What are the complications and management options for myopia?

From the Guidelines

Myopia complications include increased risk of retinal detachment, glaucoma, cataracts, and myopic macular degeneration, particularly in high myopia (greater than -6.00 diopters), and management options vary based on severity and patient age. For children, myopia progression can be slowed with atropine eye drops (typically 0.01% to 0.05% concentration applied nightly), specialized contact lenses like orthokeratology (worn overnight) or multifocal soft lenses (worn during the day), or multifocal eyeglasses, as supported by recent studies 1. These interventions work by reducing peripheral retinal defocus or altering the eye's growth signals.

• Increasing outdoor time (at least 2 hours daily for children) has been shown to reduce the likelihood of myopia onset, as noted in a study published in 2023 1.
• Reducing near work and maintaining proper reading distance (at least 30 cm) may also help prevent myopia onset and progression. For adults, vision correction options include standard eyeglasses, contact lenses, or refractive surgeries such as LASIK, PRK, or implantable collamer lenses for appropriate candidates, with the choice of surgery dependent on individual patient characteristics or surgeon preferences 1.
• Regular comprehensive eye examinations are essential for all myopic patients, with dilated fundus examinations recommended annually for those with high myopia to monitor for retinal changes.
• Lifestyle modifications, such as increasing outdoor time and reducing near work, may help prevent myopia onset and progression, as suggested by recent research 1. The management approach should be individualized based on the patient's age, myopia severity, progression rate, and risk factors, with the goal of both correcting vision and preventing sight-threatening complications, as emphasized in a recent study 1.

From the Research

Complications of Myopia

• Myopia is associated with several pathologic eye conditions, leading to irreversible vision loss 2
• Severe forms of myopia (pathologic myopia) are associated with a risk of other associated ophthalmic problems, such as macular degeneration, retinal detachments, glaucoma, and cataracts 3, 4
• Complications associated with axial elongation from myopia are the sixth leading cause of blindness 4

Management Options for Myopia

• Various options have been assessed to prevent or reduce myopia progression in children, including:
  • Spending more time outdoor 5, 6
  • Optical interventions such as bifocal/progressive spectacle lenses, soft bifocal/multifocal/extended depth of focus/orthokeratology contact lenses 5, 6, 4
  • Refractive surgery 5
  • Pharmacological treatments, such as atropine eye drops 5, 6, 4
• Increased outdoor activities, atropine, orthokeratology, and specialized spectacle lenses have been associated with the highest, moderate, and lower efficacies in controlling myopia progression in children, respectively 5, 6
• Dual-focus contact lenses remain the only myopia treatment in the United States approved by the US Food and Drug Administration 6