What is Myopia?

Last Updated on February 9, 2024 by Josh Wilkerson

You are on the road to check out a restaurant for the first time. Your GPS is set and you are on your way. Even though your GPS tells you to make a turn on a specific street, you had a hard time making out the letters until you got close enough. The next thing you know is that you missed the street you were supposed to make a turn on. Yes—the GPS was there, but your eyes couldn’t tell and you wanted to read the sign before making a turn. Not to worry—it is a common mistake. The GPS will redirect you to your destination, but the real concern here is myopia. Ever heard of myopia? Think again—because chances are that you may have myopia even if you didn’t have it before. The eye specialist may not even have used that term in front of you or to you. Instead, he or she may have used “nearsightedness”. We all know what that is, but you may not know if you actually have it. It never hurt to know something you didn’t know yesterday, so here is a basic guideline on myopia.

What is Myopia?
It sounds like a name of another planet, doesn’t it? All jokes aside, myopia is another term for nearsightedness. It is the most common refractive error of the eye and it has become prevalent over the years. The exact cause of it is unknown, but doctors feel it has something to do with eye fatigue from prolonged computer and other tasks that affects near vision. Genetics also plays a role in having myopia.

What Causes Myopia?
This can happen when the eyeball is too long which is relative to the focusing power of the cornea and lens. This causes light rays to focus in front of the retina, rather than directly on its surface. Myopia can also be caused by the cornea and/or lens being too curved for the length of the eyeball. Myopia can also be caused by a combination of these factors as well. Genetics plays a huge role—do your parents have nearsightedness? Chances are you might have it as well for this reason. Myopia generally begins during childhood so make sure your kids’ eyes are checked regularly by an eye specialist.

Signs and Symptoms of Myopia
Are you the student that started out sitting in the back of the classroom, but soon you realized that you couldn’t see the every word written on the whiteboard? Did you notice that when you sat closer the whiteboard, the words became clearer? If the answer is yes to these questions, this could be a sign of myopia. This also applies when you have difficulty reading road signs and seeing distant objects clearly while being able to see well when you’re doing close-up tasks such as reading or using the computer. Some other signs include squinting or eyestrain and headaches. You may also feel fatigues when driving or playing sports which can be a sign of myopia. As always, if you are experiencing any of these symptoms, please consult your eye specialist for a comprehensive eye exam. We also recommend to seek an optometrist even when you’re wearing glasses and/or contacts and you are faced with these symptoms.

Myopia Treatment
So when you’re faced with this dilemma of not seeing objects clearly from a distance, you need to know what your options to correct your vision. You can wear glasses, contact lenses or do refractive surgery. It all depends on your eye health and the intensity level of myopia affecting your eyes. For instance, some people may only need their glasses or contacts when they’re reading or watching TV while others may need it all the time in their daily lives. Did you ever take a look at your prescription? A lot of numbers and signs, right? If you’re nearsighted, the first number (sphere) on your eyeglasses prescription or contact lens will be preceded by a minus sign (-). The higher the number, the more nearsighted you are. By knowing this, you can compare your previous prescriptions with the current to see how your vision changed—if any.

Some of us may not enjoy wearing glasses or taking care of lenses on a daily basis which is why people tend to go with refractive surgery. Refractive surgery is the latest trend out there for correcting vision just about permanently. This procedure can reduce or eliminate the need for glasses or contacts. So, it is almost a permanent solution for myopia and other eye conditions. It is performed by the excimer laser.

Types of Refractive Surgery for Myopia:

  • In PRK (photorefractive keratectomy), a type of refractive surgery, the laser removes a layer of corneal tissue, which flattens the cornea and allows light rays to focus more accurately on the retina
  • In LASIK, the most common refractive procedure, a thin flap is created on the surface of the cornea, a laser removes some corneal tissue, and then the flap is returned to its original position
  • Phakic IOLs – (also known as implantable lenses) is a surgical procedure for correcting myopia, especially individuals with high amounts of myopia or thinner-than-normal corneas that could increase risk of complication from LASIK or other laser vision correction procedures. The term, implantable lenses (Phakic IOLs), is exactly what you think it means. It is just like wearing contact lenses only permanently. This is permanently placed in the eye, which means that no maintenance is needed. The eye’s natural lens are not replaced by any means and are left intact

Non-surgical Option:

  • Orthokeratology—yes, quite a mouthful isn’t it? This is a non-surgical procedure is where you wear special rigid gas permeable contact lenses at night that reshaped your cornea while you sleep. When you remove the lenses in the morning, your cornea temporarily retains the new shape, so you can see clearly during the day without your glasses or contact lenses. This procedure is also known as corneal refractive therapy (CRT) and has been proven to be effective at temporarily correcting mild to moderate amounts of myopia. This procedure is a good alternative for individuals who are too young for LASIK or are not good candidates for refractive surgery for other reasons

Controlling Myopia
It all begins with controlling myopia during childhood—the early stages. So far we know that there are several methods that have been tried to control myopia such as fitting children with bifocals, progressive lenses and gas permeable contact lenses. However, research is still being done. Recently, researchers in New Zealand are experimenting with a dual focus soft contact lenses for myopia control in nearsighted children. What’s special about these lenses? They have less power in the periphery of the lens compared to the center and it is though that this peripheral defocus may reduce the tendency for greater lengthening of the eye that leads to progressive myopia. In 2011, the study showed that 70% of nearsighted children (ages 11-14) who wore the experimental lenses in one eye and a standard soft contact lens in the other, myopia progression was reduced by 30% or more in the eye while wearing the dual focus contact lens.

Degenerative Myopia
This is a severe version of the regular myopia (which is a minor condition). Degenerative myopia is also known malignant or pathological myopia which is hereditary and usually begins in early childhood. Even though this is a rare condition, we thought we should mention it. About 2% of Americans are afflicted and it is the leading cause of legal blindness. So what happens in this rare case? The elongation of the eyeball can occur rapidly, leading to a quick and severe progression of myopia and loss of vision. People with this condition have a significantly increased risk of retinal detachment and other degenerative changes in the back of the eye. This includes bleeding in the eye from abnormal blood vessel growth (neovascularization). In summary, not a fun situation to be in. To make things worse, degenerative myopia also may increase the risk of cataracts.

Treatments
The main method is surgical treatment. There is a combination of drug and laser procedure called photodynamic therapy that is also used in the treatment for macular degeneration. A recent pilot study found there is an oral medicine called 7-methylxanthine (7-mx) which is effective in slowing the elongation of the eye in nearsighted children ages (8 to 13).

Our Final Thoughts
In the US, there is a prevalence of 30-40% of adults who have myopia and about 80% or higher in the Asian population—especially China. These numbers are projected to grow as well so myopia is not going away or reducing anytime soon. So, if you have myopia, you are not alone. With the advancement in technology, it is hard to avoid screens—mobiles, tablets, and laptops. We suggest to get outside whenever you have the chance so your eyes can have a break and it can give you some fresh air as well for a change. An overall healthy lifestyle that combines diet and exercise can help stabilize your eyes from getting higher prescriptions as well.