Nearsightedness (Myopia): Causes, Signs & Treatments
If you can see things clearly when they are close to you, but the sharpness of the images fade when the item moves away from your face, you are dealing with nearsightedness, also known as myopia. It’s a common condition that often develops during childhood and worsens through middle age.
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Myopia is blamed on a combination of genetics and lifestyle, and researchers are investigating options that could help children avoid the condition.
Myopia can be treated with contact lenses, glasses, and LASIK surgery. Some people suggest that myopia could also be treated with exercises or vitamins, but researchers do not agree. A qualified eye care professional can help you understand what therapy might be right for you.
How Many People Have Myopia?
Myopia just might be one of the most common conditions in the world today. In a study published in the journal Ophthalmology, researchers examined data published since 1995, and they determined that 49.8 percent of the population will have myopia in 2050. If about half of all the people in the world have myopia, it’s safe to call it a common disorder.
In order to see images clearly, the light that enters your eye must coalesce into one shard that points at the back of your eye. The retina on the back of the eye can translate that sharp point of light into an electrical signal, and it’s that signal that moves through the optic nerve to the brain.
People with myopia have an eyeball that is too long, so the focused light terminates in the middle of the eye rather than on the retina. A lens that is too thick or a cornea that is too curved can also cause or contribute to myopia. Any structural change that amends the light’s ability to focus on the back of the eye results in fuzzy images perceived from objects far from the eye.
Myopia is often discovered, according to the American Academy of Ophthalmology, when children are between the ages of 8 and 12. Children may:
- Complain of headaches.
- Rub their eyes.
- Squint frequently.
- Perform poorly in school.
- Trip, fall, or seem clumsy.
As children grow, their eyes may continue to elongate. That elongation can make symptoms of myopia worse, and that can continue until people reach early adulthood when growth stops.
The American Optometric Association reports that adults may also experience a form of nearsightedness caused by their work. This “pseudo myopia” is caused by overused eye muscles. People who read, sew, repair clocks, or perform another form of close work for long periods of time may simply wear out the muscles in the eye, and they may find it’s hard to see things at a distance when they look up from their work. Rest can solve the problem, but continued overuse can lead to a permanent loss of distance vision.
Myopia can vary in severity. For some people, the issue is a mere annoyance. They may be able to see well enough to handle everyday tasks, such as housecleaning or gardening, but they may need to wear corrective lenses in order to drive. Some people have severe forms of myopia in which they cannot see clearly enough without lenses to do anything at all.
Myopia Develops Through Genetics and Lifestyle
Just as genes play a role in the color of our eyes, they can be a factor in the development of myopia. According to the National Eye Institute, there are more than 20 genetic risk factors for myopia. The risks overlap and interplay, meaning that people with many of these genetic shifts are much more likely to have myopia than people who have none or only a few of them.
This makes intuitive sense, and it helps to explain why the photos of some families show no faces without glasses. But genetics are not the only factor at play in the development of myopia. Childhood habits can also help to spur the development or worsening of nearsightedness.
Research cited by Nature suggests that rates of myopia are on the rise due to modern lifestyle choices. At one point, children spent hours outside each day, either working in the fields or playing in their yards. Now, children in some urban areas do not have safe spaces in which to play, and so they stay inside after school. In some cultures, children are encouraged to spend hours each day in study, even after school is over, and they may spend very little time outside at all. Researchers cited in this article suggest that kids should spend about three hours outside each day. Modern kids may not come close to that number.
It is not clear why bright light would play a role in the growth and development of the eye, but research conducted on animals suggests that low light levels tend to result in a longer eye. Time outside might also be connected to physical activity and increased blood flow, and that may also play a role.
Higher levels of education have also been associated with myopia. In a study published in The BMJ, researchers found that people with 17 years of education are estimated to be at least 1 diopter more myopic than someone with 12 years of education. That means the difference, researchers said, between wearing glasses while driving and not needing lenses at all.
Succeeding in school means spending time reading printed materials, either on paper or a computer screen. People in school may opt to do their work inside rather than outside. Those two factors could explain why myopia and education are linked. But it could also be associated with factors researchers just haven’t untangled yet.
Myopia Treatment with Contact Lenses
Since myopia involves a suboptimal bending of light, lenses seem like an ideal solution. Lenses help to bend the light before it even enters the eye, and that could help to amend the blurriness caused by myopia.
Standard contact lenses sit atop the cornea of the eye. They are nourished by tears within the eye, and after a small period of adjustment, they may not even be noticeable to the person wearing them. Traditional lenses like this are worn during the day, allowing for crisp vision without glasses. At night, they are cleaned and removed, so the eye has a rest period.
