What is myopia?

From the Guidelines

Myopia, also known as nearsightedness, is a common vision condition where you can see nearby objects clearly, but distant objects appear blurry, and it typically develops in childhood and can progress until early adulthood, with treatment options including corrective lenses, orthokeratology, refractive surgery, and atropine eye drops. Myopia occurs when the eye grows too long from front to back, causing light rays to focus in front of the retina instead of directly on it, resulting in distant objects appearing out of focus, as noted in the refractive errors preferred practice pattern 1. Genetics and environmental factors like prolonged close-up work can contribute to myopia development, and common symptoms include squinting to see distant objects, difficulty seeing clearly while driving (especially at night), and eye strain or headaches. Some key points to consider in the management of myopia include:

• Increased outdoor time and low-concentration atropine have been shown to reduce the likelihood of myopia onset, as highlighted in the refractive errors preferred practice pattern 1.
• Antimuscarinic eyedrops, multifocal spectacles and contact lenses, and overnight orthokeratology have been shown to be variably effective in some populations for myopia control, that is, to reduce the progression of myopia in school age children, as discussed in the refractive errors preferred practice pattern 1.
• Atropine eye drops, particularly low-dose atropine (0.01% to 0.05%), may slow myopia progression in children, with studies confirming their efficacy and safety, as reported in the refractive errors preferred practice pattern 1. Regular eye exams are essential for early detection and management of myopia, especially in children, and outdoor activities and limiting screen time may help reduce the risk of developing or worsening myopia in young people, as emphasized in the refractive errors preferred practice pattern 1. Treatment options for myopia include:

1. Corrective lenses: Glasses or contact lenses are the most common treatment.
2. Orthokeratology: Wearing special contact lenses at night to temporarily reshape the cornea.
3. Refractive surgery: Procedures like LASIK can permanently reshape the cornea.
4. Atropine eye drops: Low-dose atropine (0.01% to 0.05%) may slow myopia progression in children. It is crucial to note that the most recent and highest quality study, as reported in the refractive errors preferred practice pattern 1, provides the most up-to-date guidance on the management of myopia, and its recommendations should be prioritized in clinical practice.

From the Research

Definition of Myopia

• Myopia, also known as nearsightedness, is a refractive error that causes blurry vision when looking at distant objects 2, 3, 4, 5.
• It occurs when parallel rays of light converge in front of the retina, resulting in blurry distance vision 4.
• People with myopia are able to see near objects better than those at a distance 5.

Risk Factors and Prevention

• The risk of myopia is lowered by exposure to daylight and increased by activities performed at short visual distances (close-up work) 3.
• A person with little exposure to daylight has a fivefold risk of developing myopia, which can rise as high as a 16-fold risk if that person also performs close-up work 3.
• Being outdoors or participation in physical activity outdoors may prevent myopia 5.
• Promoting a healthy lifestyle, particularly increasing physical activity and outdoor time, is essential for myopia control 4.

Complications and Treatment

• Highly nearsighted people are at greater risk of several vision-threatening problems such as retinal detachments, choroidal atrophy, cataracts, and glaucoma 2.
• Interventions that have been explored to slow the progression of myopia include bifocal spectacles, cycloplegic drops, intraocular pressure-lowering drugs, muscarinic receptor antagonists, and contact lenses 2.
• Anti-muscarinic topical medication has been found to be the most likely effective treatment to slow myopia progression, but it has side effects and is not yet commercially available 2.
• Multifocal optical corrections, such as progressive addition lenses and bifocal spectacles, have been found to yield a small slowing of myopia progression 2, 3.
• Contact lenses, including multifocal soft contact lenses and extended depth of focus soft contact lenses, have been found effective in slowing myopia 6.