:
Retinal detachment – The retina is thinner and under greater tension in longer eyes, increasing vulnerability to tears and detachment.
Myopic macular degeneration – Progressive damage to the central retina that can lead to permanent vision loss, even in those who have had refractive surgery.
Glaucoma – Myopic eyes have structural characteristics that increase susceptibility to optic nerve damage.
Earlier cataract development – Higher myopes tend to develop visually significant cataracts at a younger age.
Critically, the relationship between myopia and disease risk is progressive. The higher the myopia, the greater the risk. Research published by Flitcroft (2012) in Progress in Retinal and Eye Research established that every additional diopter of myopia meaningfully increases risk.
Bullimore and Brennan (2019) quantified this further, demonstrating that reducing a child’s final myopia by just one diopter could reduce the lifetime risk of myopic maculopathy by approximately 40%. This is not a marginal benefit — it is clinically profound.
Every diopter of myopia matters. Reducing your child’s final prescription — even by one diopter — can substantially reduce their lifetime risk of serious eye disease.
Organisations including the World Health Organisation have identified myopia as a major and growing global public health concern. This is not about cosmetic inconvenience. It is about long-term eye health and quality of life.
Today’s Children Are Developing Myopia Earlier — and More Severely
Compared to previous generations, children today are spending more time on near work — tablets, phones, and extended homework — while spending significantly less time outdoors.
Screen exposure is beginning at very young ages. Research by Holden et al. (2016), published in Ophthalmology, projects that nearly half the world’s population could be myopic by 2050, with a significant proportion reaching high myopia.
If you were nearsighted, your child is already at elevated risk. If both parents were myopic, that risk increases substantially.
Why the Age of Onset Is Critical
Here is something many parents do not fully appreciate: the younger a child becomes myopic, the more severe their myopia is likely to become — and the greater the threat to their long-term ocular health.
The reason is straightforward. Myopia progresses during the years of active ocular growth. A child who becomes myopic at age six has far more years of potential progression ahead of them than one who becomes myopic at age twelve.
Research by Donovan et al. (2012) demonstrated clearly that younger age of myopia onset is one of the strongest predictors of a child’s final myopic outcome. A child who becomes myopic at age six is significantly more likely to reach high myopia (−6.00 dioptres or beyond) than one who becomes myopic at age twelve.
And it is high myopia that carries the most serious ocular health implications. Waiting until a prescription becomes “bad enough” before intervening is no longer considered best practice — and may result in outcomes that could have been meaningfully prevented. The goal of myopia management is not simply to reduce dependence on glasses during childhood. It is to reduce the final amount of myopia reached in adulthood — because that is what determines your child’s lifetime risk profile.
LASIK Is Not the Answer for Children
It is worth addressing directly the perception that myopia in childhood is not a serious concern because “they can always have LASIK later.” This reasoning, while understandable, overlooks several important realities:
First, LASIK and other refractive surgeries are not available to children. Prescriptions must be stable — typically for a minimum of two years — before surgery can even be considered, which generally means not until early adulthood at the earliest.
Second, not every patient is a suitable candidate for laser refractive surgery; suitability depends on corneal thickness, prescription level, and other ocular factors.
Third, and most importantly: the structural changes and associated health risks that accumulate during years of myopic progression are not reversed by LASIK. The eye remains elongated. The retina remains under tension. The elevated risks remain. The window during which the most significant damage risk accumulates is childhood and adolescence — not adulthood.
Waiting for LASIK is not a strategy that protects your child’s eyes. Early myopia management is a far better strategy.
Monitoring True Progression: The Role of Axial Length Measurement
One of the most important advances in myopia management is the ability to monitor not just a child’s spectacle prescription, but the actual physical growth of the eye itself.
This is done through a precise measurement called axial length biometry — a painless, non-invasive measurement of the length of the eye from front to back.
