Understanding Myopia: Causes, Symptoms, and Effective Treatments

If you’ve had trouble seeing, especially faraway objects, you’re not alone. We get it—this is frustrating and we understand it’s frustrating and can even be overwhelming when you have no idea what’s going on with your eyes.

Myopia, otherwise known as nearsightedness, is among the most common conditions and millions of people, including children, are affected. Whether you’re just now experiencing the blurriness or it’s something you have dealt with for years, you may have many questions. Is this something that can get worse? Can it be corrected? And if it can, what are your options? In this blog, we are going to dive deep into myopia—what causes it, how it can be managed and the treatment options available—so you can have a better understanding of your vision and feel comfortable in the next steps.

Whether you want to manage myopia for yourself or someone you love, together we will share practical advice, options, and insights to support you in making proactive choices for healthier eyes.

What causes myopia and who is at risk?

Myopia, or nearsightedness, is a common refractive error that allows people to see near places but not remote jumbles. It happens if the eye is too long from front to back (axial myopia), or if the cornea (the clear front surface of the eye) is too curved. This means that light that reaches the eye collects in front of the retina, rather than right on the center of it, leading to blurred sight of things far away.

Causes of Myopia

The exact cause of myopia is still under investigation, but it is thought to be a combination of genetic and environmental factors:

Genetic Factors

1. Family History: Myopia is more common in people whose parents have it, indicating a strong hereditary factor. This risk rises in people with more myopic family members.
2. Specific Genes: Several genes associated with myopia have been identified by researchers. These genes play roles in how the eye develops and the structure of the eye, affecting its growth and the way it focuses light.

Environmental Factors

1. Close-Up Work: Activities such as reading, using a smartphone, or working on a computer for long periods require considerable near-focused attention, which may contribute to the condition of the eye in the long term.
2. Reduced Time Outdoors: More time spent outdoors in childhood may lower the risk of developing myopia. Natural light and tasks requiring the focus on more distant objects appear to be protective, but the precise mechanism isn’t well understood. This process may be linked to dopamine production, which may prevent the eye from elongating too much.
3. Lack of Distance Viewing: If children and adolescents focus more on near-work activities and spend less time on activities that require distance vision, this could contribute to myopic development.

Eye Growth and Development

The eye is usually growing rapidly throughout childhood. If the eye becomes too long, it causes the light entering the eye to focus before reaching the retina, resulting in myopia. This may be influenced by genetic predisposition and environmental factors such as near work.

Optical Factors

The eye is a lens-filled, pear-shaped organ, and the long pear shape of the eye sphere—as well as the shape of the transparent cornea in front of the lens—is considered to be a main driver of myopia progression. Myopia is caused by focusing light on the retina in an abnormal way.

Who Is At Risk?

Children and Adolescents

Myopia commonly starts in childhood and can worsen throughout the teenage years, particularly during rapid eye growth. People who develop myopia at an early age are more likely to have progression of the disease into adulthood and the chance of progressing to high myopia increases.

Children who spend excessive hours doing things like reading, using devices, or completing homework are also more likely to face eye fatigue, especially if they do these things for hours on end or without a break.

Similarly, children who don’t play outside as much — particularly during early childhood — are at greater risk of developing myopia.

Individuals with a Family History of Myopia

People whose own parents are myopic (i.e., one or both of them) have a greater likelihood of having the disease. The risk doubles if both parents have it.

Ethnicity:

Myopia is more common in some ethnic groups. For instance, myopia is seen more frequently in East Asian populations (especially those in China, Japan, and South Korea) than in European or African populations. These are more likely to be related to certain genes and the strong presence of near-work cultural activities.

People with High Levels of Education:

There’s a direct link between the level of education and rates of myopia. Those who spend more time doing near work (such as reading and studying) when young may be at greater risk. This is believed to stem from the amount of time spent in close-up work.

Urban Dwellers:

Urban residents with less outdoor activity and/or more screen time and/or near work tend to have a higher prevalence of myopia than people living in rural areas. It may be related to lifestyle differences and environmental factors.

Recognizing these causes and risk factors allows us to maneuver our myopia progression in the right direction, better yet, at the right time, when it matters most in childhood and adolescence.

How to recognize symptoms of nearsightedness?

Nearsightedness, also called myopia, is a condition that relates to how well (or not) you can see objects far away. A typical symptom is blurry vision in the distance, like when you are looking at road signs while on a drive or at the chalkboard in a classroom. For many myopic individuals, this is particularly apparent when we need to focus on items more than a few feet in front of us.

Nearsighted people may also take to squinting more often or attempting to strain their eyes to see distance more clearly, which improves the clarity of images in a temporary way by decreasing the amount of light that is entering eyes. If a person is constantly bringing objects closer to their face, whether it be their phone, their book, or their computer screen, it is likely an indicator that they are struggling to see well in the distance.

