Results from a 20-year study suggest measuring children’s refractive error as early as age six could help predict those who will become nearsighted by the eighth grade. 

Researchers for the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) study followed 4,500 children with normal vision between the ages of six and 11 years, evaluating at this range of baseline ages and at least two additional annual visits using cycloplegic autorefraction. 

The researchers initially set out to see “what measures could we have done in first grade to predict who was going to need glasses by the eighth grade?” said lead author Karla Zadnik, OD, PhD, professor and dean of the College of Optometry at The Ohio State University.

The final answer? Screen children to evaluate whether they have more or less hyperopia. Children who grow up to have normal vision are actually somewhat hyperopic in first grade, so those who have little to no hyperopia at an early age are likely to develop myopia as their eyes continue to grow, the study found. 

The results are applicable across all ethnicities, too. The study’s racial composition included white, Hispanic, African American, Native American and Asian American children.

“The prevalence of nearsightedness differs among ethnicities, but the mechanism is the same.” Dr. Zadnik said. “If you become nearsighted, it’s because your eyeball has grown too long. This prediction model works.”

The study also contradicts the notion that near work—such as frequent reading, playing electronic devices or sitting too close to the TV—can bring on myopia. “In this large dataset from an ethnically representative sample of children, we found no association,” Dr. Zadnik said. 

The researchers hope these results will eventually lead to mandated eye exams before kids enter school, giving parents the opportunity to better plan for their child’s future vision needs. 

“At an eye examination as early as first grade, an optometrist can provide parents with an idea of how likely their child is to develop myopia by eighth grade,” Dr. Zadnik says. “This might be of particular interest to parents who are themselves myopic and worried about their child in that regard, and the information could be used to guide the eye exam schedule for a given child.”

Zadnik K, Sinnott LT, Cotter SA, et al. Prediction of juvenile-onset myopia. JAMA Ophthalmol. 2015 Apr 2. [Epub ahead of print].