FREQUENTLY ASKED QUESTIONS ABOUT MYOPIA
As the number of children affected by myopia grows, so does our understanding of it. Staying informed is key to taking charge of myopia. That’s why we’ve put together some of the most frequently asked questions we hear. Below are the answers that may help you care for your child or yourself.
What are the signs and symptoms of myopia?
Signs and symptoms of myopia may include:
- Trouble seeing far away
- Getting unusually close to digital devices, TV or books
- Struggling to see the board at school
- Complaints of tired eyes
What causes myopia in children?
The cause of myopia is yet unknown, but there are a number of risk factors for myopia development and progression we do know about. Those include:
To learn more about different factors that contribute to the development of myopia, you can take our Myopia Assessment Quiz.
- Having myopic parents1
- Extensive time spent on “near work,” like reading books or viewing digital devices2,3
- Spending under two hours per day outside4
- Developing myopia at an early age (such as 5 or younger)5
Does myopia worsen with age in children?
Typically, myopia does tend to worsen with age when it presents in children. The earlier a child develops myopia, the greater the chance of developing higher levels of myopia. That’s because the eye grows more rapidly in younger children and will likely progress for a greater number of years.5Every child should be monitored for myopia from an early age, with annual comprehensive eye exams starting by age 5.6,7 A comprehensive eye exam—which is much more extensive than an annual vision screening at school—can detect the early signs of myopia, as well as more than 270 systemic and chronic diseases.8Talk to your eye doctor to learn more about strategies for managing myopia.
How do astigmatism and myopia differ?
Myopia is when the eye grows longer than it’s supposed to, causing light to focus in front of the retina instead of on it.9 This results in blurry distant vision, and over time, the eye becomes strained due to this unusual lengthening. Because of this extra strain on the structure of the eye, myopia can lead to blindness later in life.10Astigmatism 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. It can be present at birth or develop later in life, and can also develop after eye injury or surgery.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.11 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 be reversed or cured?
As far as scientists know, it’s not possible to reverse or cure myopia. However, spending time outdoors is one evidence-based way that may delay the onset of myopia in children.12 Growing evidence supports the theory that more time outdoors may also slow the progression of myopia and benefit all children.12 Limiting near work has been shown to help as well.2 Talk to your doctor to learn more about managing 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.9,10,13 Over time, this can put strain on the delicate structures of the eye, leading to other vision complications later in life.9,10,13 Some of these complications include myopic macular degeneration, glaucoma, cataracts, retinal detachment, and even blindness.14
What’s the difference between vision screening performed at school or the pediatrician’s office versus a comprehensive eye exam?
While school vision screenings are a useful tool in detecting vision problems in children, they are not a substitute for a comprehensive eye exam by an eye doctor. There are several reasons why a comprehensive eye exam is important for your child, even if they have received a vision screening at school:
School vision screenings are useful for detecting vision problems in children, but they are not a substitute for a comprehensive eye exam by an eye doctor.
- Screenings have a limited scope
School vision screenings typically only check for the ability to see clearly at a distance. However, a comprehensive eye exam performed by an eye doctor includes a thorough evaluation of your child's eye function, eye health, and general health, as well as the prescription for glasses or contact lenses if needed.
- Early detection of eye problems
This allows for prompt treatment and reduces the risk of more serious problems later. Some common eye problems, such as amblyopia (lazy eye) or strabismus (eye turn), can only be diagnosed with a comprehensive eye exam.8
- Personalized recommendations
An eye doctor can identify the appropriate type and prescription of eyeglasses or contact lenses for your child. They can also advise on lifestyle changes that may help protect your child's vision and overall eye health.
- Regular monitoring
Regular comprehensive eye exams can help track the progression of any eye problems and ensure timely changes to your child's vision correction or treatment plan.
How often should my child have an eye exam?
Every child should be monitored for myopia from an early age, with annual comprehensive eye exams starting by the age of 5.6,7 A comprehensive eye exam—which is much more extensive than an annual vision screening at school—can detect the early signs of myopia, as well as more than 270 systemic and chronic diseases.8 Your eye doctor may recommend seeing your child more frequently if they start any kind of treatments or if it’s necessary to monitor their myopia.
Where can I get my child screened for myopia?
An eye doctor (optometrist or ophthalmologist) performs eye exams that include screening for myopia. To find an eye doctor near you who follows myopia screening guidelines provided by Johnson & Johnson Vision, use our eye doctor search tool.
What should I expect from a myopia eye exam?
A myopia exam is just like any other eye exam. Your child’s eye doctor will look at your child’s vision, overall eye health, and find out how your child uses their vision at school, sports, hobbies, etc. They’ll also test eye muscle function, evaluate the health of their 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.
What are some common eye health words I may hear during the eye exam?