This matters because myopia is caused by the eye growing too long. A change in spectacle prescription reflects that growth, but it is a lagging indicator. Axial length measurement allows clinicians to detect changes in eye growth earlier, more accurately, and in a way that can be compared against age-expected norms for ocular development.
This provides a far more precise picture of whether a child’s myopia is progressing, stabilising, or responding to treatment.
Not all optometry practices are equipped to perform precise biometry. Practices that are well set up to manage myopia progression — such as ours — have the instrumentation and clinical expertise to measure and monitor axial length growth over time, giving families the most complete and accurate picture of their child’s ocular development.
This level of monitoring is particularly important because two children with the same spectacle prescription can have very different axial lengths — and therefore very different risk profiles. Comprehensive myopia management requires this depth of assessment.
What Is Myopia Control?
Myopia control refers to evidence-based treatments designed not merely to correct vision, but to actively slow the progression of myopia in children. The earlier these interventions begin, the greater the cumulative benefit — more years of slowed progression translates directly to a lower final prescription and a meaningfully reduced lifetime risk of ocular disease.
Current evidence-based options include:
Orthokeratology (Ortho-K) – Specially designed rigid lenses worn overnight that gently reshape the cornea, providing clear vision during the day without glasses or contact lenses, while also slowing eye growth.
Soft Myopia Control Contact Lenses – Dual-focus soft contact lenses such as MiSight 1 day are clinically proven to slow the progression of myopia in children. These are daily disposable lenses designed specifically for myopia management.
Low-Dose Atropine Eye Drops – Prescribed in very low concentrations (typically between 0.01% to 0.05%), these drops have been shown in multiple clinical trials to meaningfully reduce the rate of myopia progression with minimal side effects.
Lifestyle Modifications – Increasing outdoor time to a minimum of two hours per day, reducing prolonged near work, and introducing frequent breaks from intensive close work, all contribute to slowing progression.
The range of management options available, and their ease of implementation, is also generally greater when myopia is caught early at lower prescription levels. This is another compelling reason not to wait.
The Socioeconomic Case for Early Action
The impact of myopia extends beyond clinical outcomes.
High myopia carries a substantial lifetime socioeconomic burden, including the ongoing cost of optical correction (glasses and contact lenses), increased frequency of specialist eye examinations, and the cost of managing myopia-related complications in later life such as retinal disease or cataract surgery.
In some professions — including certain armed forces, aviation, and emergency services roles — very high myopia can also limit career options.
Early myopia management, by reducing the final level of myopia a child reaches, has the potential to reduce this burden significantly. The investment in early intervention is modest compared to the potential lifetime savings in both financial cost and quality of life.
“But I Turned Out Fine…”
This is something many parents who had LASIK understandably say. And it is true
— you are functioning well. But consider the context that has changed:
You may not have had screen based equipment exposure at an early age.
You may not have had six or more hours of daily near work during your primary school years.
You may not have had two myopic parents, compounding your genetic risk.
The visual environment children are growing up in today is fundamentally different from the one you experienced. And because LASIK resolved your day-to-day vision difficulties, it is easy to forget what progressive myopia felt like — and what it can mean for long-term eye health. Your experience is a reason to act early for your child, not a reason to wait.
Signs Your Child May Be Developing Myopia
Squinting to see distant objects clearly
Sitting very close to screens or the television
Complaining of headaches, particularly after school
Moving closer to the board or struggling to read it from their seat
Losing interest in activities that require good distance vision
It is also important to note that children do not always report visual difficulties — they often assume what they see is normal.
Even if your child passes a school vision screening, a comprehensive eye examination remains essential, particularly with a family history of myopia. School screenings are not a substitute for a full clinical assessment.
What You Can Do
Schedule a comprehensive eye examination early — and repeat it at least annually. Do not wait for your child to complain.
Ask specifically about myopia control options. A practice equipped to manage myopia progression will discuss axial length monitoring, evidence-based treatment options, and a management plan tailored to your child.
Encourage at least two hours of outdoor time daily. This is one of the most consistently supported environmental protective factors in the research literature.
