FAQs about myopia | Signs, symptoms, & management strategies

Question 1

What are the signs and symptoms of myopia?

Accepted Answer

Signs and symptoms of myopia may include:SquintingTrouble seeing far awayGetting unusually close to digital devices, TV or booksStruggling to see the board at schoolHeadachesComplaints of tired eyes

Question 2

What causes myopia in children?

Accepted Answer

The cause of myopia is yet unknown, but there are a number of risk factors for myopia development and progression we do know about. Those include:Having myopic parents[^3]Extensive time spent on "near work", like reading books or viewing digital devices[^4],Spending under two hours per day outside[^19]Developing myopia at an early age (such as 5 or younger)[^1]To learn more about different factors that contribute to the development of myopia, you can take our Myopia Assessment Quiz

Question 3

Does myopia worsen with age in children?

Accepted Answer

Typically, myopia does tend to worsen with age when it presents in children. The earlier a child develops myopia, the greater the chance of developing higher levels of myopia. That's because the eye grows more rapidly in younger children and will likely progress for a greater number of years.[^1]Every child should be monitored for myopia from an early age, with annual comprehensive eye exams starting by age 5.[^7,11] A comprehensive eye exam—which is much more extensive than an annual vision screening at school—can detect the early signs of myopia, as well as more than 270 systemic and chronic diseases.[^12]Talk to your eye doctor to learn more about strategies for managing myopia.

Question 4

How do astigmatism and myopia differ?

Accepted Answer

Myopia is when the eye grows longer than it's supposed to, causing light to focus in front of the retina instead of on it.[^13] This results in blurry distant vision, and over time, the eye becomes strained due to this unusual lengthening. Because of this extra strain on the structure of the eye, myopia can lead to eye disease later in life.[^14]Astigmatism comes from imperfections in the curvature of either the front surface of the eye (cornea) or the crystalline lens inside the eye. Simply put, your eye's surface is supposed to be round like a basketball but with astigmatism, it is oval like an American football. Astigmatism comes with blurry or distorted vision both close up and afar. It can be present at birth or develop later in life, and can also develop after eye injury or surgery.While they are two different conditions, it is possible for a patient to have both myopia and astigmatism.

Question 5

What is high myopia?

Accepted Answer

High myopia is defined as having a refractive error of -5.00D (diopters) or more.[^15] A refractive error is determined by measurements performed by an eye doctor. A person with high myopia would experience more blurring of distance vision than a person with lower levels of myopia.

Question 6

Can myopia be reversed or cured?

Accepted Answer

As far as scientists know, it's not possible to reverse or cure myopia. However, spending time outdoors is one evidence-based way that may delay the onset of myopia in children.[^16] Growing evidence supports the theory that more time outdoors may also slow the progression of myopia and benefit all children.[^16] Limiting near work has been shown to help as well.[^22] Talk to your doctor to learn more about managing myopia.

Question 7

Can myopia lead to blindness?

Accepted Answer

Although we used to think of myopia as just nearsightedness, we now know that it's much more. Myopia is a chronic, progressive disease in which the eye grows longer than it's supposed to.[^13,14,17] Over time, this can put strain on the delicate structures of the eye, leading to other vision complications later in life.[^13,14,17] Some of these complications include myopic macular degeneration, glaucoma, cataracts, retinal detachment, and even blindness.[^18]

Question 8

What’s the difference between vision screening performed at school or the pediatrician’s office versus a comprehensive eye exam?

Accepted Answer

While school vision screenings are a useful tool in detecting vision problems in children, they are not a substitute for a comprehensive eye exam by an eye care professional. There are several reasons why a comprehensive eye exam is important for your child, even if they have received a vision screening at school:Screenings have a limited scope: School vision screenings typically only check for the ability to see clearly at a distance. However, a comprehensive eye exam performed by an eye doctor includes a thorough evaluation of your child's eye function, eye health, and general health, as well as the prescription for glasses or contact lenses if needed.Early detection of eye problems: This allows for prompt treatment and reduces the risk of more serious problems later. Some common eye problems, such as amblyopia (lazy eye) or strabismus (eye turn), may only be diagnosed with a comprehensive eye exam.[^12]Personalized recommendations: An eye doctor can identify the appropriate type and prescription of eyeglasses or contact lenses for your child. They can also advise on lifestyle changes that may help protect your child's vision and overall eye health.Regular monitoring: Regular comprehensive eye exams can help track the progression of any eye problems and ensure timely changes to your child's vision correction or treatment plan.School vision screenings are useful for detecting vision problems in children, but they are not a substitute for a comprehensive eye exam by an eye doctor.