Refractive Error: This refers to a category of vision problems where the patient struggles to see clearly. Common types of refractive error are:
Vision Correction: Any kind of glasses or contacts lenses that help correct vision issues like nearsightedness or farsightedness.Diopter: A term used to reference the optical power or correction needed in a pair of contact lenses or glasses. For example, you may see a prescription for glasses or contacts referred to as -2.0D or +2.0D. In both instances, the D stands for diopters. When you’re nearsighted (unable to see far away), your prescription is represented with a minus sign (i.e. -2.0D). When you’re farsighted (unable to see up close, like needing glasses to read), your prescription is represented with a plus sign (i.e. +2.0D).Axial Length: How long the eye is from the front of the eye to the back. This measurement can be used to understand if the eye is growing too long due to myopia and monitor myopia progression.Binocular Vision: Refers to having both eyes capable of facing the same direction to perceive a single image. This involves your brain's ability to use information from both of your eyes at once. Having good binocular vision helps us accurately judge distance and depth, and keeps our eye movements coordinated.
- Nearsightedness (myopia): Trouble seeing far away or items in the distance are blurry
- Farsightedness (hyperopia): Nearby object or up-close objects look blurry
- Astigmatism: Makes far-away or nearby objects look blurry or distorted due to the eyeball being shaped more like an American football than a soccer ball.
- Presbyopia: Develops later in life, usually early to mid 40s, making it hard to read or to see items up close
Can sunlight or vitamin D help prevent or slow myopia?
Research suggests that healthy lifestyle changes like spending at least 2 hours outside every day may help prevent or slow the progression of myopia.12 The benefits of time outdoors could be related to the impact of different visual environments, such as viewing objects from afar vs. up-close, or it could be the large, focused field of view in the outdoor visual environment. Brightness, or type of light such as sunlight vs. indoor lighting could play a role, but more research is needed to determine the mechanisms behind the elongation of the eye.15,16There is no evidence yet that supports vitamin D slowing the progression of myopia.
Can reduced screen time cure or reduce myopia?
Studies indicate that reducing ‘near work’ activities may have a positive impact on myopia.2 ‘Near work’ includes all activities where the child is looking at something close to their face, like reading a book, drawing a picture, or looking at a tablet. New studies are being done to further our understanding. When doing near work, it’s important to take frequent breaks.17 Try following the 20-20-20 rule next time you or your child are using your eyes to see close-up. Every 20 minutes, look 20 feet away for 20 seconds.
Can eye 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 under-correcting myopia (providing less prescription than recommended) help myopia? I’ve heard giving glasses to my child will make their eyes worse over time.
There is a common misconception that wearing glasses or contacts with a lower prescription than the doctor recommends or skipping glasses entirely makes your eyes work harder to see, therefore reducing myopia, but this has been disproven.18 Studies show that under-correcting myopia can actually make myopia progress faster. 19 Under-correcting also means your child will still struggle to see items clearly in the distance since you’re using a weaker prescription. They may struggle to see the board in school or become disinterested in sports since they can’t see clearly. It is recommended to use the prescription your doctor has identified for your child. Talk to your doctor about different myopia management options.
Can LASIK treat or cure my myopia?
LASIK may safely correct refractive error in adults and potentially eliminate the need for glasses or contact lenses,20 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.21For more information on LASIK, please see https://www.aao.org/eye-health/treatments/lasik.
Do regular glasses and contacts help or hurt myopia? What’s the difference between vision correction and myopia management?
Regular prescription glasses and contacts for vision correction will help address symptoms of myopia like blurry distance vision and allow you or your child to see clearly. However, they aren’t able to stop or slow the eye from continuing to grow longer over time, which is what causes vision to get worse. Talk to your doctor about the difference between vision correction and myopia management treatment options to see what may work for you or your child.
Are there treatments available for myopia?
There are a variety of different treatment options available for myopia. Talk to your doctor to learn more about what treatment options work best for you or your child.
Will I see better with myopia management treatment options?
Talk to your doctor to find out what myopia management treatment option would work best for you. Your eye doctor can help make sure you have clear vision while managing your myopia.
Do I still need to change my child’s prescription when undergoing myopia management?
Once treatments for myopia have started, it’s recommended to stay in a treatment until your doctor is able to confirm that your child’s eye has stopped growing or growing has slowed.22 This tends to occur in teenage or young adult years, but every person progresses differently. Talk to your doctor about treatment options for myopia management.
When should myopia management start?
Myopia management should begin as soon as you notice symptoms, such as struggling to see items far away, squinting to see items that are far away, sitting unusually close to the TV, headaches, and any signs that children are falling behind in school. Talk to your doctor about what myopia management options are right for you or your child.
Are there age restrictions on myopia management? Is my child too young or too old?
Myopia management options should be started as soon as myopia has been identified in the patient. This could be at a younger age in childhood, or later in teenage/young adult years. Talk to your doctor about what myopia management options are right for you or your child.
How long will I need myopia management for?
Once treatments for myopia have started, it’s recommended to stay in a treatment until your doctor is able to confirm that the eye has stopped growing or growing has slowed. This tends to occur in teenage or young adult years, but every person progresses differently.22 Talk to your doctor about treatment options for myopia management.
Are there side effects with myopia management?
As with any type of medical intervention, there may be side effects to treatment. Talk to your eye doctor about what type of myopia management product is best for you and any associated side effects.
What can I do around the house to help manage my kid’s myopia?
