People with nearsightedness struggle to see things far away from the face. For people with extreme nearsightedness, defined as a prescription of -6.0 diopters or more, it may be difficult to see anything more than a foot or so away from the face.
In addition to making sight difficult, high myopia can come with severe complications. The causes of extreme nearsightedness cannot be fixed, but the condition can be treated.
Table of Contents
A Formal Definition of High Myopia
Nearsightedness, also known as myopia, is a condition involving distance. For someone with myopia, it can be easy to see items that are close to the face. These images seem sharp, crisp, and distinct even when the person is not wearing glasses or contacts. When there is distance involved, the sharpness fades. Unless the person uses glasses or contacts, things at a distance may always seem slightly blurry.
Changes in visual acuity are measured in diopters. People with myopia have prescriptions measured in negative diopters. According to the National Eye Institute, the term “high myopia” applies when that prescription reaches -6.0 diopters or more.
According to estimates from the American Academy of Ophthalmology, 9.6 million American adults have this level of myopia. While many people may struggle with a lower level of myopia, few people have such severe difficulties that they qualify for the high-myopia label.
The American Academy of Ophthalmology reports that most people with high myopia have the condition due to unusual growth of the eyeball. Their eyes are slightly longer than what is considered optimal, and it is that length that causes symptoms of nearsightedness to form. Eye growth typically stabilizes by age 20 to 30, and that means prescriptions stop shifting and myopia does not grow worse.
But there are some people who have a form of myopia that does get progressively worse year after year. And even people with stable levels of high myopia can face health risks others do not face.
What Causes Extreme Nearsightedness?
There is no single cause for myopia that is known. High myopia, or extreme nearsightedness, is sometimes a genetic condition that is inherited.
Essentially, the eyeball grows too long. This distorts the eye’s standard proportions, causing light to focus in front of the retina instead of on it.
It is believed that certain factors can increase the likelihood of nearsightedness, though they don’t directly cause the condition. People who work on a computer or do concentrated visual work up close may be at a higher risk of developing high myopia.
What Are the Risks?
In order to see clearly, the light that moves through the eye must connect with special tissue on the back of the eye. This retinal tissue has the ability to translate the light into signals, and those signals are pushed to the brain through the optic nerve. The retina plays an absolutely crucial role in sight, and people with high myopia have unique retinal risks.
According to the National Eye Institute, people with high myopia have a higher risk of retinal detachment than people without high myopia. When the retina detaches, it pulls away from the back of the eye, and it is no longer supplied with the nutrients it needs to survive. If the retinal tissue dies, sight can be lost.
The Fundacion IMO reports that high myopia is connected to retinal problems due to the elongation of the eye. When an eye is longer than it should be, the tissues are elongated and under pressure, and that constant pressure can lead to detachment.
High myopia has also been connected to a higher risk of:
- Glaucoma, which causes pressure levels to rise within the eye. If those levels rise too high, sight can be lost.
- Vessel growth beneath the retina, which can lead to blurring vision.
- Holes in the macula, the light-sensitive tissue within the retina. That can cause blurred vision.
- Separation of the layers of the macula, which can also lead to blurring.
Symptoms of Extreme Nearsightedness
The symptoms of high myopia are similar to the symptoms of nearsightedness but more intense. They include the following:
- Blurry vision
- Squinting to see things
- Eye pain
- Trouble with distance vision
How Is High Myopia Treated?
The underlying cause of high myopia cannot be treated. That's why it is so vital for people with high myopia to visit an eye doctor on a regular basis for examinations.
Doctors can look deep into the structures of the eye and ensure that the risks caused by the condition are kept at bay. People with this condition need to continue with their exams even if they use solutions in order to see better.
Those solutions can vary, and many of them involve surgery. For people with extreme nearsightedness, these surgeries can help to reduce the need to wear glasses or contact lenses all the time, and that could be transformative.
One such surgical correction, described by the University of Rochester Medical Center involves replacing the lens inside of the eye. Surgeons make a small incision in the side of the eye, break the existing lens apart, and place a new lens inside of the eye. This can be a good option for people with severe myopia that cannot be treated by LASIK, researchers say.
