Short-sightedness

Both parents short-sighted: what it means for your child

Mum wears minus five, Dad wears minus four, and you wonder whether your child is bound to follow. What the studies say about the odds, what else matters, and what a family can do from the start.

by Dr Chan Li Yen · MBBS, MOphth (UM), Fellowship in Paediatric Ophthalmology & Strabismus

Dr Chan Li Yen, consultant paediatric ophthalmologist, MMC 43128, NSR 132980 · Eagle Eye Centre Kuala Lumpur, Petaling Jaya

11 min read · 2,008 words

Key takeaways

Short-sighted parents raise a child's odds of short-sightedness, and two raise them more than one. In a study of 9,793 children under 6 across Singapore, Los Angeles and Sydney, the odds were 1.42 times higher with one short-sighted parent and 2.70 times with two.
Odds are not a chance. Most of the studies describe groups, and none can say what one child's eyes will do.
A parent who became short-sighted in childhood counts for more than one who needed glasses as an adult, so the age you first wore glasses is worth telling the eye doctor.
Genes are not the whole picture. Time outdoors lowers the average risk modestly in school trials, and it will not cancel what a family carries.
Book an eye examination rather than relying on a chart, before school age if a parent is short-sighted. Nothing sold as a cure for short-sightedness is real.

Mum is minus five. Dad is minus four. It is easy to look at the baby and think she does not stand a chance, and just as easy to feel it was your doing.

This page is about that worry. It sets out what having short-sighted parents (rabun jauh in the family) really changes for a child, what it does not change, and what a family can do from the start. Nothing here is a prediction for one child, and nothing here is a reason to feel at fault.

If both of us are short-sighted, will our child be too?

Not for certain, but the odds are higher. In a study of 9,793 children aged 6 months to 6 years from Singapore, Los Angeles and Sydney, the odds of short-sightedness were 1.42 times higher with one short-sighted parent and 2.70 times higher with two, compared with none. They rose to 3.39 times when both parents had become short-sighted in childhood. The pattern held in Asian, African American, Hispanic and white children alike.

"Odds" is not the same as "chance". A figure of 2.70 does not mean a child is 2.7 times as likely to need glasses, and it does not mean most of these children will. It means the family background shifts the balance. In an older California study of 366 eighth-grade children, the odds were 6.4 times higher with two short-sighted parents, but the possible range was very wide, from about 2 to about 19. Treat these as a direction, not a verdict.

For plain percentages in 12-year-olds, your first child wears glasses: what about the second sets out an Australian study, and it is honest about what is not known for brothers and sisters. The action: read your own family history as a reason to look early, not as a forecast.

Is the risk already there before my child needs glasses?

Often, yes, in the way the eye is growing. In that same multi-country study, children of short-sighted parents had a longer eye relative to the curve of the front surface, and a more short-sighted measurement, even among children who were not yet short-sighted. In a Hong Kong study of Chinese children aged 5 to 16, the eye grew faster in those with a stronger parental history: about 0.37 mm a year with two short-sighted parents, 0.26 mm with one and 0.20 mm with none.

Those are group averages over one year. They show a head start in growth, and they do not tell you what one child's eyes will do. A child who has already been measured and called "at risk" has a page of her own: pre-myopia: at risk but not short-sighted yet covers her side. This page stays on yours. The action: if you are short-sighted, say so at your child's first eye visit, with the age you first needed glasses.

If genes matter this much, is there anything we can change?

Yes. Genes are the strongest single factor in the studies, but they are not the whole picture. The same California study that found the strong parental link also found smaller, separate contributions from near work and from less time in sport. The International Myopia Institute review of risk factors says time outdoors is protective, confirmed in randomised trials, that more years of schooling raise the risk, and that studies of near work give inconsistent results.

One American study followed 514 children, and 111 of them became short-sighted. Low levels of sport and outdoor activity raised the odds more in children with two short-sighted parents than in children with none or one. That is an observation, not a trial, but it points the same way as the trials. In Guangzhou, adding one 40-minute outdoor class to each school day for six-year-olds went with 30.4% becoming short-sighted over three years, against 39.5% in the comparison schools. A Cochrane review of five trials and 10,733 children found 22.5% against 26.7% after two years.

So outdoor time lowers the average, modestly, and it will not cancel what a family carries. The trials were in school-age children, mostly aged six to nine, and not in Malaysian children. Free, good for any child, and worth doing; the sizing is in two hours outside: the cheapest myopia habit, sized honestly. The action: find a shaded outdoor hour, in the cooler part of the day, and do it most days.

Does it matter which parent, which sibling, which grandparent?

The studies count parents, and they count when the parents became short-sighted. The multi-country study found that short-sightedness beginning in childhood in a parent was linked more strongly to a child's short-sightedness than adult-onset. So "how old were you when you first needed glasses?" is a more useful question than "do you wear glasses?". A parent who needed glasses in childhood counts for more in these studies than one who needed them at thirty.

Grandparents were not counted in the studies above, so there is no number to give for them, and no honest sibling figure either. What a grandparent's glasses can do is tell you which side the family trait came from, and remind you that their own eyes need checking too. Eye checks for the whole family covers the adult side, from reading vision to cataract and glaucoma. A parent with a high prescription should also know the warning signs of a retinal tear, which are set out in spots floating in the sight: floaters, flashes and when to go today, because being very short-sighted is a listed risk for retinal detachment.

If an older child already wears glasses, the younger ones are worth a look sooner, not later. The action: write down who in the family is short-sighted, from which age, and keep the note with the child's health book.

When should our child's eyes be checked, and how?

