Can your child see clearly? Should you take them to test their eyesight?

You’re right to be concerned, because Singapore’s myopia rate is among the highest in the world. In fact, 65 per cent of children here are myopic, or shortsighted, by age 12.

What’s more, up to 20 percent of children in Singapore have high myopia. But what does this actually mean?

Here’s what you should know: myopia or shortsightedness happens when the eye grows a little too long, or when either the cornea (the clear front surface of the eye) or the lens (inside the eye) is too curved. The cornea and the lens are different parts, but together they focus light so it lands on the retina — a light-sensitive layer at the back of the eye that sends signals to the brain.

If the cornea or lens bends the light entering the eye too much, the focus falls in front of the retina instead of on it. This makes far-away things look blurry. Nearby things still look clear, because the light from close objects doesn’t need as much bending to reach the retina.

As for high myopia, it is usually defined as more than -5.00 to -6.00 diopters (D) in each eye, depending on the guideline used. 

In Singapore, many people use the term “degrees” instead of diopters, where 100 degrees = -1.00 D. A higher diopter value, such as -6.00 D (600 degrees), indicates more severe myopia compared to -2.00 D (200 degrees).

With high myopia, stronger lenses are required to bring the light back into focus on the retina for clear vision.

Bearing all of this in mind, how will you know if your child’s eyes are less than healthy? And what can be done if your child is having eyesight issues? We’ll answer your questions below!

Will my child's eyesight be tested in primary and secondary school? What health screenings are covered in Singapore schools?

Yes, your child’s eyesight will be tested, if they attend a Singapore primary school.

Students in a Singapore primary or secondary school will have access to the following screening tests by the Health Promotion Board:

Currently, local children will receive school-based vision tests from Primary 1 to Primary 4. In Primary 5, they will only go through a colour vision screening test.

If, after testing, it is determined that a child needs further assessment, they will be given an appointment to be reviewed by a qualified optometrist or optician. They may also be referred to the Health Promotion Board’s Student Health Centre.

I’ve received notification that my child’s vision levels are fine. Should I still watch out for vision symptoms?

Yes you should. Vision levels can deteriorate at any time, so the Health Promotion Board’s advice is to stay alert, and look out for the following signs from your child:

• Saying that distant objects appear blurry
• Consistently sitting too close to the TV or holding a book too close when reading
• Squinting or tilting the head to see better
• Frequent eye rubbing
• Sensitivity to light and/or excessive tearing
• Closing one eye or frowning to read or watch TV
• Avoiding activities that require near vision, such as reading or homework, or distance vision, such as participating in sports or other recreational activities
• Complaining of headaches or tired eyes
• Making mistakes when copying from the board

If you notice any of the above, it’s better to consult a professional on your own, instead of waiting till the next school screening.

Should my child see an optician, optometrist, or eye specialist in Singapore? What’s the difference?

In Singapore, opticians, optometrists, and eye specialists play different roles in eye care.

An optician is trained to make and dispense glasses or contact lenses based on an existing prescription. Their main role is fitting and adjusting eyewear, and some may also provide basic vision checks. Local opticians might hold a Higher Nitec certificate in opticianry, and they are required to register with the Opticians and Optometrists Board (OOB).

You might see an optician if your child already has a prescription and simply needs new glasses made, repaired, or adjusted.

An optometrist is a healthcare professional who can carry out comprehensive eye exams, test vision, and detect common eye conditions such as myopia. They also fit contact lenses, and can advise on myopia control methods, such as special lenses or atropine drops.

In Singapore, optometrists will minimally require a diploma to practice, and they too will need to register with the Opticians and Optometrists Board. Do note that they are not medical doctors.

Parents usually bring their children to an optometrist for regular eye checks and monitoring of myopia progression. If you are budget-conscious, the optometrist is the first professional to see, and they will refer you to a specialist if needed.

An eye specialist, or ophthalmologist, is a fully qualified medical doctor who has completed medical school and several years of specialist training in eye diseases and surgery.

These are the only professionals who can diagnose and manage complex eye conditions, prescribe the full range of medications, and perform surgical procedures, such as squint correction in children.

Some parents prefer to bring their child directly to an eye specialist, because of the reassurance of medical training and access to advanced tests such as retinal scans, which may not be available at an optometry practice.

The trade-off is cost: specialist consultations and tests at private clinics are typically more expensive than optometrist visits, although public hospital clinics may be subsidised.

You should see an eye specialist if your child has very high or rapidly worsening myopia, if vision does not improve with glasses, or if an eye care professional recommends further evaluation.

Need advice on eye checks? The KiasuParents forum has a Health section for parents to share tips!