Can you prevent myopia?

Short-sightedness is on the rise. We investigate ways to manage and even prevent it in both children and adults.

Nicola Conville
January 2019

Myopia, also called short-sightedness, is a common condition in which close objects appear clear, but faraway objects appear blurry. It’s the most common eye problem affecting children and is rapidly growing around the world, reports the Brien Holden Vision Institute. There are currently 4 million cases of myopia in Australia, which is tipped to jump to 22 million by 2050.

But why is it on the rise? Some experts say spending time indoors, away from natural light, could be partly to blame.

Can You Prevent Myopia?

Understanding the condition

Myopia usually begins in childhood (from age 6 onwards) and can worsen through to early adult years. It can also occur in adults with no prior history of eye problems and affect babies at birth (known as congenital myopia).

A myopic eye is too long from front to back, says the US National Eye Institute. As a result, light rays focus in front on the retina instead of on it, bringing clarity to close vision but blurriness far away. The retina is at the back of the eye.

Professor Padmaja Sankaridurg, head of the Global Myopia Centre at the Brien Holden Vision Institute, says that uncorrected short-sightedness in children can impact classroom involvement, social development and peer engagement. If uncorrected into adulthood, there can be further complications.

“High myopia increases the risk of vision impairment and also sight-threatening complications such as myopic maculopathy, cataracts, glaucoma” and retinal detachment.

Although the condition can’t be cured, corrective glasses or contact lenses to adjust the focus onto the retina can improve vision and reduce future deterioration. Prof Sankaridurg recommends regular testing and monitoring to ensure you stay on top of treatment.

What causes myopia?

Short-sightedness is influenced by both genetic and environmental factors but an exact cause isn’t known. Optometrist Dr Jessica Chester explains that if both of your parents have myopia, you’ll probably develop it too.

Environmental factors, she adds, can include staring at close objects such as books and screens for too long without regular breaks.

The Royal Australian and New Zealand College of Ophthalmologists explains that although there’s no hard evidence that screen time adversely affects children’s eyesight, we should keep it to a minimum. Read the Australian Government guidelines on screen time.

The benefits of light

What is emerging though is growing evidence of the role of outdoor time (safe exposure to natural daylight) on healthy eye development.

Can We Prevent or Control Nearsightedness?

Can You Prevent Myopia?

Qi Yang / Getty Images

Myopia, also known as nearsightedness, occurs when the eyeball is longer than normal or when the cornea is steeper than average. Nearsightedness causes light to focus in front of the retina instead of directly on its surface.

Someone with nearsightedness may squint noticeably when trying to view objects in the distance. They may also sit very close to the television or bring books very close to their eyes when reading. Myopia requires visual correction, usually in the form of eyeglasses or contact lenses. Refractive surgery, such as LASIK, can also correct nearsightedness.

Myopia is receiving much more attention lately because the prevalence appears to be increasing significantly. Some countries view nearsightedness as either an epidemic or a public health crisis.

In the United States, the prevalence of myopia has increased as much as 40 percent over the past 30 years.

In some countries, such as China, the prevalence of myopia approaches 80 percent of the population.

Myopia has become a hot topic because of the possible risks associated with it. High myopia, usually defined as over 5.

0 units or diopters (D), creates an increased risk for glaucoma, cataracts, retinal detachment, and myopic maculopathy. Just 1.

0 D of myopia doubles a person's risk for myopic maculopathy and cataracts and triples the risk of retinal detachment compared to people with emmetropia.

Emmetropia is the state when you do not need any vision correction, also known as normal vision. At 3.

0 D of myopia, the risk of cataract triples and the risk of retinal detachment and myopia maculopathy is nine times that of someone with no vision problems. Furthermore, at 5.

0 D of myopia, the risk of cataract is five times higher, 21 times the risk for retinal detachment and 40 times higher risk for developing myopic maculopathy.

No one knows for sure what causes myopia. Genetics appear to play a big role. In fact, if one parent is nearsighted, the child has a three-fold risk of becoming nearsighted. If both parents are nearsighted, that three-fold risk doubles.

Historically, there has been a long history of an association of the increase in nearsightedness in people who are actively involved in doing more near work.

