Today you’re going to learn everything you need to know about myopia. And to explain it, I will only use simple English. I like to avoid using complicated words, as I believe that gets in the way of everyone having equal access to knowledge.
Myopia (also called nearsightedness or shortsightedness) is one of the most common eye conditions in the world today. In recent years, the number of people with myopia increased at an alarming rate.
This is bad news because nearsighted folks are more likely to develop serious eye health problems that can even cause blindness. For this reason, it’s very important to understand what is myopia. In this article, I will address the causes, symptoms, and treatment options of this condition.
So whether, you suspect you or your child have nearsightedness, or you’re simply an eye enthusiast and want to learn more, I hope you get a lot of value from this post. Let’s dive in:
What is Myopia?
If you have myopia, you have difficulty seeing distant objects clearly, like reading road signs or watching TV from across the room. However, you are able to see clearly for close-up tasks, such as using your computer or reading a book. Here’s why this happens:
When light enters your eye, the lens located in the front part of the eyeball converges that light into a single point inside your eye.
In order to see sharp and clear, this focal point of the light that enters your eye needs to be right on the retina. The retina is located in the back of your eye and is responsible for translating light into an image that the brain can read.
Unfortunately, for people with myopia, the focal point of light is in front of the retina, instead of on it. In other words, the light that enters the eye converges too quickly.
This happens because if you have myopia, you have an eyeball that is longer than normal. This is called axial elongation. It can also be because you have a cornea (front part of the eye) that is too curved.
These anomalies in the eyeball are what cause the image to not focus correctly, causing blurred distance vision.
Nearsightedness typically begins in childhood and stabilizes in early adulthood, although sometimes it continues to progress with age.
Now, you may be wondering why is it that only distant objects appear blurry. If the eyeball has this problem, shouldn’t vision be blurry at all distances? That’s a very good question:
Why Can Myopic People See Up Close?
To answer this question we need to dive a little bit deeper into how your eyes work.
The lens inside your eye has the ability to change shapes depending on if you’re looking at something up close or in the distance. This process is called accommodation. It’s an involuntary reflex that doesn’t require you to consciously think about it.
According to how you use your eyes, the lens becomes more round or more flat, with the goal of bending light in a way that keeps its focal point on the retina.
The reason why people with nearsightedness can still see clearly up close is that our eyes have no problem adjusting to close-up vision.
To see an object up close, the muscle that controls the shape of the lens contracts, making the lens more round and converging light to the retina. This has nothing to do with the problem of myopia. Myopes can do that just fine.
The problem occurs when looking at distant objects and the muscle that controls the shape of the lens relaxes. No matter how much it relaxes and the lens becomes more flat, it won’t be enough to move the focal point of light to the retina because the eyeball is just too long.
So now we understand what causes myopia, but not really. If you have myopia, you may be wondering, why do I have an eyeball longer than normal? What happened? Here’s the deal:
What Causes Myopia?
Currently, there isn’t enough strong evidence to attribute myopia to a single cause. However, most researchers believe the underlying cause is a combination of both genetic factors and lifestyle habits (especially during childhood).
There is a correlation between myopia in parents and their children. Many studies show a higher rate of myopia in children with nearsighted parents and an even higher risk for children with two nearsighted parents.
If you have myopia and are a parent, your children are more likely to develop myopia as well.
Other than genetic factors, environmental factors are also an important factor in the development of nearsightedness. The main lifestyle habits that have been investigated for their role in nearsightedness are near work and urbanization.
A review of 27 studies on the effects of near work and reading in myopia showed children who spend long periods of time inside doing close-up activities — such as reading, writing, computer/phone use, and playing video games — have a higher probability of developing myopia. This review included studies on thousands of children from all over the world.
To look at the effects of urbanization, this review also included studies on children with very similar genetic backgrounds, but that grew up in different environments (rural vs. urban areas). They concluded that those growing up in rural environments have a lower chance of becoming nearsighted.
These results on urbanization support a review by the American Academy of Ophthalmology on the connection between time spent outdoors and myopia in children and adolescents. The results are clear: outdoor activity reduces the risk of developing myopia and its progression in children and adolescents.
