A child sitting at the back of the classroom gets up to copy something from the board.
Another moves closer to the television, squints when looking at distant objects or rubs their eyes more often.
None of these behaviours may seem particularly alarming, especially when the child never says there is anything wrong.
But that is precisely what makes childhood myopia easy to miss.
“Most of the kids don’t complain. What they do is adapt,” said Ara Damansara Medical Centre Consultant Ophthalmologist, Paediatric Ophthalmologist and Strabismus Surgeon Dr Norazah Abdul Rahman.
For children, blurry distance vision can simply become their version of normal, particularly when myopia develops gradually.
Instead of telling their parents they cannot see clearly, they find ways to compensate, often without realising they are doing it.
When children learn to adapt
“They might squeeze their eyes like that to see and focus, or they may develop other kinds of behavioural adaptations to make the image clearer,” she said.
There is another reason parents should not rely entirely on what their child says they can see. If one eye has poorer vision while the other sees normally, a child may continue behaving as though nothing is wrong.
That is why early eye checks matter, particularly for children with a family history of myopia, rather than waiting for them to complain about their vision.
The urgency is also growing beyond individual children. Myopia has become a global public health concern, with projections suggesting that half the world's population could be short-sighted by 2050.
More than a screen-time problem
Screens are an obvious part of modern childhood, but Dr Norazah says the issue is broader than the device itself.
Children are spending more time on activities that require sustained near vision, whether that means phones, tablets, computers or reading, while spending less time outdoors.
“Kids nowadays are very digitally oriented. They are doing a lot of near work, whether it is looking at screens for education, social media, games or entertainment. Everything is on a screen nowadays,” she said.
Near work is one risk factor, while genetics also plays a role.
Outdoor exposure, meanwhile, appears to offer a protective effect, which is why the goal should not simply be to take screens away, but to create a healthier balance between close-up activities and time spent looking into the distance.
Dr Norazah recommends at least two hours of outdoor daylight exposure a day.
“Make sure they get at least 120 minutes of good sunlight a day - a good two hours a day,” she added.
Catching it before it catches up
Age matters because myopia that begins early can progress more quickly.
“But we only see this faster progression when myopia has an early onset, such as when a child develops myopia at four years old, compared with someone who starts developing it at around seven or eight years old,” said Dr Norazah.
The aim is not simply to wait until a child needs stronger glasses, but to identify myopia early and manage its progression.
“If you don't give the child glasses, the power will increase faster. By the time you realise it, the prescription may already be too high,” she said.
For parents, that means looking beyond the obvious signs and not assuming that a child who never complains is necessarily seeing well.
With so much of children’s time now spent on screens, indoors and doing near work, simple habits such as spending more time outdoors and getting their eyes checked can make a real difference to their vision. - POP FAMILY