Myopia (Nearsightedness)

What is myopia?

Myopia is the medical name for nearsightedness, which means that you can see objects that are near clearly but have difficulty seeing objects that are farther away. For example, if you have nearsightedness, you may not be able to make out highway signs until they’re just a few feet away.

Myopia affects a significant percentage of people. It’s an eye focus disorder that’s normally corrected with eyeglasses, contact lenses or surgery.

How common is myopia?

Myopia is common. According to one estimate, more than 40% of people in the U.S. have nearsightedness. This number is rapidly rising, especially among school-aged children. Eye experts expect this trend to continue in the coming decades.

One in four parents has a child with some degree of nearsightedness. Some eye experts believe that if your child spends a great deal of time engaged in “near” activities, such as reading or using smartphones and computers, it may raise their risk of developing myopia.

Are there types of myopia?

Eye specialists divide myopia broadly into simple myopia and pathologic myopia. Pathologic myopia is a newer name for degenerative myopia.

People with simple myopia have contact lenses or eyeglasses that help provide clear vision, while those with pathologic myopia may not be able to have clear vision even with corrective lenses.

What are the symptoms of myopia?

If you have nearsightedness, you may notice:

• Faraway objects look blurred or fuzzy.
• Close items appear clear.
• Headaches.
• Eye strain.
• Squinting.
• Tiredness when driving, playing sports or looking more than a few feet away.

Some additional symptoms of myopia to watch for in your children include:

• Poor performance in school.
• Shortened attention span.
• Holding objects close to their face.

Most cases of myopia are mild and easily managed with eyeglasses, contact lenses or refractive surgery.

What causes myopia?

If you have myopia, more than likely, at least one or both of your biological parents do, too. Eye experts are still unsure of the exact cause of myopia, but believe it to be a mix of hereditary and environmental factors.

It’s possible that you can inherit the ability to be myopic. If your lifestyle produces just the right conditions, you’ll develop it. For example, if you use your eyes for a lot of close-up work, like reading or working on a computer, you may develop myopia.

Myopia usually appears in childhood. Typically, the condition can worsen in early childhood but tends to level off by the end of teen years.

Because the light coming into your eyes doesn’t focus correctly, images are unclear. Think of it as being a little like a misdirected spotlight. If you shine a spotlight on the incorrect place in the distance, you won’t be able to see the correct object clearly.

What are the risk factors for myopia?

Risk factors for nearsightedness may include:

• A family history of myopia.
• Spending a lot of time doing “close-up” work, like reading or using screens like those on smartphones or computers.
• Not spending a lot of time outdoors. Certain studies indicate that this may be a factor in developing myopia.
• Ethnicity. Some groups of people have higher rates of myopia than others.

What are the complications of myopia?

In most cases, providers can treat nearsightedness with glasses, contact lenses or corrective surgery, like LASIK. However, some cases of pathologic myopia can lead to more serious eye conditions, including:

• Cataracts.
• Glaucoma.
• Optic neuropathy.
• Neovascularization.
• Retinal detachment.

Pathologic myopia may make you more vulnerable to other more serious eye conditions. These include:

• Developing unwanted blood vessels in your eye (neovascularization).
• Glaucoma.
• Myopic optic neuropathy.
• Retinal detachment.
• Cataracts.

High myopia happens when your child’s eyeballs are too long, or their corneas are too steep.

How is myopia diagnosed?

An eye care provider can diagnose myopia using standard eye exams. Providers usually diagnose myopia in childhood, but it can also develop in adults because of visual stress or diabetes.

Testing an adult for myopia

Your provider will evaluate how your eyes focus light and measure the power of any corrective lenses you may need. First, they’ll test your visual acuity (sharpness) by asking you to read letters on an eye chart. Then, they’ll use a lighted retinoscope to measure how your retina reflects light.

Your provider may also use a phoropter. A phoropter is an instrument that measures the amount of your refractive error by placing a series of lenses in front of your eyes. This is how your provider measures the lens strength you need.

Testing your child for myopia

Your pediatrician will check your child’s eyes at each well-child visit. A first eye exam should be before age 1, if possible. If your child has no evident eye problems, then schedule a repeat eye exam before kindergarten.