Frequent headaches are another common symptom commonly caused by eye strain in attempting to focus on distant objects. In particular, activities that demand sustained focus, such as reading or working on a digital device.

Some people may also find that their vision deteriorates in low-light conditions — for example at night, when the difference between objects becomes more difficult to distinguish. Night driving is one activity where this is quite difficult because it is important to see street signs, other vehicles, etc. clearly during the night.

If you have any of these symptoms, it’s advised to go see an eye care professional for diagnosis and correction measures.

Potential Complications

If myopia becomes high, it even can cause complications that can harm will be in your overall eye health:

• Retinal Detachment: This expands the risk of red to be detached and it can also cause permanent loss of sight if it occurs.
• Glaucoma: The increased pressure within the eye in high myopia can lead to glaucoma, resulting in the deterioration of the optic nerve, and, if untreated, may result in blindness.
• Cataracts: where the lens of the eye may be more susceptible to clouding.
• Age-related macular degeneration: Myopia, particularly high myopia, may also raise the likelihood of age-related macular degeneration, where the central part of the retina (the macula) degenerates, causing loss of central vision.

Diagnosing myopia: what to expect from an eye exam?

An eye exam is the number one way to diagnose myopia, the eye care professional will assess your vision and detect if you are nearsighted. The process usually starts by going over your medical history (including any vision problems you’ve had in the past), your family history of myopia and any symptom you may be having.

Your optometrist or ophthalmologist will then perform a variety of tests to assess the health of your eye and your vision. The first of which is typically a visual acuity test, where you read letters on a chart, most often the Snellen chart, at a distance. This puts you to the test with your capacity to see the questions from a distance and interprets the items from afar which helps the examiner to know if your distant vision is bad.

Next, the refraction test is done: The doctor uses a machine called a phoropter to check your prescription for glasses or contact lenses. It’s all through different lenses, and the doctor will tell you to compare which one makes the printed words clearer. Detecting this allows them to know precisely how much myopia or nearsightedness and your most accurate prescription for correction.

To assess the overall health of your eyes, the doctor might also conduct a slit-lamp exam, which employs a specialized microscope to examine the structures of your eyes: the cornea, lens and retina. That can uncover any related risk factors like cataracts or retina problems related to high myopia.

If there is concern about progression to myopia, other imaging tests may include corneal topography and retinal imaging. These provide more detailed views of the cornea and retina and may assist in tracking any structural changes of the eye that are linked to myopia.

If the diagnosis is myopia, then the eye care specialist will prescribe a treatment regimen in the form of prescribed glasses or contact lenses, or more advanced approaches to slowing the progression, especially in children, such as atropine eye drops or myopia control contact lenses.

Treatment options: glasses, contacts, and beyond

Now, we will explore the various treatment options available for myopia, including traditional corrective lenses and more advanced methods aimed at slowing the progression of the condition. The treatment is mostly based on myopia severity, age, and individual choice.

Glasses

Glasses—the most common and straightforward method of treatment. They compensate for the eye’s failure to focus light accurately onto the retina, restoring distance vision clarity. Your prescription lenses will be custom-made, according to the degree of your myopia. For the general population, glasses are a quick and effective solution. But they can be clunky for sports or physical activities, and some people dislike how they change their look.

Contact lenses

A contact lens is another commonly used optically refractive device that provides more independence than wearing glasses, especially for individuals who do not want a rim to limit their range of vision. As with glasses, contact lenses redirect the focus of light entering the eye, but instead, they do so directly on the surface of the eye, giving a broader and less obstructed field of vision. Soft contact lenses, the most widely used type, are available for patients with different degrees of myopia. There are also rigid gas permeable lenses or hybrid lenses that can offer better clarity for those with more severe myopia. Contact lenses, on the other hand, carry their own risks like dryness, irritation, or infection if not well cared for.

Orthokeratology (Ortho-K)

Ortho-K is a non-surgical, reversible method used to treat corneal reshaping for temporary correction. These are hard gas permeable contact lenses that are worn overnight, the theory being that they reshape the cornea overnight. Afterward, the lenses are taken out in daytime and during the daytime, the reshaped cornea aids in clear vision with the help of spectacles or contact lenses. Ortho-K is also popular for children and young adults with myopia, as it may slow the disease’s progression, in part because the treatment reduces eyeball elongation. However, the effects are temporary and wearing the lenses for normal periods is required to maintain results.

Atropine eye drops

Another treatment option is atropine eye drops, which are particularly suitable for children with progressive myopia. Intra-ocular strain (induced by the muscles used to “focus” the eye) is relaxed by the atropine drops and consequently, they have more recently been found to slow progression of myopia. The precise way it works is still under investigation, but researchers suspect that atropine helps inhibit the eyeball from becoming too elongated. This procedure is used mainly as a supplement to eyeglasses or contact lenses and is most beneficial when begun in early childhood.

