A significant increase in myopia among young children in Hong Kong is projected, according to recent findings from the Hong Kong Association of Private Practice Optometrists. The association warned that up to two-thirds of eight-year-olds could be nearsighted by 2028, a rise linked to a diminishing "hyperopic reserve," which normally helps delay the onset of short-sightedness.
The association conducted a screening of more than 3,500 primary school students across eight schools between November and May. Their results revealed that 67 percent of six-year-olds already exhibited less hyperopic reserve than the recommended threshold of 0.75 diopters, while nearly a quarter of these children were found to be myopic. Hyperopic reserve refers to the natural farsightedness present at birth, which decreases as the eye grows and serves as a protective mechanism against early myopia development. Children who lose this reserve prematurely are more vulnerable to becoming shortsighted.
Drawing on research from mainland China, which indicates that 62 percent of children with insufficient hyperopic reserve develop myopia within two years, the association forecasts that 66 percent of these six-year-olds could become myopic by the time they reach eight years old. Queenie Yip Siu-lai, the association’s president and chairwoman of its task force on children’s eye health policy, emphasized the urgent need for timely intervention to mitigate what she described as “the heavy burden of related eye diseases” that come with high myopia.
Comparative data from a recent cross-border study showed that the average hyperopic reserve for seven-year-old children in Hong Kong was 0.78 diopters, markedly lower than averages reported in Europe (1.44 diopters) and Australia (1.32 diopters). Benny Tam Bing-tin, vice-chairman of the task force, noted that while hyperopic reserve is innate and cannot be restored—paralleling the irreversibility of myopia—factors such as the size of the child’s home and time spent outdoors can influence its depletion. He stressed the importance of early identification and intervention for children with insufficient hyperopic reserve.
The association advocates that parents begin comprehensive eye examinations for their children starting at age three. It also recommends lifestyle modifications such as increasing outdoor activities, limiting screen time, maintaining proper reading distance and posture, and ensuring adequate rest to help protect children’s vision. Additionally, the association has called on the government to implement policies addressing childhood myopia management and to enhance public awareness.
A separate survey conducted in September involving 67 association members found that nearly 80 percent of parents did not seek eye checks for their children until vision difficulties became apparent or screenings detected problems, highlighting a gap in proactive eye care.
The personal case of seven-year-old Owen illustrates these concerns. After he failed an eye screening two years ago, he was diagnosed with significant myopia—100 degrees in his left eye and 850 degrees in the right. His condition worsened during the subsequent summer to 150 degrees and 1,050 degrees respectively. Owen’s grandmother recalled early signs such as uneven eyes and a leaning posture during writing, which were not initially linked to vision problems. Following the prescription of myopia control glasses and lifestyle adjustments including limited screen time and increased physical activity, his vision has since stabilized.