The American Academy of Pediatrics reports that contact lenses can be a good solution for people, including kids, that are likely to lose or break glasses, as well as those who feel uncomfortable in glasses. But they do come with risks. People who do not clean and disinfect lenses can develop very serious eye infections. At times, those infections can cause loss of sight.
Traditional contact lenses are not the only solutions available for myopia. Newer lenses are used in a treatment known as orthokeratology, which is used to amend the shape of the eye. Lenses used in this treatment are firm, and they are made to wear overnight. During sleep, the eye is compressed and flattened, resulting in clearer vision the next day.
The American Association for Pediatric Ophthalmology and Strabismus reports that is unclear how this procedure helps to amend vision, but researchers believe the compression helps to shift the eye’s focal point. That shift results in clearer distance vision, but the effect tends to wear off when people stop wearing the lenses at night. Those who participate in the treatment need to wear lenses regularly to get the biggest benefit.
An analysis by CNN suggests that these nighttime lenses hold dangers. Wearing contact lenses at night, when tear production decreases, can increase the risk of eye infections. Again, some infections grow serious enough to threaten sight, so this is not a minor concern.
Myopia Treatment with Glasses
Contact lenses are not the only lenses that can assist with myopia. The lenses found in glasses can also bend light before it enters the eye. Eyeglass lenses can be custom-made to your specific prescription, and doctors can measure just how far the lens should be from your eye to give you the most benefit. Glasses can be taken off when you need to do close work, and they can be taken off without worry of eye contamination.
Glasses have been in use for people with myopia for hundreds of years. In fact, according to an analysis from National Public Radio, people with myopia have been using glasses to help them see clearly since the 15th century. These early glasses were heavy, and they were more akin to magnifying glasses one would hold up in front of the eyes rather than wearing them at all times. But they were designed to bring things at a distance into clear focus, just as modern glasses do.
Modern glasses come with improvements that can be helpful for people with myopia. For example, bifocal glasses come with a pane or panel in the bottom of the lens that is optimized for close vision. That small panel can allow for close work, while the upper part of the lens is made for distance vision. This can keep people from sliding glasses on and off multiple times during the day. Bifocals may be especially helpful for people with myopia.
According to research cited in Review of Ophthalmology, small studies suggest that wearing bifocals can slow myopia progression in children. More studies are required in order to understand just how these lenses help eyes to focus clearly, but these small studies do suggest that there is a benefit in these lenses that might not be available in standard lenses.
Researchers are also investigating a new type of glasses lens to help people avoid myopia progression. According to Healthline, these lenses have multiple micro-lenses embedded throughout. This forces the eye to overcome pockets of focus, and researchers suggest that this can strengthen eye muscles and halt the body’s wish to elongate the eye. These lenses are new, and the research is being conducted on children, but they could be an exciting tool to use in the fight against myopia.
Myopia Treatment With LASIK
At some point in early adulthood, myopia typically stops progressing. The level of vision loss people have at that age tends to be the level of vision loss they experience throughout life. This makes myopia an ideal condition to treat with laser-assisted in-situ keratomileusis (LASIK). This is a permanent surgery that changes the shape of the outer portion of the eye.
During LASIK, surgeons make a flap in corneal tissue. This flap is lifted, and a laser is lowered near the eye. The laser pulses for a few seconds, removing a predetermined amount of corneal tissue. The laser is then lifted, and the corneal flap is replaced. The result is an eye that is slightly shorter than it was prior to surgery, which can mean light hits the back of the eye in an ideal, focused beam.
As is the case with most surgeries, doctors perform many tests before the cutting begins. People with very dry eyes, large pupils, or underlying health conditions are often considered poor candidates for surgery, and they may be encouraged to keep using glasses or contact lenses for correction. But those who are ideal patients may have a quick surgery that results in years of good vision.
In a 10-year follow-up of people with myopia who had LASIK, published in the American Journal of Ophthalmology, researchers found that only 5 percent experienced a two-line loss in best-corrected visual acuity after surgery. This suggests that most people who have surgery can see better after the procedure than they did before the surgery began. It also seems to suggest that complications after surgery, which could keep people from seeing clearly, are relatively low.
It is important to note that age-related changes can take hold after surgery, and those changes could prompt some level of eyesight degradation. With age, the muscles that line the eye weaken, and those muscles are not able to tug with extreme force on the lens of the eye. In addition, the lens stiffens and grows harder to move.