Question 9

How often should my child have an eye exam?

Accepted Answer

Every child should be monitored for myopia from an early age, with annual comprehensive eye exams starting by the age of 5. [^7,11] A comprehensive eye exam—which is much more extensive than an annual vision screening at school—can detect the early signs of myopia, as well as more than 270 systemic and chronic diseases.[^12] Your eye doctor may recommend seeing your child more frequently if they start any kind of treatments or if it's necessary to monitor their myopia.

Question 10

Where can I get my child screened for myopia?

Accepted Answer

An eye doctor (optometrist or ophthalmologist) performs eye exams that include screening for myopia.

Question 11

What should I expect from a myopia eye exam?

Accepted Answer

A myopia exam is just like any other eye exam. Your child's eye doctor will look at your child's vision, overall eye health, and find how your child uses their vision at school, sports, hobbies, etc. They'll also test eye muscle function, evaluate the health of their eyes and surrounding structures, and check for any signs of eye diseases or conditions. The exam may involve a number of tests and procedures, including a visual acuity test, a dilated eye exam, tonometry to measure eye pressure, a slit-lamp exam to check the health of the front of the eye, and other equipment to check the health of the back of the eye. Based on the results of the exam, the doctor may recommend treatment options.

Question 12

What are some common eye health words I may hear during the eye exam?

Accepted Answer

Refractive Error: This refers to a category of vision problems where the patient struggles to see clearly. Common types of refractive error are:Nearsightedness (myopia): Trouble seeing far away or items in the distance are blurryFarsightedness (hyperopia): Nearby object or up close objects look blurryAstigmatism: Makes far away or nearby objects look blurry or distorted due to the eyeball being shaped more like an American football than a soccer ballPresbyopia: Develops later in life, usually early to mid 40s, making it hard to read or to see items up closeVision Correction: Any kind of glasses or contacts lenses that help correct vision issues like nearsightedness or farsightedness. Diopter: A term used to reference the optical power or correction needed in a pair of contact lenses or glasses. For example, you may see a prescription for glasses or contacts referred to as -2.0D or +2.0D. In both instances, the D stands for diopters. When you're nearsighted (unable to see far away), your prescription is represented with a minus sign (i.e. -2.0D). When you're farsighted (unable to see up close, like needing glasses to read), your prescription is represented with a plus sign (i.e. +2.0D). Axial Length: How long the eye is from the front of the eye to the back. This measurement can be used to understand if the eye is growing too long due to myopia and monitor myopia progression. Binocular Vision: Refers to having both eyes capable of facing the same direction to perceive a single image. This involves your brain's ability to use information from both of your eyes at once. Having good binocular vision helps us accurately judge distance and depth, and keeps our eye movements coordinated.

Question 13

Can sunlight or vitamin D help prevent or slow myopia?

Accepted Answer

Research suggests that healthy lifestyle changes like spending at least 2 hours outside every day may help prevent or slow the progression of myopia.[^16] The benefits of time outdoors could be related to the impact of different visual environments, such as viewing objects from afar vs. up-close, or it could be the large, focused field of view in the outdoor visual environment. Brightness, or type of light such as sunlight vs. indoor lighting could play a role, but more research is needed to determine the mechanisms behind the elongation of the eye.[^19,20]There is no evidence yet that supports vitamin D slowing the progression of myopia.

Question 14

Can reduced screen time cure or reduce myopia?

Accepted Answer

Studies indicate that reducing 'near work' activities may have a positive impact on myopia.[^4] 'Near work' includes all activities where the child is looking at something close to their face, like reading a book, drawing a picture, or looking at a tablet. New studies are being done to further our understanding. When doing near work, it's important to take frequent breaks.[^21] Try following the 20-20-20 rule next time you or your child are using your eyes to see close up. Every 20 minutes, look 20 feet away for 20 seconds.

Question 15

Can eye exercises/vision therapy cure myopia?

Accepted Answer

While there is no evidence to suggest that eye exercises can cure myopia, there are activities that may help slow the progression of myopia. An example of this is following the 20-20-20 rule when doing near work activities like reading, writing, painting, or spending time on a digital device. For every 20 minutes of near work, look at a target 20 feet(6 metres) away for 20 seconds before returning to your near work activity. Talk to your doctor about activities that may contribute to your overall eye health.

Question 16

Can under-correcting myopia (providing less prescription than recommended) help myopia? I’ve heard giving glasses to my child will make their eyes worse over time.

