If you have nearsightedness, also known as myopia, you are certainly not alone. Thousands of people all around the world have this condition, and they use a variety of different methods to help them see more clearly. (Learn more)
Some people use glasses for nearsightedness, which allows them to take their correction away from their eyes when they wish to do so. (Learn more) Some people use contact lenses for nearsightedness, which allows them to avoid the change in appearance and the hassles associated with glasses. (Learn more) And finally, some people undergo LASIK surgery to permanently alter their vision, so they can avoid constant use of glasses or contacts. (Learn more)
Your personal preference, hobbies, and lifestyle choices all play a role in the solution that is best for you. (Learn more) Your doctor can be a good ally as you determine the best way to sharpen your vision.
Nearsightedness Is Both Common and Challenging
People who are nearsighted have an eyeball that is a little too long, a cornea that is a little too thick, or both. Those unusual eye shapes mean light does not move through the eye in an optimal manner. Items that should come into focus at the back of the eye, where the optic nerve is located, instead come into focus in the middle of the eye. Those images can seem fuzzy and indistinct rather than crisp and clear.
The National Eye Institute reports that people who have nearsightedness can typically see well enough to read items in a book or on a computer screen. But these people may find it hard to see things farther away, and the effort of trying to make out the details of distant objects can lead to eyestrain and headaches.
Myopia can also be influenced by environmental factors, including sun exposure. The interplay between genes and environment can lead to different forms of myopia, and some are more severe than others.
According to UC Davis, about 4 percent of adults have high myopia, which is defined as a right-eye prescription of -6.0 diopters or worse. Some people have a form of high myopia that is stable, meaning that their prescriptions do not grow stronger with each passing year. But other people do have a progressive form of myopia, and that degenerative disease can lead to blindness.
Technically, there is no cure for myopia. As the Canadian Association of Optometrists points out, doctors can use tools to help people see clearly despite myopia. The tools can, in other words, help people to cope with the disorder. But none of the tools doctors use can cure the disorder entirely.
Using Glasses for Nearsightedness
Glasses can help to sharpen distant images for people with nearsightedness. The lenses work to lengthen the focal point, so the images sharpen at the back of the eye where the optic nerve lies. Each lens is specifically designed to amend the correction error in that eye, and if your vision changes, your doctor can change the lenses in your glasses to match.
If your prescription does not change and you maintain your eyeglasses properly, a pair can last for years. That makes eyeglasses a good option when compared to contact lenses. There are no solutions to buy or replacements to order regularly.
Glasses also offer a distinct advantage in terms of their removability. Aging eyes have stiff lenses, and that can lead to difficulties seeing things close up. People with glasses can accommodate that shift by removing their lenses when they want to see something close. People who use contact lenses or who have LASIK do not always have that option.
At one point, people thought that wearing glasses made myopia worse. According to the American Optometric Association, research has proven that wearing glasses does not influence myopia progression. Wearing weaker glasses also doesn't help to stop myopia from progressing. As a result, it is best to get glasses that match your need for sharp vision correction.
The American Academy of Ophthalmology reports that glasses can be enhanced to improve your vision even more. For example, your doctor may be able to place a nonreflective coating on your glasses to cut back on glare during night driving. These subtle shifts are not always possible with other forms of vision correction.
Using Contact Lenses for Nearsightedness
Contact lenses work in a similar manner to glasses. They help to amend the way light moves through the eye, allowing images to come into sharp focus at a specific point at the back of the eye. Unlike glasses, which sit in front of the eye, contact lenses sit on the eye. That allows people to amend their vision without anyone else knowing they have a vision problem at all.
According to the Centers for Disease Control and Prevention, 45 million people in the United States wear contact lenses. When they are worn properly, they can allow you sharp and clear vision without some of the hassles associated with glasses. And newer forms of contact lenses may be custom-made for people with myopia.
As researchers writing in Clinical and Experimental Optometry make clear, some types of contact lenses are made to improve the shape of the eye, which could help to reduce the risk of nearsightedness. Older forms of these lenses were worn at night, but researchers are experimenting with newer forms that are worn during the day. Researchers say that newer lenses require more study before they can be recommended for everyone, but they could be an exciting option for some people dealing with myopia problems.
In order to take care of your contact lenses, you must:
- Place the contact lens in your eye, which involves touching your eye.
- Wash your hands before touching your eye throughout the day.
- Remove your contact lens, which again involves touching your eye.
- Clean your lenses.
- Replace them on a schedule your doctor determines for you.
Skipping some of these steps, particularly those involving hygiene, could lead to serious side effects. According to the U.S. Food and Drug Administration, serious eye issues associated with contact lens use include eye infections, corneal ulcers, and blindness.
