Myopia is a common eye condition. People with myopia cannot see things well that are far away without glasses, but they can see things more clearly when they are close-up. Myopia usually happens because the eyeball has grown too long. This means that the eye does not focus the image properly. Glasses or contact lenses can bring things into focus.
Myopia often affects children at primary or secondary school. Whilst the young person is still growing, the eyeballs can also grow, which increases the myopia. The glasses or contact lens prescription may therefore need changing quite frequently. In most people, eye-growth naturally slows down in teenage years, but in some people, the myopia can still get worse until they complete school or university, or even in adulthood.
Things in the distance look blurred, and things close-up look clearer. Myopia can make it difficult to see the board at school or recognise people far away.
Myopia does not change the way you look, unless you wear glasses.
In most people, the eye brings an image into perfect focus on the retina, the layer at the back of the eye which sends visual information to the brain. When the eye is too long, the image is out of focus, and things look blurred.
Myopia is becoming a lot more common – 10 to 25% of children in the UK have myopia; those from South-Asian communities have a much higher risk.
Some people develop myopia because it runs in the family, particularly if one or both parents have myopia. Environmental factors are also known to contribute towards myopia development. Spending less time outside and spending lots of time on near work activities (such as reading and screen use) may put children at greater risk of getting myopia, and for myopia getting worse.
Once you have myopia, it usually gets worse over time. Having a healthy, active lifestyle and balancing time spent playing outdoors with time engaging in near activities can help to slow the eye growth. It is recommended that children/young people spend 2 hours outside per day. This is particularly true for young children who do not yet have myopia but who have parents with myopia.
An optometrist or eye doctor can use a special torch called a retinoscope to shine a light at your child’s eyes, whilst holding different lenses in front of the eye. That determines whether they need glasses, and how strong the prescription needs to be for them to see clearly again. Sometimes they may need to have eyedrops to get an accurate result. The drops make your eyes temporarily more light sensitive and blur their vision for a few hours (see also our leaflet on dilating for glasses?)
For many, the primary concerns about short-sightedness are inconvenience and expense. The more short-sighted a person is, the more they will need their glasses or contact lenses to see clearly. Stronger spectacle lenses are also thicker and heavier to wear.
Until the age of 16 years, or 19 years if in full-time education, the NHS will pay for standard glasses. Families can choose to pay extra for particular frames or thinner lenses, or if the young person wants to try contact lenses. Adults have to pay fully themselves. Myopia also matters, because it can be associated with other eye conditions later in life. The risks are small but these conditions are more likely with more highly myopic spectacle prescriptions. Because the eyeball is too long, all the tissues of the eye are stretched. This can cause breaks or detachments of the retina, damage to the central retina (macular degeneration) and glaucoma.
Screen use does not directly cause myopia, but spending a lot of time on near work can cause myopia. If you do a lot of near-work, including on screens, it is important that you take regular breaks. Try to follow the ‘20-20-2 Rule’ - after 20 minutes of close work, children should gaze at objects in the distance for at least 20 seconds, and they should be outside intermittently for at least 2 hours per day.
Children usually start with glasses, and some try contact lenses as they get older. It is important to wear the prescribed glasses full-time. Some people have laser surgery or other operations as adults, so they don’t need glasses or contact lenses any longer. Glasses, contact lenses and surgery make the vision clearer, but they do not change the length of the eyeball. Wearing the correct prescription glasses does not make the myopia worse. Myopia will progress during childhood and teenage years.
There are now special glasses and contact lenses which can slow down myopia progression. They work by blurring the peripheral vision and slowing eye growth. The central vision remains clear. The different brands of special glasses and contact lenses seem to work equally well in slowing myopia progression.
At the moment these treatments are not available on the NHS. Families can purchase them privately, instead of standard glasses and contact lenses. You can find out more by seeking the advice of local community optometrist regarding current lens options and pricing.
Low dose atropine drops: There are also eyedrops that can slow down the worsening of myopia: low dose atropine eyedrops (most commonly 0.01% and 0.05%) which are used once a day at bedtime. These are currently only available in private eye clinics or as part of research trials.
Moorfields runs several research projects about new treatments to slow down myopia. If you are interested in taking part, e-mail us at moorfields.myopia@nhs.net.