Even as far back as the 1800s, scientists showed a relationship that people that had higher education or worked in an occupation that included a lot of near work, were much more nearsighted than those that did not have higher education or worked outside.

However, what is still not clear is the fact that personalities that are drawn to higher intellectual occupation or ones that involve much more near work (activities that involve a short working distance) may be made up of people who are drawn to those types of jobs or scholarly studies. This area is currently being investigated by many researchers.

Most of us are exposed to an inordinate amount of near stimuli with smartphones, tablets, computers and a host of other digital devices. The jury is still out on whether this is really something we as a society need to be concerned about or not.

There are just as many studies that show that near work does not cause nearsightedness as there are studies that show that it does. It is probably a more complex algorithm that includes genetics and the amount of time spent outdoors.

Prevent Myopia From Getting Worse

Can You Prevent Myopia?It can be easy to prevent myopia from getting worse once you know what causes it. Myopia, more commonly known as nearsightedness, is caused by a distortion in the shape of the eyeball. Due to this slight distortion, images are projected on the front of the retina rather than directly onto the retina. Those with myopia probably see objects very well when they are up close, but have trouble seeing things that are far away.

See also:  ‘stint’ or ‘stent’?

Most people with myopia wear glasses or contact lenses, but these things do not prevent myopia from worsening. Instead, they reduce the symptoms of myopia. Here are some ways that you can prevent myopia from getting worse.

Spend a lot of time outside

If you are interested in trying to prevent myopia from worsening, you may want to consider spending more time outside. Myopia worsens when one spends too much time in a state of near focus.

Activities such as reading for long periods of time or knitting can lead to a worsening of the condition.

To prevent myopia from worsening, spend time outside and try to focus on objects that are in the distance.

Take breaks when using computers or cell phones

As mentioned above, myopia worsens when one spends too much time looking at objects that are in near focus. This includes your computer and cell phone screens! It can be easy to spend hours on end looking at electronics screens, but this will inevitably worsen the condition of your eyes.

Try to give your eyes a break every fifteen to twenty minutes. Take a minute or two to focus your eyes on something other than the screen. This routine exercise of the eyes will help prevent myopia from worsening.

It is also beneficial to give the eyes a break from looking at the harsh light of the screen.

Vision therapy

Myopia Control – A Cure for Nearsightedness?

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If your child has myopia (nearsightedness), you're probably wondering if there is a cure — or at least something that can be done to slow its progression so your child doesn't need stronger glasses year after year.

For years, eye care practitioners and researchers have been wondering the same thing. And there's good news: A number of recent studies suggest it may indeed be possible to at least control myopia by slowing its progression during childhood and among teenagers.

Watch this video to learn more about myopia and what can be done to slow the progression of nearsightedness in children.

What Is Myopia Control?

Although an outright cure for nearsightedness has not been discovered, your eye doctor can now offer a number of treatments that may be able to slow the progression of myopia.

These treatments can induce changes in the structure and focusing of the eye to reduce stress and fatigue associated with the development and progression of nearsightedness.

Why should you be interested in myopia control? Because slowing the progression of myopia may keep your child from developing high levels of nearsightedness that require thick, corrective eyeglasses and have been associated with serious eye problems later in life, such as early cataracts or even a detached retina.

Currently, four types of treatment are showing promise for controlling myopia:

  • Atropine eye drops
  • Multifocal contact lenses
  • Orthokeratology (“ortho-k”)
  • Multifocal eyeglasses

[See also: What is Myopia Control?]

Here's a summary of each of these treatments and of recent myopia control research:

Atropine Eye Drops

Atropine eye drops have been used for myopia control for many years, with effective short-term results. But use of these eye drops also has some drawbacks.

Topical atropine is a medicine used to dilate the pupil and temporarily paralyze accommodation and completely relax the eyes' focusing mechanism.

Atropine typically is not used for routine dilated eye exams because its actions are long-lasting and can take a week or longer to wear off. (The dilating drops your eye doctor uses during your eye exam typically wear off within a couple hours.)

A common use for atropine these days is to reduce eye pain associated with certain types of uveitis.

Because research has suggested nearsightedness in children may be linked to focusing fatigue, investigators have looked into using atropine to disable the eye's focusing mechanism to control myopia.

