Myopia—causes, symptoms, treatments

An illustrated side-view of an eye with various parts labeled, including how light focuses in front of the retina.
What is Myopia?

Myopia: More than just nearsightedness

Myopia, also commonly referred to as nearsightedness, is when the eye grows too long from front to back, making it harder to focus on things that are far away.1 For example, a person with myopia may be able to read a book just fine, but may struggle to read a street sign. While blurry distance vision is the most well-known symptom of myopia, it’s important to note that myopia also increases the chances of eye complications later in life. That’s because the lengthening of the eye means more strain on delicate structures like the retina (the part of the eye that turns light into what you see). Myopia is also very common, and only becoming more common by the day.

Myopia is a growing problem

  • The number of people with myopia has nearly doubled over the past 20 years2
  • It is estimated that by 2050, nearly half the people in the world will have myopia
  • Lifestyle changes, including more time spent focusing on digital screens, books, and other up-close objects, are contributing to a rise in children developing myopia at an early age3,4
Causes

Who's at risk for myopia?

If you’re looking for a definitive cause of myopia, you won’t currently find one, because doctors and scientists still aren’t completely sure. They currently believe it comes down to a combination of two main factors:

Genetic factors play a role in myopia development, but just because your parents have it doesn’t mean you’ll have it too.

Lifestyle factors like increased near work (reading, playing video games) and decreased time outdoors have also been implicated as risk factors. These lifestyle changes likely disrupt the eye’s normal growth signals, causing the eye to grow longer than it should. Further studies are needed to understand the exact processes and signals that the eye uses to drive the growth of the eye.

Symptoms

How to tell if you have myopia

Three main symptoms

Without a comprehensive eye exam, myopia is often discovered when a child struggles to see distant objects clearly, like the board in school. While only a comprehensive eye exam can determine if you are myopic (and at what level), some common symptoms of uncorrected myopia include:  

Blurry distance vision

Things that aren’t up close may look blurry and hard to distinguish. This is why a telltale sign of myopia is squinting to see objects that aren’t up close.

Poor depth perception

Since things that aren’t very close by are so blurry, it can become hard to judge exactly how far away things are, which can make even simple things like walking around more dangerous.

Headaches and frequent eye strain

People with uncorrected myopia may have to squint to be able to see many things in their everyday life, like street signs and the faces of those around them. This squinting and difficulty focusing can cause headaches and feelings of eye strain.

An illustrated bar chart shows prescription ranges for low levels of myopia in green, myopia in yellow, and high myopia in red

The benefit of catching myopia early

The earlier a child develops myopia, the greater the likelihood of developing higher levels of myopia. This is because the eye grows more rapidly in younger children and will likely progress for a greater number of years. Why is this important? Because every change in eyesight matters. While high levels of myopia tend to increase the risk of sight threatening complications later in adulthood, there is no safe level of myopia.1 Even lower levels of myopia can be associated with an increased risk of eye issues.1 Every diopter (for example, a change in prescription from -2D to -3D) increase in myopia raises the risk of myopic macular degeneration, a sight threatening eye disease, by 67%.5

Treatments

What to do about myopia: Correct it, or manage it?

For children, a myopia management plan

Every child should be monitored for myopia from an early age, with annual comprehensive eye exams starting by the age of 5.6,7 Once a child develops myopia, it’s irreversible and very likely to worsen as they grow. The good news is, it’s possible to slow excessive eye growth with certain treatments and lifestyle changes. Together, these treatments for myopia are called myopia management and depending on the unique needs of your child’s eyes, your eye doctor may recommend: 

Orthokeratology

This treatment uses customized lenses to manage myopia while your child sleeps. They work by gently reshaping the cornea at night so that the child can experience clear vision during the day, usually without the need for additional vision correction.

Explore Orthokeratology

Corrective lenses

Traditional eyeglasses and contact lenses can alleviate blurry vision. It’s important to note that as the child’s myopia progresses, the continuous eye growth can result in the need for higher and higher prescriptions.8

Eye drops

Low-dose atropine has been show to slow the progression of myopia in children and teens.