Simple lifestyle changes can help. Make sure they’re spending at least 2 hours outside every day.17 When they’re indoors, there are other tips and tricks you can implement into their daily life to help keep their eyes health.
- The elbow rule: Keep an elbow-to-hand distance away from books and screens to avoid them being too close to the eyes.
- The 20-20-20 rule: Take regular breaks from reading to reduce demand on the visual system. Every 20 minutes, take a break for 20 seconds and look across the room.
- Less near work: Try to limit near work activities (outside of schoolwork) as much as possible in school-aged children.2
1. Tedja MS et al. IMI - Myopia Genetics Report. Invest Ophthalmol Vis Sci 2019;60:M89-M105.2. Huang et al. The Association between Near Work Activities and Myopia in Children: A Systematic Review and Meta-Analysis. PLoS One 2015;10:e0140419.3. Wen L et al. Objectively measured near work, outdoor exposure and myopia in children. British Journal of Ophthalmology Published Online First: 19 February 2020. doi: 10.1136/bjophthalmol-2019-315258.4. Wu PC et al. Increased Time Outdoors Is Followed by Reversal of the Long-Term Trend to Reduced Visual Acuity in Taiwan Primary School Students. Ophthalmology. 2020 Feb 8:S0161-6420(20)30139-1.5. Chua SY et al. Age of Onset of Myopia Predicts Risk of High Myopia in Later Childhood in Myopic Singapore Children. Opthal Physiol Opt 2016;36:388-94.6. American Optometric Association Comprehensive Pediatric Eye and Vision Examination Evidence-Based Clinical Practice Guidelines. 2017.7. 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;62:134-149.8. Systemic Conditions with Ocular and Visual Manifestations. American Optometric Association. December 2019.9. Pärssinen O, Kauppinen M. Risk factors for high myopia: a 22-year follow-up study from childhood to adulthood. Acta Ophthalmologica. 2019;97(5):510-518.10. Flitcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Prog Retin Eye Res. 2012;31(6):622-660.11. World Health Organization The impact of Myopia and High Myopia - Report of the Joint World Health Organization -Brien Holden Vision Institute Global Scientific Meeting12. Wu PC, Chen CT, Lin KK, et al. Myopia Prevention and Outdoor Light Intensity in a School-Based Cluster Randomized Trial. Ophthalmology 2018;125:1239-50.13. Donovan L, Sankaridurg P, Ho A et al Myopia progression rates in urban children wearing single-vision spectacles. OVS 2012;89(1):27-32.14. Haarman AEG, Enthoven CA, Willem Tideman JL, Tedja MS, Verhoeven VJM, Klaver CCW. The complications of myopia: A review and meta-analysis. Investigative Ophthalmology and Visual Science. 2020;61(4):49-49.15. Sanchez-Tocino H, Villanueva Gomez A, Gordon Bolanos C, et al. The Effect of Light and Outdoor Activity in Natural Lighting on the Progression of Myopia in Children. J Fr Ophtalmol 2019;42:2-10.16. Ngo C, Saw S-M, Dharani R, Flitcroft I. Does sunlight (bright lights) explain the protective effects of outdoor activity against myopia? Ophthalmic and Physiological Optics. 2013;33(3):368-372. doi:10.1111/opo.1205117. Klaver C, Polling JR; Erasmus Myopia Research Group. Myopia management in the Netherlands. Ophthalmic Physiol Opt. 2020 Mar;40(2):230-240. doi: 10.1111/opo.12676. PMID: 32202320.18. Németh J, Tapasztó B, Aclimandos WA, Kestelyn P, Jonas JB, De Faber JHN, Januleviciene I, Grzybowski A, Nagy ZZ, Pärssinen O, Guggenheim JA, Allen PM, Baraas RC, Saunders KJ, Flitcroft DI, Gray LS, Polling JR, Haarman AE, Tideman JWL, Wolffsohn JS, Wahl S, Mulder JA, Smirnova IY, Formenti M, Radhakrishnan H, Resnikoff S. Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute. Eur J Ophthalmol. 2021 May;31(3):853-883. doi: 10.1177/1120672121998960. Epub 2021 Mar 5. PMID: 33673740; PMCID: PMC8369912.19. Kahmeng Chung, Norhani Mohidin, Daniel J. O’Leary, Undercorrection of myopia enhances rather than inhibits myopia progression, Vision Research, Volume 42, Issue 22, 2002, Pages 2555-2559, ISSN 0042-6989, https://doi.org/10.1016/S0042-6989(02)00258-4.20. Kato N, Toda I, Hori-Komai Y, Sakai C, Tsubota K. Five-year outcome of LASIK for myopia. Ophthalmology. 2008 May;115(5):839-844.e2. doi: 10.1016/j.ophtha.2007.07.012. Epub 2007 Sep 27. PMID: 17900692.21. 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: 16209449.22. Németh J, et al. Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute. Eur J Ophthalmol. 2021 May;31(3):853-883. doi: 10.1177/1120672121998960. Epub 2021 Mar 5. PMID: 33673740; PMCID: PMC8369912.PP2023OTH4607