And results of studies of atropine eye drops to control myopia progression have been impressive — at least for the first year of treatment. Four short-term studies published between 1989 and 2010 found atropine produced an average reduction of myopia progression of 81 percent among nearsighted children.

However, additional research has shown that the myopia control effect from atropine does not continue after the first year of treatment, and that short-term use of atropine may not control nearsightedness significantly in the long run.

Interestingly, one study found that when atropine drops were discontinued after two years of use for myopia control, children who were using drops with the lowest concentration of atropine (0.

01 percent) had more sustained control of their nearsightedness than children who were treated with stronger atropine drops (0.1 percent or 0.5 percent).

They also had less “rebound” myopia progression one year after treatment.

Also, many eye doctors are reluctant to prescribe atropine for children because long-term effects of sustained use of the medication are unknown.

Other drawbacks of atropine treatment include discomfort and light sensitivity from prolonged pupil dilation, blurred near vision, and the added expense of the child needing bifocals or progressive eyeglass lenses during treatment to be able to read clearly, since his or her near focusing ability is affected.

Orthokeratology

Orthokeratology is the use of specially designed gas permeable contact lenses that are worn during sleep at night to temporarily correct nearsightedness and other vision problems so glasses and contact lenses aren't needed during waking hours.

But some eye doctors use “ortho-k” lenses to also control myopia progression in children. Evidence suggests nearsighted kids who undergo several years of orthokeratology may end up with less myopia as adults, compared with children who wear eyeglasses or regular contact lenses during the peak years for myopia progression.

Many eye care practitioners refer to these lenses as “corneal reshaping lenses” or “corneal refractive therapy (CRT)” lenses rather than ortho-k lenses, though the lens designs may be similar.

In 2011, researchers from Japan presented a study that evaluated the effect of ortho-k lenses on eyeball elongation in children, which is a factor associated with myopia progression.

A total of 92 nearsighted children completed the two-year study: 42 wore overnight ortho-k lenses and 50 wore conventional eyeglasses during the day.

The average age of children participating in the research was about 12 years at the beginning of the study, and children in both groups had essentially the same amount of pre-existing myopia (-2.

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57 D) and the same axial (front-to-back) eyeball length (24.7 mm).

At the end of the study, children in the eyeglasses group had a significantly greater increase in the mean axial length of their eyes than children who wore the ortho-k contact lenses.

The study authors concluded that overnight orthokeratology suppressed elongation of the eyes of children in this study, suggesting ortho-k might slow the progression of myopia, compared with wearing eyeglasses.

In 2012, the same researchers published the results of a similar five-year study of 43 nearsighted children that showed wearing ortho-k contact lenses overnight suppressed axial elongation of the eye, compared with wearing conventional eyeglasses for myopia correction.

Also in 2012, researchers in Spain published study data that revealed children 6 to 12 years of age with -0.75 to -4.00 D of myopia who wore ortho-k contact lenses for two years had less myopia progression and reduced axial elongation of their eyes than similar children who wore eyeglasses for myopia correction.

Kids do look cute in glasses! But with the proliferation of ortho-k and other myopia control techniques, fewer kids may need eyeglasses for myopia in the future.

In October 2012, researchers in Hong Kong published yet another study of the effect of ortho-k contact lenses on controlling myopia progression in children. A total of 78 nearsighted children ages 6 to 10 years at the onset of the investigation completed the two-year study.

Children who wore ortho-k lenses had a slower increase in axial length of their eyes by 43 percent, compared with kids who wore eyeglasses. Also, the younger children fitted with the corneal reshaping GP lenses had a greater reduction of myopia progression than the older children.

Furthermore, as myopia control expert Jeffrey J. Walline, OD, PhD, from The Ohio State University College of Optometry pointed out in his analysis of the study published in the same issue of Investigative Ophthalmology & Visual Science, the benefit of slowed myopia progression from wearing the corneal reshaping lenses extended beyond the first year of myopia treatment.

In March 2014, researchers in Taiwan published results of a study that compared the use of ortho-k contact lenses vs. atropine eye drops for the control of myopia in children ages 7 to 17. Participants had myopia ranging from -1.50 to -7.50 D (with up to -2.75 D of astigmatism) at the beginning of the three-year study period.