Myopia management contact lenses

These contacts are worn during the day, and have special optics that both help correct vision and manage myopia.

More time outdoors

Research shows that spending at least two hours per day outdoors can help reduce myopia onset or slow its progression.9

Less near work

Reducing the amount of time spent on near work (e.g. reading, tablets) outside of school can help reduce myopia onset.10

The 20-20-20 rule

Every 20 minutes, look 20 feet away for 20 seconds when doing near work activities like reading, screentime, or homework.11

A woman in a grey shirt sits in a chair smiling and talking to her male eye doctor

For adults, correct vision and get checked often

The eye growth that causes myopia is irreversible, but adults with myopia have a number of options to correct their blurry vision. Some of the most common myopia treatment options include:

  • Eyeglasses
  • Contact lenses
  • Orthokeratology
  • Laser eye surgery

While these treatments help correct the nearsightedness of myopia, those with myopia should plan on seeing their eye doctor annually because of the increased risk of other eye complications.

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FAQs

Frequently asked questions

How do astigmatism and myopia differ?

Myopia is typically caused by the eye growing longer than it's supposed to, resulting in blurry distant vision and an increased risk in eye health issues later in life. That’s because the extra length of the eye puts strain on the structure of the eye, leading up complications including blindness later in life. Astigmatism comes from imperfections in the curvature of either the front surface of the eye (cornea) or the crystalline lens inside the eye. Simply put, your eye's surface is supposed to be round like a basketball but with astigmatism, it is oval like an American football. Astigmatism comes with blurry or distorted vision both close up and afar. While they are two different conditions, it is possible for a patient to have both myopia and astigmatism. 

What is high myopia?

High myopia is defined as having a refractive error of -5.00D (diopters) or more.12 A refractive error is determined by measurements performed by an eye doctor. A person with high myopia would experience more blurring of distance vision than a person with lower levels of myopia. 

Can myopia lead to blindness?

Although we used to think of myopia as just nearsightedness, we now know that it's much more. Myopia is a chronic, progressive disease in which the eye grows longer than it's supposed to. Over time, this can put strain on the delicate structures of the eye, leading to other vision complications later in life. Some of these complications include myopic macular degeneration, glaucoma, cataracts, retinal detachment, and even blindness. 

What should I expect for a myopia eye exam?

A myopia exam is just like any other eye exam. Your eye doctor will look at your vision, overall eye health, and ask about lifestyle. They'll also test eye muscle function, evaluate the health of the eyes and surrounding structures, and check for any signs of eye diseases or conditions.
The exam may involve a number of tests and procedures, including a visual acuity test, a dilated eye exam, tonometry to measure eye pressure, a slit-lamp exam to check the health of the front of the eye, and other equipment to check the health of the back of the eye. Based on the results of the exam, the doctor may recommend treatment options. 

Can exercises/vision therapy cure myopia?

While there is no evidence to suggest that eye exercises can cure myopia, there are activities that may help slow the progression of myopia. An example of this is following the 20-20-20 rule when doing near work activities like reading, writing, painting, or spending time on a digital device. For every 20 minutes of near work, look at a target 20 feet away for 20 seconds before returning to your near work activity. Talk to your doctor about activities that may contribute to your overall eye health. 

Can LASIK cure or treat my myopia?

LASIK may safely correct refractive error in adults and potentially eliminate the need for glasses or contact lenses,13 however it does not cure myopia. Myopia candidates who undergo LASIK may still be at risk of sight-threatening complications later in life due to the lengthening of the eye that occurred before LASIK. LASIK does not prevent myopia progression, and usually LASIK can only be performed after a myopia candidate has slowed or stopped progression in their prescription. LASIK candidates need to be assessed by an eye care practitioner and the eye prescription and ocular health needs to fit certain parameters for this procedure to correct vision successfully. LASIK is not federally approved for use in children/anybody under the age of 18, and some higher prescriptions may not be candidates for LASIK.14 For more information on LASIK, please see https://www.aao.org/eye-health/treatments/lasik 

Related content

The letter "S" sits underneath two illustrations of eyes, one labeled normal and the other astigmatism

Myopia vs. astigmatism: What's the difference?