As myopia runs in families, if your child has family members with vision issues, it’s even more important to test their eyes early. If you or your pediatrician notice any vision issues, your child may be referred to an optometrist or pediatric ophthalmologist.

During a children’s eye exam, your eye care provider will do a physical examination of your child’s eyes and check for a regular light reflex. For children between the ages of 3 and 5 years, your provider will also conduct vision screenings using eye chart tests, pictures, letters or the “tumbling E game,” also called the “Random E’s Visual Acuity Test.”

As your child’s vision continues to change as they grow, continue to make sure they get vision screenings by their pediatrician or eye care provider before first grade and every two years thereafter. While most schools conduct eye screenings, they’re usually not complete enough to diagnose myopia. Providers diagnose most children when they’re between the ages of 3 and 12.

Your provider may mention categories — mild, moderate or high myopia. These terms refer to the degree of nearsightedness as measured by refractive error. Refractive errors are issues with the natural shape of your eyes that make your vision blurry. It’s possible to have myopia and another refractive error, like astigmatism.

How is myopia treated?

Glasses or contact lenses can correct myopia in children and adults. For adults only (with rare exceptions for children), there are several types of refractive surgeries that can also correct myopia.

With myopia, your prescription for glasses or contact lenses is a negative number, such as -3.00. The higher the number, the stronger your lenses will be. The prescription helps your eye focus light on your retina, clearing up your distance vision.

• Eyeglasses: The most popular way for most people to correct myopia is with eyeglasses. Depending on the degree of vision correction needed, you’ll wear eyeglasses either daily or only when you need distance vision. You may only need glasses for driving. Some kids with myopia may only need glasses to play ball, watch a movie or view the chalkboard. Some people may need to wear glasses constantly to see clearly. A single-vision lens will make distance vision clearer. But people over 40 who have myopia may require a bifocal or progressive lens to see clearly both near and far.
• Contact lenses: Some people find that their distance vision is sharper and wider with contact lenses. A potential downside is they require more care to keep clean. Ask your provider which type might be right for your myopia level and other refractive errors.
• Ortho-k or CRT: Some people with mild myopia may be candidates for temporary corneal refractive contact lenses that you wear to bed to reshape your cornea temporarily, long enough to see for your daily activities.
• LASIK is a laser-assisted in situ keratomileus procedure, the most common surgery to correct nearsightedness. In a LASIK procedure, your ophthalmologist uses a laser to cut a flap through the top of your cornea, reshape the inner corneal tissue and then drop the flap back into place.
• LASEK is a laser-assisted subepithelial keratectomy procedure. In a LASEK procedure, your ophthalmologist uses a laser to cut a flap through only the top layer (epithelium) of your cornea, reshape the outer layers, and then close the flap.
• PRK is short for “photorefractive keratectomy,” which is a type of laser eye surgery used to correct mild or moderate nearsightedness. It may also correct farsightedness and/or astigmatism. In a PRK procedure, your ophthalmologist cuts off the front surface of your cornea and uses a laser to reshape the surface, which flattens it and allows light rays to focus on your retina. Unlike LASIK, the ophthalmologist doesn’t cut a flap, and your cornea will regrow its top layer in one to two weeks. PRK is better for people with corneas that are thinner or have a rough surface because it disrupts less corneal tissue than a comparable LASIK surgery.
• Phakic intraocular lenses: These are an option for people who have high myopia or whose corneas are too thin for PRK or LASIK. Your provider places phakic intraocular lenses inside of your eye just in front of your natural lens.
• Intraocular lens implant: This allows your ophthalmologist to surgically insert a new lens in your eye, replacing your natural one. This procedure happens before a cataract develops.
• Vision therapy: This is an option if spasms of your focusing muscles cause myopia. You can strengthen the muscles through eye exercises and improve your focus. This treatment isn’t appropriate for everyone with myopia. After an eye exam, your ophthalmologist will let you know if it’s an option for you.

Can myopia be prevented?

You can’t prevent myopia as it’s a condition that tends to run in families, but you may be able to lower your risk of nearsightedness in some ways.