It’s also worth noting that if you do an excessive amount of near-vision work you may experience a false or “pseudo” myopia. In this case, overusing the focusing mechanism of your eyes is what causes blurred distance vision, because your eyes are temporarily unable to refocus to see clearly in the distance. Clear distance vision usually returns after resting your eyes.
Connecting the Dots
In my own personal case, it’s interesting that none of my parents have myopia, yet I do.
I got my first pair of glasses to correct myopia when I was in the 4th grade. I remember as a child I didn’t play outside as much as my friends did. I also remember being top of my class, which involved long hours of studying (near work). Also, it was around this time that my parents got me a PSP (PlayStation Portable). I spent insane amounts of hours glued to that thing.
I’m starting to connect the dots and see that it’s very likely these bad habits contributed to the onset and progression of my myopia.
If you also are nearsighted, you may start to remember some of your vision habits as a child and realize they probably contributed to the state of your eye health today.
Unfortunately, the damage is already done so let’s let bygones be bygones. The only thing we can do is stir our children in a better direction and protect their eyes.
Symptoms of Myopia
The most common signs that you may have myopia (other than blurry distance vision) include the following:
- Squinting when looking at distant objects
- Blurry night vision
- Sitting too close to the television
Generally, these symptoms become more obvious when children are between ages 8 and 12 years old. However, myopia may also develop in adults due to visual stress or health conditions such as diabetes.
If you or a loved one are experiencing some of these symptoms, an eye exam by an ophthalmologist will determine if you have nearsightedness or not. To correct this condition, your doctor may recommend one of the following:
Solutions for Myopia
People with myopia have some options available to see well again. However, there is no best method for correcting myopia. The most appropriate correction for you depends on your unique eyes and your lifestyle.
Discuss your lifestyle with your eye doctor. Together, you can decide which correction is most suitable for you:
Eyeglasses (also called spectacles) are the most common treatment option for myopia.
The prescription for the glasses or contact lenses of a myopic person will be a negative number. The more negative the number, the stronger your lenses will be — meaning the worse your vision is. For example, -2.00 is worse than -1.50.
For nearsightedness the lenses are concave (also called “minus” lenses). This type of lens will move the focal point of light further back to the retina, which is where we want it for clear vision, instead of letting the focus point of light fall short of the retina.
If you’re an active person that does a lot of sports, contact lenses are probably better for you than eyeglasses. Along with glasses, they are the easiest and most common ways to correct vision problems.
To correct nearsightedness, contact lenses are slightly thinner in the center than at the edges. This isn’t noticeable to the naked eye, but because they sit so close to your eyes, these small changes are enough to correct vision.
There’s also a different type of contact lens with a technology called Orthokeratology (Ortho-K). You put on these specially designed contact lenses at bedtime, and when you wake up you will have clear vision for the whole day without having to wear glasses or contact lenses. They work by temporarily reshaping the curvature of the front part of your eye to improve vision.
In most cases, eye surgery will involve permanently reshaping the cornea (front part of your eye). The most common procedures are LASIK and PRK.
During LASIK, the surgeon will create a thin flap on the outer cornea, lift it, and then apply a laser that corrects your vision by reshaping the inner cornea. After that, the flap is put back in place and smoothed out. The recovery is fast because the flap will act as a natural bandage.
In PRK, no flap is created so recovery takes longer. However, PRK is more suitable for people who do contact sports because with LASIK there’s a risk that a blow to the face will dislodge the flap created.
As with any surgery, there are risks of possible complications and side effects. After eye surgery, you may see glare or halos around lights (double vision), dry eyes, light sensitivity, and experience increased eye pressure.
Now that you know the three main ways to correct for myopia, you may be wondering if it’s possible to cure myopia completely or even reverse myopia:
Can Myopia Be Cured?
For children, it’s important to spot symptoms as early as possible, as it’s possible to control the progression of myopia.
Because people with high myopia are at a greater risk of developing cataracts, glaucoma, and tears on the retina, myopia management is very important to help maintain eye health.
To better understand myopia control, we need to divide it into two components — preventing myopia from starting in the first place and stopping the progression of myopia if you (or your child) already have it.