The two myopia control treatments produced comparable results: children wearing the ortho-k lenses experienced myopia progression of -0.28 D per year, and those who wore eyeglasses and applied 0.125 percent atropine eye drops nightly had an average myopia progression of -0.34 D per year.

Although this study did not include a control group that received no treatment to control myopia, the study authors mentioned that in similar studies the progression of nearsightedness among children wearing ortho-k lenses for myopia control was roughly half that of those who received no myopia control treatment over a two-year period.

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Multifocal Contact Lenses

Multifocal contacts are special lenses that have different powers in different zones of the lens to correct presbyopia as well as nearsightedness or farsightedness (with or without astigmatism).

But researchers and eye doctors are finding that conventional or modified multifocal soft contact lenses also are effective tools for myopia control.

In 2010, researchers from Australia, China and the United States presented data from a study of experimental myopia control contact lenses worn by Chinese schoolchildren for six months. The contacts had a special dual-focus multifocal design with full corrective power in the center of the lens and less power in the periphery.

Participants were between the ages of 7 and 14 at the onset and had -0.75 to -3.50 diopters (D) of myopia, with no more than 0.50 D of astigmatism.

A total of 65 children wore the experimental multifocal contacts, and 50 children wore eyeglasses.

After six months, the children wearing the multifocal contact lenses had 54 percent less progression of their myopia than the children wearing eyeglasses.

In June 2011, researchers in New Zealand reported on a comparison of an experimental multifocal soft contact lens and conventional soft lenses for myopia control in children.

A total of 40 nearsighted children ages 11 to 14 participated in the study.

The children wore the multifocal contact lens on one randomly assigned eye and a conventional soft contact lens on the fellow eye for 10 months, then switched the lenses to the opposite eye for another 10 months.

In 70 percent of the children, myopia progression was reduced by 30 percent or more in the eye wearing the experimental multifocal contact lens in both 10-month periods of the study.

In November 2013, researchers in the U.S. published the results of a two-year study that revealed nearsighted children who wore multifocal soft contact lenses on a daily basis had 50 percent less progression of their myopia, compared with similarly nearsighted children who wore regular soft contact lenses for two years.

Children participating in the study ranged in age from 8 to 11 years and had -1.00 to -6.00 D of myopia at the time of enrollment.

  • The study authors concluded that the results of this and previous myopia control studies indicate a need for a long-term, randomized clinical trial to further investigate the potential of multifocal soft contact lenses to control the progression of nearsightedness in children and thereby reduce risks associated with high myopia.
  • Children's Vision News

Nearly Half Of The Global Population May Be Nearsighted By 2050, Researchers Say

February 2016 — Researchers at the Brien Holden Vision Institute in Sydney, Australia, recently pored over data from 145 studies and analyzed the prevalence of myopia and high myopia among 2.1 million study participants. The group also used data published since 1995 to estimate trends from 2000 to 2050.

What they found was alarming.

An estimated 1.4 billion people worldwide were nearsighted in 2000. That's about 23 percent of the total global population. But by 2050, the researchers predict this figure will soar to 4.8 billion, afflicting 49.8 percent of the world's population.

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The good news is, there are ways to protect your children from landing on the wrong side of this statistic. One key may be to encourage them to turn off their electronic devices and head outdoors.

Myopia Control –
Stop Nearsightedness from Getting Worse

Myopia ControlMyopia, also called nearsightedness, is a visual condition where objects nearby or a short distance away are clear but objects that are far away are blurred. It is caused by the eye being slightly too long or the cornea (the front cap of the eye) being excessively curved.

Nearsightedness Gets Worse

It's common for prescriptions for glasses & contact lenses in children to grow stronger year by year. Why is this and is it preventable?

Myopia is a real problem.  Per studies, in the United States, myopia increased from 25% of the population having it in 1972 to over 40% in 2004.  And that was over 15 years ago!  In Asia, it is estimated that over 80% of the population is myopic!

Additionally, because myopia is caused by the shape of the eye changing, it increases the chance of other major eye problems such as retinal detachments, glaucoma, cataracts and macular degeneration.