The surface of the eye is warm and moist, which makes it an ideal breeding ground for bacteria. When bacterial cells invade the space between the contact and the eye, they can multiply and spread. If not caught and treated properly, those infections can progress and cause severe damage that leads to blindness.
Contact lenses can also be an expensive solution for myopia. To maintain those lenses, you will need to invest in cleaning products that can kill bacteria. You will also need to invest in replacement lenses on a regular basis, as lenses tend to deteriorate with time.
That expense could be worth it to you if you decide that surgery isn't right for you, but you do not want to wear glasses each and every day.
Using LASIK for Nearsightedness
During a LASIK procedure, your surgeon removes a specific amount of corneal tissue from the front of your eye. This permanently changes the way light moves through your eye, and it could allow you to see things at a distance without the constant need for glasses or contact lenses. This surgery cannot change age-related eye issues, so you may develop the need for reading glasses later in life. But the surgery can help you to avoid needing to grab for glasses or contacts first thing in the morning to see across the room.
Research suggests that LASIK could be a good option for people with all levels of myopia, including high levels. For example, in a study in the Journal of Refractive Surgery, researchers found that the surgery was effective even in people who had prescriptions measuring up to -12 diopters. That is a significant level of correction, and results like this could mean that these people saw clearly after surgery with no glasses or contacts for the first time in a long time.
LASIK isn't right for all people. For example, the surgery does involve an injury to the front of the eye, and to heal, the eye will rely on a steady stream of tears. People with dry-eye conditions may not have enough tears to allow their eyes to heal. In addition, some people with thin corneas may not be suitable for surgery, as they will not have enough healthy tissue when the procedure is complete. Doctors assess suitability before surgery, and it is not uncommon for these professionals to turn some people away who want to have surgery.
But those who get surgery have a one-time expense that can result in years of clear distance vision. For some people, that is very much worthwhile.
How Can You Decide?
There are some factors that make one form of vision correction ideal for you. For example, if you perform close work on a regular basis, you may prefer to wear glasses. As research in JAMA Ophthalmology points out, people with nearsightedness can struggle to see things up close while they are using their corrective lenses for nearsightedness. Glasses allow for quick removal of correction, and that could be ideal for you if you knit, embroider, sew, or read for pleasure.
If you're an athletic person, contact lenses might be right for you, according to the Centers for Disease Control and Prevention. Contacts do not move around on your face or fog up like glasses do, so they can be easier to wear during athletic activities. In addition, LASIK does involve an injury to the eye, and you will need to protect that injury for the rest of life. If you play high-contact sports like boxing, you may not be able to offer that protection. Contacts might be a better option.
If your prescription is severe, contacts or glasses might be best for you. According to research in the Korean Journal of Ophthalmology, people with significant corrections can experience a regression in visual acuity after LASIK. For reasons that aren't clear, their eyes return to their pre-surgery shape, and that means poor vision returns. A change in prescription is easier to handle with glasses or contact, but isn't so easy to amend with LASIK, aside from having another surgery.
If you do not wish to be bothered with ongoing maintenance, LASIK could be the right choice for you. After surgery, you will have no lenses to clean, supplies to buy, or steps to follow. When your eyes heal, you will be done with dealing with myopia. This might be the right choice for you if your prescription and your eye health make surgery a good choice.
If you’re confused about your options, don't worry. This is not a decision you must make alone. A doctor can examine your eyes and help you decide what is the right choice for you.
We would love to be part of that discussion. Please contact us for an appointment with one of our qualified doctors.
Facts About Myopia. (October 2017). National Eye Institute.
Nearly 10 Million U.S. Adults Severely Nearsighted. (June 2016). UC Davis Health.
Myopia (Nearsightedness). Canadian Association of Optometrists.
Common Myopia Myths. American Optometric Association.
Eyeglasses for Vision Correction. (December 2015). American Academy of Ophthalmology.
Healthy Contact Lens Wear and Care. (October 2018). Centers for Disease Control and Prevention.
Contact Lenses to Slow Progression of Myopia. (September 2017). Clinical and Experimental Optometry.
Contact Lens Risks. (September 2018). U.S. Food and Drug Administration.
LASIK for -6.00 to -12.00 D of Myopia With Up to 3.00 D of Cylinder Using the Allegretto Wave: 3- and 6-Month Results with the 200- and 400-Hz Platforms. (October 2010). Journal of Refractive Surgery.
The Accommodation Requirement in Myopia. (July 1966). JAMA Ophthalmology.
Benefits of Vision Correction With Contact Lenses. (January 2015). Centers for Disease Control and Prevention.
Factors Affecting Long-Term Myopic Regression After Laser In Situ Keratomileusis and Laser-Assisted Subepithelial Keratectomy for Myopia. (April 2016). Korean Journal of Ophthalmology.