By an eye examination, not a chart alone, and early rather than late. A chart answers whether a child sees well today. It does not show where the eyes are heading, and a child can pass it and still be on the way to short-sightedness. In a Klang Valley school study reported in The Star, short-sightedness peaked at 44.7% at age nine, and the lead researcher advised that eye checks begin in preschool or at least by age seven. That is her advice for the population, not a rule for a family with a history.

Malaysia already has checks along the way: the klinik kesihatan child health book, and school screening in Year 1, Year 6 and Form 3. Who is covered and what a pass means is set out in children's eye checks in Malaysia and the first eye test before school. A screening is a quick pass or refer on one day, and it is not an eye examination.

At a full examination, drops are used so the eye's focusing muscle relaxes and the measurement shows the real power. The American Association for Pediatric Ophthalmology and Strabismus describes one kind of drop that relaxes the eye's ability to focus (cycloplegia) and another that enlarges the pupil, usually given together. Relaxing the focusing is the point: it lets the measurement show the eye's real power. The action: with a short-sighted parent at home, book an examination before school age, and ask whether drops will be used.

What should we not buy into?

Anything sold as a cure. No eye drop, supplement or exercise reverses short-sightedness, because the eyeball has grown longer than it should and nothing shortens it again. Drops marketed that way have been reported to contain steroids, which can raise eye pressure; the details and the registration check are in eye drops that cure short-sightedness.

What exists is slowing, and it is for an eye doctor to prescribe: low-dose atropine drops and some special lenses, with evidence of different strength, set out in the guide to myopia control in Malaysia and in slowing myopia down: drops, lenses and honest numbers. They are for a child who is already short-sighted, after an examination. They are not a purchase to make because the parents wear glasses.

And one last thing. A child's short-sightedness is not a parent's failure. The action: if someone offers a cure, ask for the registration number and the name of the doctor who will follow the child, then book an examination first.

Book the eye check now, not at the next routine slot, if your child…

Squints or screws up the eyes to see things far away.
Sits very close to the screen or the television.
Says the board at school is blurry, or has headaches after reading.
Brings home a school screening letter that says to see an eye doctor.
Has an eye that turns in or out, or seems to see less with one eye.

Common questions

Both my husband and I are short-sighted. Will our child definitely be?

No. The odds are higher, but nothing is certain. In a study of 9,793 children aged 6 months to 6 years, two short-sighted parents went with 2.70 times the odds of short-sightedness compared with none. That describes groups of children, and it cannot tell you what one child's eyes will do.

How much does having one short-sighted parent raise the risk, compared with two?

In the same multi-country study, the odds were 1.42 times higher with one short-sighted parent and 2.70 times higher with two, compared with none. They rose to 3.39 times when both parents became short-sighted in childhood. These are odds ratios, not the chance that a child will need glasses.

Does it matter how old I was when I became short-sighted?

It seems to. The multi-country study found that a parent's short-sightedness beginning in childhood was linked more strongly to the child's short-sightedness than adult-onset. When you see an eye doctor, say how old you were when you first needed glasses.

Can playing outdoors cancel the genes?

No, but it helps on average. A Cochrane review of five trials with 10,733 children found 22.5% became short-sighted in two years with extra outdoor time, against 26.7% without. A California study found low outdoor activity raised the odds more in children with two short-sighted parents. It lowers risk modestly and promises nothing for one child.

When should a child with short-sighted parents have the first eye examination?

No study gives an age that fits every family. A Klang Valley researcher reported in The Star advised eye checks from preschool, or at least by age seven. With short-sighted parents at home, an examination before school age is reasonable, and asking whether drops will be used to measure the true power.

Is there a drop or supplement to stop it running in the family?

No eye drop, supplement or exercise cures short-sightedness. Drops sold as a cure have been reported to contain steroids, which can harm the eye. Low-dose atropine drops slow the climb in a child who is already short-sighted, prescribed and followed by an eye doctor.

My husband is short-sighted but I am not. Does that count?

Yes. In the multi-country study, one short-sighted parent was linked to 1.42 times the odds in the child compared with no short-sighted parent. That is a smaller rise than for two parents, and it is still a reason to have the child's eyes examined rather than only screened.

What about brothers and sisters, and grandparents?

The studies count parents only, so there is no honest figure for siblings or grandparents. If an older child already wears glasses, a younger one is worth examining sooner. A grandparent's glasses can show which side of the family the trait came from.

References

JAMA Ophthalmology · Association of Parental Myopia With Higher Risk of Myopia Among Multiethnic Children Before School Age (Jiang et al., 2020) · pubmed.ncbi.nlm.nih.gov
Investigative Ophthalmology & Visual Science · Parental myopia, near work, school achievement, and children's refractive error (Mutti et al., 2002) · pubmed.ncbi.nlm.nih.gov
Investigative Ophthalmology & Visual Science · Parental history of myopia, sports and outdoor activities, and future myopia (Jones et al., 2007) · pubmed.ncbi.nlm.nih.gov
Investigative Ophthalmology & Visual Science · The effect of parental history of myopia on children's eye size and growth (Lam et al., 2008) · pubmed.ncbi.nlm.nih.gov
Investigative Ophthalmology & Visual Science · IMI Risk Factors for Myopia (Morgan et al., 2021) · pubmed.ncbi.nlm.nih.gov
JAMA · Effect of Time Spent Outdoors at School on the Development of Myopia Among Children in China (He et al., 2015) · pubmed.ncbi.nlm.nih.gov
Cochrane Database of Systematic Reviews · Interventions to increase time spent outdoors for preventing incidence and progression of myopia in children, 2024 (CD013549, PMC copy) · pmc.ncbi.nlm.nih.gov
AAPOS · Dilating eye drops · aapos.org
The Star · Too many kids with eye problems (26 August 2025) · www.thestar.com.my

By Dr Chan Li Yen. General information only. It does not replace a consultation. If you are worried about your child's eyes or vision, please see an eye doctor.