Multifocal lenses

Different types of lenses (bifocal/progressive lenses to correct near and distance vision) are available but some studies have shown that bifocal and progressive lenses could help to slow down the progression of myopia. These lenses use a specially designed mechanism to help children and young adults focus on objects at the distance which may relieve the stress of prolonged near work. Some of these are lenses prescribed to children to prevent the progression of myopia.

Refractive surgery

For those over 18 with moderate to high levels of myopia, and stable prescriptions, a surgical option called refractive surgery is available, including LASIK (Laser-Assisted in Situ Keratomileusis) and PRK (Photorefractive Keratectomy). These procedures correct vision on a permanent basis by reshaping the cornea with a laser to focus light optimally on the retina. LASIK and PRK are effective and can free you from glasses or contact lenses but not everyone is eligible. For example, people with corneas that are too thin, or a specific type of eye disease such as keratoconus, or very high prescriptions may not be eligible.

Scleral reinforcement

Scleral reinforcement is an operation performed on patients who have high myopia (or ’nearsightedness’), as these patients are at an increased risk of retinal detachment. The technique aims to make the white part of the eye (the sclera) stronger in order to reduce the risk of complications, especially in patients with high myopia.

The decision about which type of treatment to select comes down to personal preferences, level of myopia, lifestyle factors, and whether the ultimate aim is only vision correction or also prevention of further progression of the condition. Especially for children, early intervention can manage myopia more effectively and reduce the progression of the condition as they mature. Regular eye examinations are necessary to monitor the progress of the condition and make sure that the best treatment remains effective and suitable for the ongoing evolution of one’s vision and eye health.

Can myopia be prevented?

Inherited myopia is something you cannot stop altogether, but you can take certain measures that could minimize the risk of myopia developing or keep it from worsening. Much of the research has centered on mitigating environmental risks and encouraging behaviors that can help protect eye health, especially in childhood, when the eye is still growing.

1. One of the best ways to help prevent myopia is to spend time outdoors. Studies have found that children who play outside more frequently are less likely to develop myopia, probably because they get more natural light and the chance to focus on distant objects. This protective effect, though, studied but not so robustly understood works through outdoor light regulating eye growth, which makes the eyeball longer than the average eye takes a lengthy time course and results in myopia. Children should ideally spend a minimum of two hours outdoors each day.
2. Reducing near work, and taking breaks from near focus activities such as reading, smartphones, or working on the computer can also alleviate stress on the eyes. One of the more common recommendations is the 20-20-20 rule: every 20 minutes, gaze at something 20 feet away for at least 20 seconds. This relaxes the focusing muscles of the eyes which can help reduce the change in myopia, especially in children.
3. You can also make adjustments to your lighting when doing close-up tasks that can help reduce eye strain. Correct lighting lessens the strain on the eyes, keeping near work comfortable and reducing myopic developments. Keeping the workspace well-lit and avoiding glare of the lighting can be helpful.
4. Good posture helps reduce eye strain, too. Encourage children and adults from straining the eyes by maintaining a proper reading distance (14–16 inches from the eyes for books/screen) and reducing excessive squinting to avoid undue strain. In fact, squinting is a sign that the eyes are attempting to focus, and can worsen vision over time.
5. Interventions that are effective in managing the progression of myopia include myopia control strategies for those children who are already at risk or who are already exhibiting early signs of developing myopia. These include special contact lenses, atropine eye drops, or multi-focus lenses, which all work to reduce the eye ball elongation process. Also, treatment with specially designed, overnight-worn contact lenses called orthokeratology (Ortho-K) has been found effective to inhibit myopia progression, especially among the younger population. Routine eye examinations keep myopia (particularly in children) in check and prevention is in stores. Optometrists or ophthalmologists, eye care professionals who prescribe corrective lenses, will monitor these changes as they grow and may see ways to help manage that growth through other methods of intervention to aid eye sight with corrective lenses, etc.

While there are no crystal clear ways to prevent myopia, we know these visual health habits (linked to the 20/20 perfect vision people) can help, combined with early interventions, if needed, to reduce the likelihood of the condition developing and its progression. Routine vision exams are also helpful in identifying myopia in children early to help slow its progression.

