Myopia

Overview

Nearsightedness, or myopia, as it is medically termed, is a vision condition in which people can see close objects clearly, but objects farther away appear blurred. People with myopia can have difficulty clearly seeing a movie or TV screen or the whiteboard in school.

Myopia occurs if the eyeball is too long or the cornea (the clear front cover of the eye) is too curved. As a result, the light entering the eye isn’t focused correctly, and distant objects look blurred.

Myopia affects nearly 30 percent of the U.S. population. While the exact cause of myopia is unknown, there is significant evidence that many people inherit myopia, or at least the tendency to develop myopia. If one or both parents are nearsighted, there is an increased chance their children will be nearsighted.

Even though the tendency to develop myopia may be inherited, its actual development may be affected by how a person uses his or her eyes. Individuals who spend considerable time reading, working at a computer, or doing other intense close visual work may be more likely to develop myopia.

Generally, myopia first occurs in school-age children. Because the eye continues to grow during childhood, it typically progresses until about age 20. However, myopia may also develop in adults due to visual stress or health conditions such as diabetes.

Diagnosis

Testing for myopia may use several procedures to measure how the eyes focus light and to determine the power of any optical lenses needed to correct the reduced vision.

As part of the testing, you will identify letters on a distance chart. This test measures visual acuity, which is written as a fraction, such as 20/40. The top number of the fraction is the standard distance at which testing is performed (20 feet). The bottom number is the smallest letter size read. A person with 20/40 visual acuity would have to get within 20 feet to identify a letter that could be seen clearly at 40 feet in a “normal” eye. Normal distance visual acuity is 20/20, although many people have 20/15 (better) vision.

Using an instrument called a phoropter, an optometrist places a series of lenses in front of your eyes and measures how they focus light using a handheld lighted instrument called a retinoscope. Or the doctor may choose to use an automated instrument that evaluates the focusing power of the eye. The power is then refined based on your responses to determine the lenses that allow the clearest vision.

Your optometrist can conduct this testing without using eye drops to determine how the eyes respond under normal seeing conditions. In some cases, such as for patients who can’t respond verbally or when some of the eye’s focusing power may be hidden, an optometrist may use eye drops. The eye drops temporarily keep the eyes from changing focus during testing.

Using the information from these tests, along with the results of other tests of eye focusing and eye teaming, your optometrist can determine if you have myopia. He or she will also determine the power of any lens correction needed to provide clear vision. Once testing is complete, your optometrist can discuss treatment options.

Treatment

Eyeglasses

For most people with myopia, eyeglasses are the primary choice for correction. Depending on the amount of myopia, you may only need to wear glasses for certain activities, like watching a movie or driving a car. Or, if you are very nearsighted, you may need to wear them all the time.

Generally, a single-vision lens is prescribed to provide clear vision at all distances. However, patients over age 40, or children and adults whose myopia is due to the stress of near-vision work, may need a bifocal or progressive addition lens. These multifocal lenses provide different powers or strengths throughout the lens to allow for clear vision in the distance and up close.

Contact lenses

For some individuals, contact lenses offer clearer vision and a wider field of view than eyeglasses. However, since contact lenses are worn directly on the eyes, they require proper care to safeguard eye health.