How can I lower my risk of developing myopia?

Some eye experts believe that you may be able to decrease your or your child’s risk of developing myopia by getting enough time outside and limiting the amount of time spent in front of screens. You may also want to be mindful of the amount of time doing close work like reading or sewing.

What can I expect if I have myopia?

Myopia is a condition that doesn’t go away. Treatments include using glasses or contact lenses. You may be able to get surgery to correct your vision.

What is the outlook for myopia?

The outlook for being nearsighted may differ depending on the type of myopia.

Usually, providers can treat simple myopia easily. In rare cases of high myopia or pathologic myopia, your outlook may be different.

High myopia usually stops getting worse between the ages of 20 and 30. You’ll still be able to get glasses or contact lenses or you may be able to have surgery.

High myopia may lead to pathologic myopia and the possibility of more serious sight conditions later in life. These complications can lead to loss of sight.

Regular eye exams are important for everyone but are especially if you have high myopia or pathologic myopia. You should follow the schedule set out by your eye care provider.

How can you prevent myopia from getting worse?

Though there’s no cure for myopia, there are everyday steps you can take that can support your overall eye health. These days, it’s especially important to set limits for your children (and yourself) on activities that lead to eye strain.

Try these sight-saving tips:

• Limit time on digital devices.
• Take screen breaks to stretch your eye muscles.
• Don’t read or work in dim light.
• Go outdoors and wear sunglasses when you’re out.
• Wear protective eye gear for sports/hobbies.
• Stop smoking.
• Schedule regular eye exams.
• Ask your provider about atropine eye drops to slow progression.
• Ask your provider about dual-focus contact lenses to slow progression in kids.

Which foods should I eat to keep my eyes as healthy as possible?

Everyone’s eyes rely on nutrients from the foods we eat to maintain vital eye tissues and functions. Nutrition is especially essential to your child’s vision as their eyes grow and develop. In addition to limiting caffeinated colas and other soft drinks, keep hydrated by drinking enough water.

Also, try to eat foods that are rich in:

• Vitamin A. You need enough of the antioxidant vitamin A in your diet to maintain the surface of your eyes and healthy vision. There are vitamin A-rich sources for every diet preference. Plant-based choices include vegetables like sweet potatoes, leafy green vegetables and carrots. Or choose animal-based foods, such as cheese, oily fish or liver.
• Vitamin C. The best foods for getting a daily dose of vitamin C are fruits and vegetables, including oranges, grapefruit, strawberries and broccoli.
• Lutein. Eat leafy green vegetables to make sure to get enough lutein, which helps your eyes filter harmful blue light that can damage retinas.

You can supplement your or your child’s diet with a multivitamin if you think you or they aren’t getting enough vitamins and minerals. Remember, though, that your body doesn’t absorb vitamins in pills as well as vitamins that occur naturally in foods. And it’s important to check with your healthcare provider before starting any supplements.

Taking safe care of your and your family’s vision means regular eye exams, a good eye care routine and a healthy diet. Keeping those healthy habits will help you all to see a future filled with all the things you love.

When should I see a doctor about myopia?

Regular eye exams are important for everyone. It’s especially important to contact an eye care provider if you have any type of change in your vision.

If you have kids and you notice that they squint a lot or pull things close to their faces to see them, make an appointment.

In any case of extreme changes in vision — like a sudden loss of vision or noticing a significant increase in the number of floaters or flashes of light you see — get immediate medical help. Some conditions, like retinal detachment, are medical emergencies.

Does myopia get worse with age?

Yes, it can. Especially during growth spurts of the pre-teen and teen years, when your body grows quickly. At the age of 20, myopia usually levels off. You can also get a myopia diagnosis as an adult. When this happens, it’s usually due to visual stress or a disease like diabetes or cataracts.

You can experience visual stress by spending too much time doing up-close activities, such as reading or doing computer work. Eye experts believe that your focusing muscles may get stuck in “near gear” from overusing them this way.

If you’re an adult experiencing sudden nearsightedness, floaters (spots that appear in your field of vision), flashes of light or shadows, or a sudden loss of sight in one eye, contact an eye care provider immediately to rule out a more serious health condition.