Myopia (Nearsightedness)

What is myopia?¹

Myopia, also known as nearsightedness, is a visual condition in which near objects are seen clearly, but distant objects are blurry and do not come into proper focus.

Why does myopia occur?^1-4

When the eyeball is too long or if the front of the eye (cornea) is too curved, light entering the eye is not focused properly onto the back of the eye (retina). The retina is the sensory layer of the eye that relays light as neural signals to the brain which allows us to see. Myopia describes the condition where lights are improperly focused onto the retina resulting in a blurry image being seen.

Myopia has both a genetic and environmental component. Children with parents who have myopia are more likely to be myopic themselves and show a faster rate of myopic progression. Increased near work such as reading and tablet use is also correlated with increased rate of myopia in children.

How common is myopia?^5-6

Myopia is a very common visual condition that currently affects 30% of the population. By 2050, the prevalence of myopia is estimated to increase to 50% of the world’s population. Along with the rising prevalence, myopia is occurring in earlier ages starting in childhood (6-7 years of age) and progressing at a more rapid rate than the previous generations.

How is myopia diagnosed?

Getting a routine eye exam is the best way to diagnose myopia. At the eye exam, the optometrist will perform tests to determine if there is a prescription for myopia. People with myopia will have trouble seeing distant objects, such as the road sign, whiteboard, movie screen and TV. However, children with myopia may not report symptoms of blur because their vision is all they have known and assume everyone sees the way they see. Therefore, routine eye exams are crucial for the early detection and management of myopia. 

How is myopia treated?^7-16

Studies have shown that an hour of outdoor time each day for children may help to delay the onset of myopia.^7,8 Remember to wear sunglasses and sunscreen while outdoors.

Depending on the child, the prescription may change or stay the same. As the child grows, so do their eyes, so oftentimes this will result in an increase in the amount of myopia as their eyes develop.¹⁰ Early detection and treatment of myopia is crucial, as some children may progress rapidly towards a higher prescription. High amounts of myopia is associated with increased risk of sight threatening conditions including retinal detachments, cataracts, glaucoma and myopic maculopathy.^11,12 It is important to note that glasses, contact lenses, laser procedures and other surgical procedures are only altering the way that light enters the eyes, but they do not cure myopia and the sight threatening risks associated with it. However, there are treatment options for children with myopia to slow down the progress of myopia.^13,14 These options include peripheral defocus glasses,¹⁵ peripheral defocus soft contact lenses,¹⁶ orthokeratology (ortho-k) hard contact lenses,¹⁷ and atropine eye drops.¹⁸

How does myopia impact daily life?

If glasses or contact lenses are prescribed, it may take up to two weeks to adjust to seeing clearly with them. Some people with myopia may find that they are restricted from some occupations such as police officers or fire fighters, due to their inability to see properly if their glasses fall off. In these cases, laser surgery may be useful. Contact lenses are very helpful for correcting myopia and are ideal for people with more active lifestyles. Visit your local optometrist to learn more about myopia.

References

1. Morgan PIG et al. Myopia. Lancet. 2012;379(9827):1739-1748.
2. Mutti DO et al. Parental myopia, near work, school achievement, and children’s refractive error. Invest Ophthalmol Vis Sci. 2002;43(12):3633-3640.
3. Kurtz D et al. Role of parental myopia in the progression of myopia and its interaction with treatment in COMET children. Invest Ophthalmol Vis Sci. 2007;48(2):562-570.
4. Tedja MS et al. IMI – myopia genetics report. Invest Ophthalmol Vis Sci. 2019;60(3):M89-M105.
5. Holden BA et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmol. 2016;123(5):1036-1042.
6. Vitale S et al. Increased prevalence of myopia in the United States between 1971-1972 and 1999-2004. Arch Ophthalmol. 2009;127(12):1632-1639.
7. Guo Y et al. Outdoor jogging and myopia progression in school children from rural Beijing: the Beijing children eye study. Transl Vis Sci Technol. 2019;8(2):2-2.
8. Xiong S et al. Time spent in outdoor activities in relation to myopia prevention and control: a meta-analysis and systematic review. Acta Ophthalmol. 2017;95(6):551-566.
9. Cooper J et al. A review of current concepts of the etiology and treatment of myopia. Eye Contact Lens. 2018;44(4):231-247.
10. Smith MJ et al. Controlling myopia progression in children and adolescents. Adolesc Health Med Ther. 2015;6:133-140.
11. Filtcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Prog Retin Eye Res. 2012:31(6):622-660.
12. Saw S et al. Myopia and associated pathological complications. Ophthalmoic Physiol Opt. 2005:25(5):381-391.
13. Walline JJ et al. Interventions to slow progression of myopia in children. Cochrane Database Syst Rev. 2020;1:CD004916.
14. Bullimore MA et al. Myopia Control 2020: Where are we and where are we heading? Ophthalmic Physiol Opt. 2020;40(3):254-70.
15. Lam CSY et al. Defocus incorporated multiple segment (DIMS) spectacle lenses slow myopia progression: a 2-year randomized clinical trial. Br J Ophthalmol. 2020;104:363-368.
16. Paul C et al. A 3-year randomized clinical trial of MiSight lenses for myopia control. Optom Vis Sci. 2019;96(8):556-567.
17. Cho P et al. Retardation of myopia in orthokeratology (ROMIO) study: a 2-year randomized clinical trial. Invest Opthalmol Vis Sci. 2012;53(11):7077-7085.
18. Li FF et al. Age effect on treatment responses to 0.05%, 0.025%, and 0.01% atropine: low-concentration atropine for myopia progression study. Ophthalmol. 2021;128(8):1180-1187.