Vietnam's myopia crisis: 30-40% of school children now nearsighted

Trương Vĩnh Thành brought his four-year-old daughter to the HCM City Eye Hospital expecting a routine checkup. Instead, he learned she was already nearsighted—0.75 dioptres of myopia, a condition he had not suspected until the examination revealed what her squinting and complaints of tired eyes after tablet use had been signaling. The discovery was unsettling enough on its own. It became alarming when the family realized that his older daughter, nine years old, had been wearing glasses for more than two years with a prescription of 3.5 dioptres, and that her vision was worsening faster than expected. At her most recent checkup, her prescription had jumped by more than one dioptre in a single year. Neither parent wore glasses. Both had taught their children proper posture while studying. Yet both daughters were now myopic, and the condition was advancing.

They are not alone. Across Vietnam, myopia has become a defining health crisis of childhood. The Ministry of Health reports that approximately five million school-age children—between 30 and 40 percent of the student population—now have refractive errors, with myopia accounting for the majority. In urban areas, the numbers are far more severe. A survey by the National Eye Hospital found that more than a quarter of secondary school students in cities are nearsighted, compared to roughly 14 to 16 percent in rural areas. In one HCM City classroom, nearly 76 percent of children had refractive errors; more than half of those were myopic. The condition is appearing earlier in childhood and progressing faster than it did a generation ago.

Doctors at specialized eye hospitals are seeing the acceleration firsthand. Nguyễn Huỳnh Yến Nhi, an ophthalmologist and head of the Myopia Control Centre at Sài Gòn Eye Hospital, has treated many children whose prescriptions have strengthened by more than one dioptre within a single year—a rate of change that, left unchecked, can lead to serious complications. The culprits are familiar: children spend hours studying, reading, and staring at smartphone and tablet screens while outdoor play and exercise have declined. Poor lighting in classrooms, inadequate viewing distances, and slouched posture compound the problem. But the real danger lies not in needing glasses. It lies in what happens when myopia progresses unchecked into what doctors call high myopia.

Each additional dioptre of myopia carries measurable risk. According to Dr. Trần Đình Minh Huy from the Refractive Surgery Department of the HCM City Eye Hospital, every dioptre increase raises the risk of blindness-causing eye diseases by 67 percent. As myopia worsens, the eyeball physically elongates, stretching the retina and increasing the likelihood of retinal damage, degeneration, and detachment—conditions that can result in severe vision loss or permanent blindness. The progression from a child needing glasses to a teenager at risk of sight-threatening complications can happen quietly, over months or a few years, while parents simply buy stronger lenses and move on.

This is where the medical approach must shift. Doctors emphasize that the goal cannot be merely to correct blurred vision with new glasses. The goal must be to slow myopia's progression before it accelerates into high myopia. This requires early detection, before a child's prescription begins to climb significantly, followed by regular monitoring and timely intervention. Dr. Nhi warns that children often adapt to reduced vision without complaining to their parents—a child may simply accept that the blackboard is blurry and stop mentioning it. Parents cannot wait for a child to say they cannot see. They must bring children for regular eye examinations at specialized facilities, particularly when prescriptions are changing rapidly.

The potential payoff is substantial. Controlling each dioptre of myopia progression can reduce the risk of serious eye complications later in life by approximately 40 percent. Yet the current system is not structured for this kind of early intervention. Schools check whether light bulbs work but rarely measure actual light levels at students' desks or assess glare on blackboards and screens. Desk and chair arrangements often do not account for children's varying heights and developmental stages, forcing some students to lean forward or crane their necks to see. The health sector in HCM City has begun implementing periodic eye examinations for students and has called on schools to improve lighting conditions and furniture arrangement, but the effort remains fragmented.

For families like Trương Vĩnh Thành's, the path forward is now clear: frequent monitoring, early intervention, and a shift away from the assumption that glasses are a solution in themselves. For the millions of Vietnamese children whose vision is already changing, the window for prevention is closing. The question is whether the country's schools and health system can move fast enough to catch them before myopia becomes not a manageable condition requiring glasses, but a threat to sight itself.