Lifestyle tips for managing myopia in children and adults

Myopia management in kids and adults includes a series of lifestyle habits that promote better eye health and help reduce strain so the condition progresses less quickly. There are some lifestyle changes which contribute to controlling myopia:

For Children:

1. Encourage Outdoor Activities:
   • At least two hours outdoors, every day. Exposure to natural light and focusing on objects in the distance can help prevent the progression of myopia.
2. Limit Screen Time:
   • Go ahead and place time limits on screen-based activities like watching TV, playing video games and using smartphones or computers. Limit screen time to less than two hours a day if possible.
3. Implement the 20-20-20 Rule:
   • Suggest that children step away from close-up work. Every 20 minutes, they need to focus on something 20 feet away, for 20 seconds. This alleviates eye strain, as excessive focusing on close-up objects is avoided.
4. Proper Reading Distance:
   • Teach children to maintain an appropriate reading distance (about 14–16 inches from the eyes). This ensures that the eyes aren’t overstrained when reading or working on other close-up tasks.
5. Ensure Good Lighting:
   • Ensure that workspaces (e.g., desks, study areas) are well illuminated. Minimize glare on screens or books, and ensure the light source isn’t so dim that readers experience a strain on their eyes.
6. Monitor Eye Health Regularly:
   • Since a family history of myopia is a risk factor, regular eye exams are critical! And getting diagnosed early enables interventions to be implemented to rectify vision and monitor the progression of the disease.
7. Use Myopia Control Lenses or Treatments:
   • If myopia is increasing rapidly, check to see if your eye doctor can recommend specialty treatments, like multifocal contact lenses, orthokeratology (Ortho-K) or low-dose atropine eye drops.

For Adults:

1. Take Breaks from Near Work:
   • Use the 20-20-20 rule while you work or study, especially while reading, using a computer or using a phone for long periods. This reduces eye strain and allows the eyes to relax.
2. Spend Time Outdoors:
   • Even in adulthood, regular exposure to outdoor light can help keep your eyes healthy. If your circumstances allow, aim for at least 30 minutes to an hour outdoors each day.
3. Limit Extended Screen Time:
   • Do your best to give the eyes a breather and reduce digital eye strain through limiting screen time. If you stare at computers or devices all day, use anti-glare screens, control your lighting and, by all means, take frequent breaks.
4. Adjust Workspace Ergonomics:
   • Check your workspace: While working from your laptops/computers, please ensure your workspace is set up to promote good posture and eye health. Place screens, including TVs, at eye level and sit at a comfortable reading distance from books and devices.
5. Use Proper Eyewear:
   • Get your prescription for eyeglasses or contact lenses updated regularly to correct your vision properly. If you are having problems with near and far vision, consider multifocal or progressive lenses.
6. Stay Hydrated and Blink Regularly:
   • Dry eyes can be a part of strain, especially for those who spend hours and hours staring at a screen. Drink plenty of water, and don’t forget to blink occasionally to keep the moisture in your eyes.
7. Protect Eyes from UV Exposure:
   • When outside, sunglasses that block 100% of both UVA and UVB should be worn. UV light may cause eyes to deteriorate gradually and worsen any existing conditions.
8. Monitor Eye Health:
   • An eye specialist should be appointment on a regular basis to test for changes in vision and detect any potential problems early. These meetings will be more common if myopia continues to progress or if your risk of disease is elevated.

Utilising these tips can help to manage myopia effectively in both children and adults and minimise the risk of further deterioration. Although myopia may not always be completely prevented, following healthy habits and bearing in mind the necessary treatments, may have a positive impact on quality of life and on reducing the consequences of the condition.

Frequently asked questions about myopia

1. Is myopia the same as nearsightedness? Myopia is, in fact, the same thing as nearsightedness. It is an optical defect that causes distant objects to be unclear, while things that are close are sharp. That happens when the eyeball is too long or the cornea too curved, so that light converges in front of, rather than directly on, the retina, resulting in blurry vision at distance.
2. Can myopia be corrected? Myopia can be corrected with prescription eyeglasses or contact lenses that refocus the light to hit the retina at the appropriate spot. More severe instances may require refractive surgery like LASIK or PRK for a permanent fix. There are also treatments such as orthokeratology and atropine eye drop that can slow down myopia specifically in children.
3. Is myopia a disability? Myopia would not be classed as a disability itself, but, when untreated, can affect vision significantly. Particularly in cases of high myopia (myopia that is greater than –6.00 D), severe myopia may increase the risk of additional complications, such as retinal detachment, glaucoma or cataracts. Most people with myopia can live normal, functional lives, however with corrective lenses or other treatment.
4. Are glasses good for myopia? Spectacles are considered a simple and effective means of managing myopia. They are designed to correct the refractive error by shaping light coming into the eye in a way that distance objects are able to be seen clearly. Spectacles are non-surgical, personalized, and simple to use, proving to be a practical solution to allow both children and adults with myopia to conserve healthy vision.

Sources

https://my.clevelandclinic.org/health/diseases/8579-myopia-nearsightedness

https://www.aao.org/eye-health/diseases/myopia-nearsightedness

https://en.wikipedia.org/wiki/Myopia

https://www.webmd.com/eye-health/nearsightedness-myopia

https://www.allaboutvision.com/conditions/myopia.htm