When it comes to preventing myopia from starting in the first place, a review of environmental risk factors showed that spending more time outdoors is consistently proven to be the most effective way to lower the chance of children developing myopia.
This means children with low levels of outdoor activity are significantly more nearsighted than those with higher levels of outdoor activity.
The review also looked into studies showing significant evidence that the rate of myopic progression changes across different seasons. They showed less myopia progression and axial elongation in the summer than in the winter.
The slower rate of myopic progression in the summer could either be due to more outdoor activity and reduced near work during the school break in the summer or maybe due to more exposure to sunlight.
The main takeaway here is that children should spend more time outdoors. The human body was not designed for the modern-day indoor digital lifestyle.
Stopping Myopia Progression
If your child already has myopia, it’s still a great idea for them to spend more time outdoors. However, different options for myopia management also come into play.
Scientists have looked into lots of ways to stop the progression of myopia, but there is no single superior agreed-upon method as of today.
Based on a recent review of several different studies on the different options for myopia control, here are the most promising ones:
- Orthokeratology: These are contact lenses that you only wear while you sleep. When you wake up you have a temporarily reshaped cornea and clear vision without the need for glasses.
- Atropine Eye Drops: Atropine is usually used before an eye exam to help relax the eyes and get accurate measurements. Doctors are not sure why atropine for the treatment of childhood myopia seems to be effective, but the hypothesis is that it attaches to certain growth receptors in the eyes, blocking the stimulation that produces the elongation of the eyeball and holding back myopia. Atropine can cause some side effects like light sensitivity, but low-concentration atropine can provide sufficient myopia control with fewer side effects.
- Soft Bifocal Contacts Lenses: These are contact lenses that have less myopic power in the peripheral part. Along with orthokeratology, the theory behind why they work is that they provide myopic blur to the retina, which acts as a signal to slow myopic eye growth.
Keep in mind more research is needed on the possibility of myopia rebounding after these treatments are stopped.
The Bottom Line
There you have it! Now you know what is nearsightedness and how it’s corrected.
Nearsightedness happens due to a combination of genetics and lifestyle factors. If you are nearsighted, you see distant objects blurry because you have an eyeball longer than normal.
Glasses, contacts, or refractive surgery will usually correct the problem immediately. There are many options to consider when buying glasses or contacts. Talk with your eye doctor about what can meet your vision and lifestyle needs.
It’s also possible to prevent the likelihood of children developing myopia by having them spend lots of time outside.
It’s important that you go see an eye doctor if you are having trouble seeing far objects or notice you or your child squinting your eyes to see the TV clearly.
Have any questions? Leave them in the comments below! I will get back to you as soon as possible.
8 Cited Research Articles
- Holden, Brien A et al. “Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050.” Ophthalmology vol. 123,5 (2016): 1036-42. doi:10.1016/j.ophtha.2016.01.006
- Foster PJ, Jiang Y. Epidemiology of myopia. Eye (Lond). 2014;28(2):202-208. doi:10.1038/eye.2013.280
- Toates, F M. “Accommodation function of the human eye.” Physiological reviews vol. 52,4 (1972): 828-63. doi:10.1152/physrev.1922.214.171.1248
- Mutti, Donald O et al. “Parental myopia, near work, school achievement, and children’s refractive error.” Investigative ophthalmology & visual science vol. 43,12 (2002): 3633-40.
- Huang, Hsiu-Mei et al. “The Association between Near Work Activities and Myopia in Children-A Systematic Review and Meta-Analysis.” PloS one vol. 10,10 e0140419. 20 Oct. 2015, doi:10.1371/journal.pone.0140419
- Sherwin, Justin C et al. “The association between time spent outdoors and myopia in children and adolescents: a systematic review and meta-analysis.” Ophthalmology vol. 119,10 (2012): 2141-51. doi:10.1016/j.ophtha.2012.04.020
- Ramamurthy, Dharani et al. “A review of environmental risk factors for myopia during early life, childhood and adolescence.” Clinical & experimental optometry vol. 98,6 (2015): 497-506. doi:10.1111/cxo.12346
- Walline, Jeffrey J. “Myopia Control: A Review.” Eye & contact lens vol. 42,1 (2016): 3-8. doi:10.1097/ICL.0000000000000207
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