Reduce prolonged near work and implement regular breaks from close work.
Stay proactive, not reactive. The earlier management begins, the greater the long-term benefit.
LASIK gave you visual freedom. But it did not erase your myopic eye structure — or the genetic risk you may have passed on. The good news is that we now have effective, evidence-based tools to actively manage childhood myopia in ways that simply were not available when you were growing up. If you once struggled to see clearly, you know firsthand what that journey felt like. Now you have the opportunity to give your child something even better: not just clear vision — but healthier eyes for life.
Frequently Asked Questions
Does LASIK cure myopia?
No. LASIK corrects how light focuses by reshaping the cornea, so you can see clearly without glasses. But it does not change the underlying structure that caused myopia in the first place, which is an eye that grew longer than average. That means your eye is still a “myopic eye” structurally, even if your vision is now improved.
If I had LASIK, can my child still inherit myopia?
Yes. LASIK does not remove the genetic tendency for myopia. If you were myopic before LASIK, your child has a higher risk of becoming short-sighted, especially if both parents were myopic.
Isn’t myopia just “needing glasses”, especially if LASIK is an option later?
Myopia is more than blurry distance vision. As myopia increases, the eye typically becomes more elongated, which can raise lifetime risk of serious eye problems such as retinal detachment, myopic macular degeneration, glaucoma, and earlier cataracts. LASIK does not reverse the eye’s elongation, so it does not remove those risk factors.
Can children get LASIK for myopia?
LASIK and other refractive surgeries are not available to children. Prescriptions must be stable — typically for a minimum of two years — before surgery can even be considered, which generally means not until early adulthood at the earliest.
Furthermore, not every patient is a suitable candidate for laser refractive surgery; suitability depends on corneal thickness, prescription level, and other ocular factors.
More importantly: the structural changes and associated health risks that accumulate during years of myopic progression are not reversed by LASIK. The eye remains elongated.
If my child can “just get LASIK later”, why does myopia control matter now?
The years when myopia often progresses the most are childhood and adolescence. The goal of myopia management is to slow progression while the eye is growing. The earlier the interventions begin, the greater the cumulative benefit. The goal is a reduced lifetime risk of ocular disease and a lower final prescription.
What are the main options to slow myopia progression (instead of waiting for LASIK)?
Evidence-based options commonly include:
Orthokeratology (Ortho-K): overnight lenses that provide clear daytime vision and can slow eye growth
Soft myopia control contact lenses: dual-focus designs made specifically for myopia management
Low-dose atropine drops: very low concentrations that can slow progression with minimal side effects for many children
Lifestyle changes: more outdoor time (often aiming for around two hours a day), plus breaks from prolonged close work
References
Bullimore, M.A. & Brennan, N.A. (2019). Myopia Control: Why Each Diopter Matters. Optometry and Vision Science, 96(6), 463–465.
Donovan, L., Sankaridurg, P., Ho, A., Naduvilath, T., Smith, E.L. & Holden, B.A. (2012). Myopia progression rates in urban children wearing single-vision spectacles. Optometry and Vision Science, 89(1), 27–32.
Flitcroft, D.I. (2012). The complex interactions of retinal, optical and environmental factors in myopia aetiology. Progress in Retinal and Eye Research, 31(6), 622–660.
Holden, B.A., Fricke, T.R., Wilson, D.A., Jong, M., Naidoo, K.S., Sankaridurg, P., Wong, T.Y., Naduvilath, T.J. & Resnikoff, S. (2016). Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology, 123(5), 1036–1042.
International Myopia Institute (2019). IMI – Clinical Myopia Control Trials and Instrumentation Report. Investigative Ophthalmology & Visual Science, 60(3), M132–M160.
World Health Organisation (2019). The Impact of Myopia and High Myopia: Report of the Joint World Health Organisation – Brien Holden Vision Institute Global Scientific Meeting on Myopia.
