What Are My Treatment Options If I Have Myopia?

If you find yourself straining or squinting to see objects that are far away, you might have myopia. Myopia, or nearsightedness, means that the shape of your cornea, or the length of your eyeball, is causing light to focus incorrectly inside your eye. The result is blurred vision. People with myopia can also experience headaches and eye strain. Undetected myopia can be particularly harmful for children, as they might have setbacks at school because they aren’t able to see the board.

Right now, 1 in 4 people in the U.S. have myopia. By 2050, that number will go up to 1 in 2. There’s no way to cure or reverse myopia. But there are ways to treat myopia and to keep it from getting worse over time. 

Glasses and contact lenses can make vision clear

Both glasses and contact lenses can treat myopia. Neither option will cure myopia, but while you're wearing glasses or contacts, your vision will be clear.

The easiest and most common way to treat myopia is with glasses. Glasses help bend the light so that images are focused onto the retina. Contacts can also be used to treat myopia. There are many types of contacts available, including soft, rigid, and hybrid lenses. 

Choosing between glasses or contacts depends on many factors, including:

• Daily activities: If you play sports or do a lot of outdoor activity, contact lenses could give you more freedom — you won’t have to worry about breaking or losing your glasses. 

• Eye health: If you have certain eye conditions, like dry eyes or eye allergies, you might be more comfortable with glasses than contact lenses.

• Myopia degree: You can have different degrees of myopia in each eye. Sometimes glasses are hard to adapt to if you have different amounts of myopia between your two eyes. Contact lenses would be a better choice.

• Financial factors: Depending on your insurance, one option might be less expensive than the other. You can use funds from a flexible spending account (FSA) or health savings account (HSA) to pay for glasses, contact lenses, and contact lens solutions. Since both glasses and contacts can improve your vision, it’s important to figure out which option works best for your budget — it might be the deciding factor for you. 

Your optometrist or ophthalmologist can help you decide between glasses and contact lenses. Many times, it comes down to personal preference. You might also decide to use both. 

Surgery can treat myopia permanently

Unlike glasses or contacts, surgery can treat your myopia so you can see clearly without any help. Several surgical techniques can treat myopia, including:

• Laser-assisted in-situ keratomileusis (LASIK)

• Photorefractive keratectomy (PRK)

• Small incision lenticule extraction (SMILE)

These types of surgery alter the shape of the cornea. This way, light is able to focus correctly inside your eye, which allows you to see clearly. 

Depending on how severe your myopia is, or if you have other eye conditions like cataracts, surgery could be a good option. Some downsides to surgery include:

• Price: Depending on your insurance, some or all of the surgery might not be covered. In addition to the surgery itself, you have to consider other costs like doctor’s visits before and after the surgery. 

• Time: Getting eye surgery is a time-intensive process. You have to go to multiple appointments before and after surgery. You’ll also have to account for recovery time after the surgery, which may affect your ability to drive, go to work, or do other activities. Get a list of required appointments — both before and after surgery — from your eyecare team. This way you can decide whether the process will work for you.

• Potential complications: All surgeries have a risk of complications, and these types of surgery are no exceptions. It’s important to talk to your ophthalmologist about the risks of surgery and how often your provider sees these complications. 

• Varying success rates: The best thing about surgery is that you’ll be free from glasses and contacts. You’ll wake up with clear vision every day! But for some people, this clear vision isn’t permanent. Your ophthalmologist should be able to give you an idea of how successful the surgery will be for you long term. If it’s likely you’ll need repeat surgery — you might decide to consider alternatives like glasses or contact lenses.  

Orthokeratology is a newer treatment option for myopia

Orthokeratology, or ortho-k, is a type of treatment that works by changing the shape of the cornea. For ortho-k you wear special contact lenses at night while you’re asleep. This causes a temporary change in the shape of the cornea, so that you can see clearly during the day — without glasses or contact lenses. Ortho-k is available for children and adults.

Many people prefer orthokeratology because it gives them freedom of clear vision during the day without the potential complications of surgery. Some downsides to orthokeratology include:

• Price: Insurance doesn’t cover orthokeratology. You’ll have to consider the price of the lenses, which need to be replaced about once a year. You’ll also have multiple visits to your eye doctor for fittings and monitoring, especially when you first start using them — the cost of these visits can add up quickly. And don’t forget to add in the cost of cleaning solutions. You can use FSA and HSA funds to cover some of these costs. Although orthokeratology is expensive in the beginning, over time it might not cost much more than your yearly contact lenses.

• Time intensive at first: Like surgery, orthokeratology requires a time commitment. You’ll need several visits to make sure the lenses fit correctly over time. Unlike surgery, you won’t have to worry about recovery time. 

• Consistent use: Orthokeratology doesn’t cure myopia — it only temporarily reshapes the cornea. That means the effects won’t last unless you wear the lenses every night. Some people can skip a day and still have clear vision, but in most cases the cornea goes back to its normal shape within 72 hours. You also have to take good care of your lenses so they continue to work and don’t need to be replaced early. 

• Limited application: Right now, it doesn’t seem like ortho-k works for people with very high degrees of myopia (more than -6.00 correction). There are clinical trials underway for different types of lenses that might work for people with higher levels of myopia. Ortho-k works best for children but can help correct vision in adults up to 40 years old. 

It’s possible to slow myopia progression

Myopia can get worse, or progress, over time. Usually, this happens in children, teens, and young adults. Myopia progression is a concern because people with more severe myopia are more likely to develop other eye problems like:

• Glaucoma

• Cataracts

• Retinal tears

• Retinal detachment

Some of these conditions can lead to significant vision loss. There are several things that can slow myopia progression in young children who are most at risk of developing severe myopia:

• Eye exercises: While doing near-vision activities, like reading or working on a screen, take a break every 20 minutes and look at something 20 feet away for at least 20 seconds. Kids spend a lot of time on screens — so it’s never too early to get them into the habit of doing this exercise. Adults with myopia can also benefit from this simple exercise.

• Playing outside: Multiple studies show that children who spend more time outdoors are less likely to develop myopia. Studies also show that children with myopia who spend more time outdoors have less myopia progression. So encourage your child to play outside — but don’t forget the sunscreen and a hat!

• Atropine drops: Low dose atropine is now being used to slow progression of myopia in school-age children. This is an off-label use, which means the FDA didn’t approve atropine as a treatment for myopia progression. The drops are placed in each eye once a day for several years. Side effects include redness and eye itchiness. 

• MiSight: MiSight contact lenses are the first FDA-approved contact lenses for controlling the progression of myopia for children between 8 to 12 years old. These disposable lenses are worn during the day, and they alter the way light hits the retina. This prevents the eye from growing too long and decreases the progression of myopia.