Accepted Answer

There is a common misconception that wearing glasses or contacts with a lower prescription than the doctor recommends or skipping glasses entirely makes your eyes work harder to see, therefore reducing myopia, but this has been disproven.[^22] Studies show that under-correcting myopia can actually make myopia progress faster.[^23] Under-correcting also means your child will still struggle to see items clearly in the distance since you're using a weaker prescription. They may struggle to see the board in school or become disinterested in sports since they can't see clearly. It is recommended to use the prescription your doctor has identified for your child. Talk to your doctor about different myopia management options.

Question 17

Can LASIK treat or cure my myopia?

Accepted Answer

LASIK may safely correct refractive error in adults and potentially eliminate the need for glasses or contact lenses,[^24] however it does not cure myopia. Myopia candidates who undergo LASIK may still be at risk of sight-threatening complications later in life due to the lengthening of the eye that occurred before LASIK. LASIK does not prevent myopia progression, and usually LASIK can only be performed after a myopia candidate has slowed or stopped progression in their prescription. LASIK candidates need to be assessed by an eye care practitioner and the eye prescription and ocular health needs to fit certain parameters for this procedure to correct vision successfully. LASIK is not federally approved for use in children/anybody under the age of 18, and some higher prescriptions may not be candidates for LASIK.[^25] For more information on LASIK, please see https://www.aao.org/eye-health/treatments/lasik

Question 18

Do regular glasses and contacts help or hurt myopia? What’s the difference between vision correction and myopia management?

Accepted Answer

Regular prescription glasses and contacts for vision correction will help address symptoms of myopia like blurry distance vision and allow you or your child to see clearly. However, they aren't able to stop or slow the eye from continuing to grow longer over time, which is what causes vision to get worse. Talk to your doctor about the difference between vision correction and myopia management treatment options to see what may work for you or your child.

Question 19

Are there treatments available for myopia?

Accepted Answer

There are a variety of different treatment options available for myopia. Talk to your doctor to learn more about what treatment options work best for you or your child.

Question 20

Will I see better with myopia management treatment options?

Accepted Answer

Talk to your doctor to find out what myopia management treatment option would work best for you. Your eye doctor can help make sure you have clear vision while managing your myopia.

Question 21

Do I still need to change my child’s prescription when undergoing myopia management?

Accepted Answer

Once treatments for myopia have started, it's recommended to stay in a treatment until your doctor is able to confirm that your child's eye has stopped growing or growing has slowed.[^26] This tends to occur in teenage or young adult years, but every person progresses differently. Talk to your doctor about treatment options for myopia management.

Question 22

When should myopia management start?

Accepted Answer

Myopia management should begin as soon as you notice symptoms, such as struggling to see items far away, squinting to see items that are far away, sitting unusually close to the TV, headaches, and any signs that children are falling behind in school. Talk to your doctor about what myopia management options are right for you or your child.

Question 23

Are there age restrictions on myopia management? Is my child too young or too old?

Accepted Answer

Myopia management options should be started as soon as myopia has been identified in the patient. This could be at a younger age in childhood, or later in teenage/young adult years. Talk to your doctor about what myopia management options are right for you or your child.

Question 24

How long will I need myopia management for?

Accepted Answer

Once treatments for myopia have started, it's recommended to stay in a treatment until your doctor is able to confirm that the eye has stopped growing or growing has slowed. This tends to occur in teenage or young adult years, but every person progresses differently.[^26] Talk to your doctor about treatment options for myopia management.

Question 25

Are there side effects with myopia management?

Accepted Answer

As with any type of medical intervention, there may be side effects to treatment. Talk to your eye doctor about what type of myopia management product is best for you and any associated side effects.

Question 26

What can I do around the house to help manage my kid’s myopia?

Accepted Answer

Simple lifestyle changes can help. Make sure they're spending at least 2 hours outside every day.[^21] When they're indoors, there are other tips and tricks you can implement into their daily life to help keep their eyes health.The elbow rule: Keep an elbow-to-hand distance away from books and screens to avoid them being too close to the eyes.The 20-20-20 rule: Take regular breaks from reading to reduce demand on the visual system. Every 20 minutes, take a break for 20 seconds and look across the room.Less near work: Try to limit near work activities (outside of schoolwork) as much as possible in school aged children.[^4]

Resources

About Myopia

Questions About Eye Exams

How Can I Manage Myopia?

Learn About What Causes Myopia and How to Treat

What is myopia and how do people develop it?

How does myopia affect a person's vision?

How to treat and manage myopia

References: