The Ultimate Guide to Understanding and Treating Short-Sightedness (Myopia) in 2024

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Myopia, commonly known as near-sightedness or short-sightedness, is a common eye condition in which near objects are clear but far objects appear blurry.

It is a refractive error where the light entering the eye is focused in front of the retina instead of directly on it.

Myopia affects a significant portion of the global population, with estimations suggesting that by 2050, approximately 4758 million people will be affected (around 49.8% of the world population) (Holden BA, et al., 2016).

Singapore has one of the highest rates of myopia in the world. By Primary 6, 65 percent of our children are myopic, and this figure rises to 83 percent in young adults. This has led to Singapore being dubbed the “Myopia Capital of the World.” Projections for 2050 suggest that 80 to 90 percent of all Singaporean adults over 18 will be myopic, with 15 to 25 percent potentially experiencing high myopia.

Causes of Myopia

Myopia, or nearsightedness, is caused by a combination of environmental and genetic factors. Urbanized lifestyles that involve intensive near work, such as reading and using digital devices, contribute significantly to the development of myopia. Additionally, limited outdoor activities can exacerbate this condition.

Genetic factors also play a crucial role. Children born to myopic parents are at a higher risk of developing myopia themselves.

Symptoms of Myopia

Common symptoms of myopia include:

  • Blurred vision at a distance
  • Squinting
  • Eye rubbing
  • Headaches
  • Eye fatigue
  • A tendency to hold reading materials closer

Diagnosis of Myopia

In an optometry practice, a comprehensive eye examination for myopia includes reviewing the patient’s history, current symptoms, and family ocular history.

Refraction would be carried out with instruments such as a phoropter and retinoscope to confirm the presence of myopia.

The degree of myopia is measured in negative dioptre (D) values, such as -1.00D,

-2.50D, or -6.00D, reflecting the power of the lens required to achieve optimal vision.

A higher negative dioptre value indicates greater myopia severity.

Treatment Options for Myopia

The simplest and most common way to correct myopia is with prescription glasses, followed by contact lenses, including soft daily lenses, extended-wear lenses, and rigid gas-permeable contact lenses.

Orthokeratology, often referred to as Ortho-K, is another option. It involves wearing specially designed rigid contact lenses overnight, which temporarily reshape the cornea. This corrects myopia so that you can see clearly during the day without needing glasses or contact lenses. The effects are reversible but can be maintained by continuing to wear the lenses regularly at night.

Refractive surgery options are available for those seeking more long-lasting myopia correction, such as laser PRK, LASIK, SMILE and ICL implantation.

Preventative Strategies

Increasing time spent outdoors has been associated with reduced risk of myopia progression. Research suggests that increased exposure to natural light and balance between indoor and outdoor activities correlates with a reduced risk of myopia advancement.

Effectively managing the amount of time for near tasks such as reading and screen time could help to manage the progression of myopia. Implement regular breaks following the 20-20-20 rule: every 20 minutes, take a 20-second break and look at something 20 feet away can alleviate visual strain and reduce risks of near work-induced myopia.

Low-dose atropine eye drops have been found to slow myopia progression in children, although they do not correct the existing myopic refractive error.

Complications of Myopia

Myopia occurs when the eyeball is too long or the cornea is too curved. Complications can arise due to the elongation of the eyeball, such as retinal detachment, glaucoma and myopic maculopathy.

Regular eye exams are therefore essential for individuals with myopia to monitor any changes in their vision and to detect and manage any complications at early stages.

Conclusion

Individuals with myopia need to undergo regular eye examinations and follow appropriate management and treatment recommendations from an eye care professional to monitor for potential complications and preserve vision health.

Early detection and intervention can help reduce the risk of vision impairment or blindness associated with myopia-related conditions.

FAQs

  1. Is astigmatism the same as short-sightedness?
    1. Although myopia and astigmatism can commonly coexist in individuals, these are two different eye conditions after all. Astigmatism affects both far and near vision, causing blurring, distortion, and overlapping images in vision.
  2. Are contact lenses safe for children?
    1. Contact lenses are safe for children as long as they are compliant with lens care hygiene and instructions. Contact lens fitting with an optometrist is vital to ensure optimal lens fitting and the best lens choice is chosen based on the lifestyle.
  3. How much does LASIK surgery cost?
    1. Depending on the type of laser refractive surgery, the surgery cost in Singapore typically ranges around $3000-$6000. Find out more here.
  4. How can I tell if my child is developing myopia?
    1. Possible symptoms of children developing myopia include a tendency to hold reading materials closer, squinting when looking at far objects, reduced performance at school, eye rubbing, and complaints of headaches.
  5. Can myopia lead to blindness?
    1. While myopia itself typically does not lead directly to blindness, it can increase the risk of certain eye conditions, such as glaucoma and retinal detachment, that may cause blindness if left untreated.
  6. Can a short-sighted person be a pilot?
    1. Individuals with myopia may become pilots, but there are certain requirements and considerations they must meet for flying depending on different country aviation authorities.