Discover the differences and similarities of the eye conditions myopia and astigmatism.

An illustrated side-view of an eye with many anatomical parts labeled, including how light focuses behind the retina

Myopia vs. hyperopia: What's the difference?

Compare the eye conditions of myopia and hyperopia to find out their similarities and differences.

A man stands on a public bus in a jacket and a hat looking at a cell phone in his right hand

Screen time: Its effect on vision and myopia

Find out more about average screen time per age and how it may affect eyes.

An illustration of three bar graphs showing levels of myopia, with the highest being a red arrow with a frowning face

Understanding high myopia and its causes

Read about what classifies as high myopia and what should be done to manage it.

Footnotes

Consult your eye care professional for more information.  Johnson & Johnson does not provide medical advice; this information is for educational purposes only.

*Free trial contact lenses available only from participating eye care professionals. Exam and fitting fees not included.

References

  1. Flitcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Progress in Retinal and Eye Research. 2012 31(6):622-660.
  2. Holden BA, Fricke TR, Wilson DA, et al. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology 2016;123:1036-42.
  3. Huang HM, Chang DS, Wu PC. The Association between Near Work Activities and Myopia in Children-A Systematic Review and Meta-Analysis. PLoS One. 2015 Oct 20;10(10):e0140419.
  4. Wu PC, Chen CT, Chang LC, Niu YZ, Chen ML, Liao LL, Rose K, Morgan IG. Increased Time Outdoors Is Followed by Reversal of the Long-Term Trend to Reduced Visual Acuity in Taiwan Primary School Students.
  5. Bullimore MA, Brennan NA. Myopia-control: Why Each Diopter Matters. Optom Vis Sci. 2019;96:463-5. 
  6. Morgan IG, French AN, Ashby RS, Guo X, Ding X, He M, Rose KA. The epidemics of myopia: Aetiology and prevention. Prog Retin Eye Res. 2018 Jan;62:134-149.
  7. American Optometric Association. Annual Comprehensive Eye Exam. American Optometric Association. Comprehensive Eye Exam. Available from: https://www.aoa.org/healthy-eyes/caring-for-your-eyes/eye-exams?sso=y
  8. Mutti DO, Hayes JR, Mitchell Gl, et al. Refractive error, axial length, and relative peripheral refractive error before and after the onset of myopia. Invest Ophthalmol Vis Sci. 2007 Jun;48(6):2510-9.
  9. Wu PC, Chen CT, Lin KK, et al. Myopia Prevention and Outdoor Light Intensity in a School-Based Cluster Randomized Trial. Ophthalmol. 2018;125:1239-50.
  10. Huang PC, Hsiao YC, Tsai CY, Tsai DC, Chen CW, Hsu CC, Huang SC, Lin MH, Liou YM. Protective behaviours of near work and time outdoors in myopia prevalence and progression in myopic children: a 2-year prospective population study. Br J Ophthalmol. 2020 Jul;104(7):956-961.
  11. Johnson & Johnson Vision. Schedule an Eye Exam: Tips to Prioritize Your Eyes At Home. https://www.jjvision.com/prioritizeyoureyes.
  12. World Health Organization The impact of Myopia and High Myopia - Report of the Joint World Health Organization -Brien Holden Vision Institute Global Scientific Meeting.
  13. Kato N, Toda I, Hori-Komai Y, Sakai C, Tsubota K. Five-year outcome of LASIK for myopia. Ophthalmol. 2008 May;115(5):839-844.e2. doi: 10.1016/j.ophtha.2007.07.012. Epub 2007 Sep 27. PMID: 17900692.
  14. Sharma N, Singhvi A, Sinha R, Vajpayee RB. Reasons for not performing LASIK in refractive surgery candidates. J Refract Surg. 2005 Sep-Oct;21(5):496-8. doi: 10.3928/1081-597X-20050901-13. PMID: 16209449.

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