Extreme nearsightedness is sometimes not curable with LASIK, as surgeons need to remove corneal tissue to make vision clear. People with extreme needs may need a large amount of tissue removed, and there may not be enough left behind to result in a healthy eye. If the prescription is too strong, some surgeons may advise their patients to avoid LASIK.
However, some types of LASIK machines are very precise, and they do allow doctors to work on people with very high levels of myopia. For example, in a study published in the Journal of Refractive Surgery, researchers used a LASIK procedure on people with prescriptions ranging from -6.12 to -15.75 diopters. Most patients achieved uncorrected vision after surgery similar to or better than their best corrected vision before surgery. This suggests that LASIK really can be a good option for some people with extreme nearsightedness, but the right equipment must be used in order to deliver the best results.
What Is Degenerative Myopia?
Degenerative myopia occurs when vision deteriorates at a faster rate than “normal.” Sometimes, this deterioration can occur incredibly rapidly and severely, leading to blindness.
While degenerative myopia can be treated with corrective lenses, there is no cure for the condition. It’s best to work closely with an eye doctor to monitor the progression of degenerative myopia.
Contact Lenses for Extreme Nearsightedness
For those who do not want surgery, or who may not qualify for either type of surgery, contact lenses can be a good solution.
According to the American Academy of Ophthalmology, contact lenses provide a better level of correction for nearsightedness when compared to glasses.
Contact lens correction is often covered by insurance, which could make this solution a good option for some people.
We Can Explain Your Choices
Some people know their visual correction needs incredibly well. Others just know that they cannot see as well as they might like to. No matter where you fall on this spectrum, we can help.
We offer a full suite of services to help people with nearsightedness. We can help you understand if surgery is right for you, and we can help you find another solution if surgery is not best. We have appointments open and would like to talk with you. Please contact us.
We Promise Our Patients Peace of MindConsultation
During the consultation, we will ask you about your eye health history and your medications, and perform some tests. You will then be examined by the surgeon who will discuss your treatment options. Your personal Patient Counselor will help you throughout the process.
Your Counselor can review payment options and schedule you for surgery and related appointments, such as pre- and post-operative exams. Prior to your procedure you will have a dilated eye exam, and you should discontinue wearing your contact lenses and begin taking eye drops as instructed.Procedure
Plan to be at the center for two to three hours the day of your procedure. ICL eye surgery is a fairly brief outpatient procedure. Your surgeon dilates your eyes, and gives you a local anesthetic to numb the area. A tiny incision is made, and the clear lens is slipped between your iris and your eye’s natural lens. The day of your procedure should be a day of rest.Post-Procedure
Your Patient Counselor will give you detailed post-operative instructions and eye drop regimen for your recovery. After ICL surgery, you’ll need several follow-ups with your eye doctor. Visual recovery is rapid, and you can expect noticeable improvement within a day or two. Most patients are generally able to return to their normal activities within two or three days following their procedure.
High Myopia and Its Risks. (2019). Community Eye Health Journal.
Facts About Myopia. (October 2017). National Eye Institute.
Nearly 10 Million Adults Found to Be Severely Nearsighted in the United States. (June 2016). American Academy of Ophthalmology.
Will High Myopia Ever Stabilize, and If So, At What Age Does this Happen? (April 2012). American Academy of Ophthalmology.
New Technology an Option for Severe Nearsightedness. (January 2005). University of Rochester Medical Center.
Safety and Effectiveness of Thin-Flap LASIK Using a Femtosecond Laser and Microkeratome in the Correction of High Myopia in Chinese Patients. (February 2010). Journal of Refractive Surgery.
What Are the Options for Correction or Reduction of High Degree Myopia? (February 2015). American Academy of Ophthalmology.
High Myopia Causes. Stanford University.
Myopia (Nearsightedness). American Optometric Association.
How Blinding Is Pathological Myopia? (May 2006). British Journal of Ophthalmology.