What causes myopia?

In children:

  1. Heredity, somewhat. Even if both parents have myopia, there is still only a 50% chance that child will develop myopia.
  2. Near work stress. Too much time spent on computers, cell phones, texting and reading.  (This does not include school work.

    )

  3. Lack of outdoor exposure.
  4. Diet – Studies have demonstrated diets high in saturated fat and cholesterol were correlated with increasing myopia.
  5. Visual efficiency. Eyes not teaming together and/or the lack of focus when reading.

In Adults:

  1. Accommodative (focusing) challenges
  2. Near-vision dominated occupations, such as spending all day on a computer

In the last 10 years, a considerable research effort has been directed toward finding the environmental elements that cause myopia to progress.

We now believe that the stimulus to axial elongation—and hence to myopia progression—is defocus not in the central retina but in the mid-periphery.

In experimental models, when the light incident on the mid-peripheral retina was in focus, the eyes did not elongate (irrespective of whether light to the central retina was focused).

In particular, hyperopic defocus on the mid-peripheral retina appears to cause axial elongation and, thus, myopia.

Methods of Controlling & Slowing Myopia

1. Multifocal Contact Lenses

How do Multifocal Contacts Work?Optometrists first began using bifocal lenses to attempt to slow myopia progression in the 1940s.  A more recent alternate theory suggests that myopic children who do not accommodate (focus) efficiently while reading, which constitute about 30% of myopic children, could benefit from multifocal contact lenses.

Contact Lenses >>

2. Orthokeratology (also called Ortho-k)

Nearsightedness (Myopia): Causes, Signs & Treatments

If you can see things clearly when they are close to you, but the sharpness of the images fade when the item moves away from your face, you're dealing with nearsightedness, also known as myopia. It's a common condition that often develops during childhood and worsens through middle age. (Learn more)

Myopia is blamed on a combination of genetics and lifestyle, and researchers are investigating options that could help children avoid the condition.

(Learn more) Myopia can be treated with contact lenses, (Learn more), glasses, (Learn more) and LASIK surgery. (Learn more) Some people suggest that myopia could also be treated with exercises or vitamins, but researchers don't agree.

(Learn more)
A qualified eye care professional can help you understand what therapy might be right for you.

Table of Contents

Myopia just might be one of the most common conditions in the world today. In a study published in the journal Ophthalmology, researchers examined data published since 1995, and they determined that 49.8 percent of the population will have myopia in 2050. If about half of all the people in the world have myopia, it's safe to call it a common disorder.

In order to see images clearly, the light that enters your eye must coalesce into one shard that points at the back of your eye. The retina on the back of the eye can translate that sharp point of light into an electrical signal, and it's that signal that moves through the optic nerve to the brain.

People with myopia have an eyeball that is too long, so the focused light terminates in the middle of the eye rather than on the retina. A lens that is too thick or a cornea that is too curved can also cause or contribute to myopia. Any structural change that amends the light's ability to focus on the back of the eye results in fuzzy images perceived from objects far from the eye.

Myopia is often discovered, according to the American Academy of Ophthalmology, when children are between the ages of 8 and 12. Children may:

  • Complain of headaches.
  • Rub their eyes.
  • Squint frequently.
  • Perform poorly in school.
  • Trip, fall, or seem clumsy.

As children grow, their eyes may continue to elongate. That elongation can make symptoms of myopia worse, and that can continue until people reach early adulthood when growth stops.

The American Optometric Association reports that adults may also experience a form of nearsightedness caused by their work. This “pseudo myopia” is caused by overused eye muscles.

People who read, sew, repair clocks, or perform another form of close work for long periods of time may simply wear out the muscles in the eye, and they may find it's hard to see things at a distance when they look up from their work.

Rest can solve the problem, but continued overuse can lead to a permanent loss of distance vision.

Myopia can vary in severity. For some people, the issue is a mere annoyance. They may be able to see well enough to handle everyday tasks, such as housecleaning or gardening, but they may need to wear corrective lenses in order to drive. Some people have severe forms of myopia in which they cannot see clearly enough without lenses to do anything at all.

Myopia Develops Through Genetics and Lifestyle

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