Those two conditions combined can result in difficulty in shifting focus from near to far, and it cannot be corrected by or prevented by LASIK. But the shift is often subtle, and reading glasses can help people to accommodate.
Alternate Treatments Are Not Proven
Natural, alternate treatments are often a great help when you are dealing with a medical condition. Gentle stretches might help you move past a pulled muscle, for example, while ice might help to soothe the discomfort of a bruise. Some people expand this idea into the visual realm, and they suggest that natural therapies could help to cure myopia, which would allow you to avoid both surgery and correction with lenses. Unfortunately, the results they deliver do not often live up to the promise.
For example, there are people who believe that eye exercises can cure myopia. Someone following this advice might be encouraged to cup the eyes with the hands and think about relaxing the optic nerve. They might also be prompted to move the eyes in a structured manner, strengthening the muscles around the eye and therefore improving eye focus.
Articles about these programs can be exciting to read. For example, in an article published in the Yoga Journal, an eye exercise promoter suggests that a woman moved from sight of 20/16 to 20/6 with just three sessions of eye exercises.
Researchers have tried to replicate these results, and they have had little success. In one such study of 24 people, published in the International Journal of Yoga, researchers found that eye exercises had little to no impact on myopia. This study lasted for eight weeks, and it is reasonable to assume that a benefit would have been noticeable within that time. But the researchers found no such benefit. They concluded that exercises could not be recommended.
In another study published in the Physiotherapy and Occupational Therapy Journal, researchers examined available studies concerning eye exercises in myopia, and they concluded that studies with better design were required. They couldn’t find evidence that the exercises worked, given the studies available. This seems to suggest that the exercises may not provide the groundbreaking help their promoters describe.
Some articles also discuss the use of vitamins to curb myopia. The issue here comes in the development of the disorder. Since myopia is caused by an unusual eye shape that typically begins in childhood and progresses until early adulthood when it stops altogether, adults taking vitamins are addressing the problem much too late. By the time you have reached adulthood, nutrition cannot solve an eye problem. Your eyes have achieved the shape they were meant to achieve, and vitamins alone cannot change that shape.
It’s understandable to look for solutions that can fix your sight issue without causing you discomfort or distress. But clearly, some articles you might see about solutions could lead you astray. That is why talking to a professional is so important. Your doctor can help you separate myth from fact.
Which Solution Is Right for You?
If you are struggling with myopia, you clearly have options that can help you see better. But the option that is right for you might not be right for another person. It may take some investigating in order to find your best fit.
For some, the answer comes down to insurance coverage and finances. Insurance companies tend to cover the cost of glasses and traditional contact lenses, but they may not cover orthokeratology lenses, nor will they cover the cost of LASIK. If you want to use advanced techniques to assist with your myopia, you may need to pay for those solutions. That is not possible for everyone.
The health of your eyes may also play a role. If you have underlying health conditions, contacts or LASIK may not be safe for your eyes. Your prescription strength could also put LASIK out of reach.
Pairing your personal preferences with the expertise of a talented doctor can help you make the right choice. Your doctor can listen to what you would like to do for your eyes and advise you on the solution that is best for your health, your budget, and your lifestyle. We can help you find that trusted doctor to partner with you. Contact us to find out more.
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- Nearsightedness: What Is Myopia? (September 2013). American Academy of Ophthalmology.
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- The Myopia Boom. (March 2015). Nature.
- Education and Myopia: Assessing the Direction of Causality by Mendelian Randomization. (June 2018). The BMJ.
- Myopia (Nearsightedness). (November 2015). American Academy of Pediatrics.
- What Did Nearsighted Humans Do Before Glasses? (July 2016). National Public Radio.
- Treatment for Progressive Myopia. (July 2017). American Association for Pediatric Ophthalmology and Strabismus.
- Parents Opt for Unapproved Treatments Instead of Glasses for Their Children. (September 2016). CNN.
- More Children Are Becoming Nearsighted. These New Glasses Might Help. (April 2018). Healthline.
- Ten-Year Follow-up of Laser In Situ Keratomileusis for High Myopia. (January 2008). American Journal of Ophthalmology.
- Exercises for the Eyes. (August 2007). Yoga Journal.
- A Comparative Study on the Effects of Vintage Nonpharmacological Techniques in Reducing Myopia (Bates Eye Exercise Therapy vs. Trataka Yoga Kriya). (January 2018). International Journal of Yoga.
- A Scoping Literature Review on Effects of Eye Exercises for Myopia in Children. (June 2015). Physiotherapy and Occupational Therapy Journal.