Key takeaways:
Myopia, or nearsightedness, is a common eye condition that causes blurry vision. There’s no cure for myopia, but treatment can keep your vision clear.
Treatment options for myopia include glasses, contacts, and surgery.
MiSight contact lenses, atropine drops, and spending time outdoors stop myopia from getting worse.
Myopia — also called nearsightedness and short-sightedness — is an eye condition that causes blurry vision. Myopia can develop because of changes in the shape of your cornea or the length of your eyeball. These changes cause light to focus incorrectly inside your eye which leads to vision changes.
Myopia tends to develop during childhood and can get worse during the early teen years. It’s important for kids to have their vision checked. Undetected myopia can impact a child’s school performance and even their safety.
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.
How is myopia diagnosed?
An eye doctor can diagnose myopia during a comprehensive eye exam. A comprehensive eye exam includes visual acuity tests (eye charts) that will test how well you can see at a distance. Your eye doctor will then use different lenses to try and make your vision clearer. This is called refraction.
Your eye doctor will use the information from your eye exam to come up with a treatment plan for myopia. Let’s take a closer look at some treatment options they may recommend.
1. Glasses and contact lenses
Both glasses and contact lenses can treat myopia. Prescription lenses can’t cure myopia. But your vision will be clear while you’re wearing them.
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.
Your optometrist or ophthalmologist can help you decide between glasses and contact lenses. Many times, it comes down to personal preference. Or you might decide to use both. Here are some things to keep in mind as you choose.
Daily activities
Contact lenses can give you more freedom if you play sports or do a lot of outdoor activity. You won’t have to worry about breaking or losing your glasses if you’re wearing contact lenses.
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Eye health
You might be more comfortable with glasses if you have eye allergies (allergic conjunctivitis) or dry eye. Contact lenses may irritate your eyes if you have these eye conditions.
Myopia degree
You can have different degrees of myopia in each eye. Contact lenses can be a better choice if you have different degrees of myopia in your eyes.
Cost
Glasses and contact lenses can be expensive. 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 — that might even be the deciding factor.
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2. Eye Surgery
Eye surgery can treat your myopia, so you can see clearly without help from glasses or contacts.
Several surgical techniques can treat myopia, including:
Laser-assisted in-situ keratomileusis (LASIK)
Photorefractive keratectomy (PRK)
Small incision lenticule extraction (SMILE)
Clear lens extraction
Phakic intraocular lens implantation
Eye surgery is a permanent solution. Here are some important things to consider.
Cost
Vision surgery can be expensive. Health and vision insurance may cover some — but not all — costs for vision surgery. In addition to the surgery itself, you’ll need to consider the cost of ongoing eye doctor visits and medicated eye drops.
Time
Getting eye surgery is a time-intensive process. You’ll 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.
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.
Success rates
The main draw for vision 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.
3. Orthokeratology
Orthokeratology, or ortho-k, is a type of treatment that works by changing the shape of the cornea. With ortho-k, you’ll wear special contact lenses at night while you’re asleep. This causes a temporary change in the shape of the cornea, so 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. Orthokeratology can also help slow down myopia, which usually gets worse over time. But there are some things to consider.
Cost
Insurance doesn’t usually 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 and cleaning solutions can add up quickly. You can use FSA and HSA funds to cover some of these costs.
Keep in mind that orthokeratology is expensive in the beginning. But over time it might not cost much more than your yearly contact lenses.
Time
Like surgery, orthokeratology requires a time commitment. 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’ll also have to take good care of your lenses so that they continue to work and don’t need to be replaced early. And you’ll need several visits to your eye doctor to make sure the lenses fit correctly over time.
Success rates
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.
4. Slow-down treatments
Myopia can get worse, or progress, over time. Usually, this happens in children, teens, and young adults.
Myopia progression can impact your eye health. People with more severe myopia are more likely to develop other eye problems, like:
There are several things that can slow myopia progression in young children, who are most at risk of developing severe myopia. These options below won’t treat myopia — you’ll still need to use prescription lenses or surgery — but they may stop myopia from getting worse.
Eye exercises
It’s important to give your eyes a break 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.
Time outdoors
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.
Atropine drops
Low dose atropine eye drops may 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 ages 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.
Frequently asked questions
You’re more likely to develop myopia if your parents had it, too. So, genetics likely play a role in myopia. But other factors also play a role in whether or not someone develops myopia. So, myopia isn’t a completely genetic condition.
Myopia doesn’t get better over time. Myopia usually gets worse during the teen years, but then can stabilize in young adulthood. People with myopia may notice vision changes as they get older, but this is usually due to other eye conditions, like presbyopia, and not myopia.
Myopia doesn’t directly cause blindness. But severe myopia, also called high myopia, increases the risk of developing other eye conditions, like retinal tears, retinal detachment, cataracts, and glaucoma. These eye conditions can cause permanent vision loss.
You’re more likely to develop myopia if your parents had it, too. So, genetics likely play a role in myopia. But other factors also play a role in whether or not someone develops myopia. So, myopia isn’t a completely genetic condition.
Myopia doesn’t get better over time. Myopia usually gets worse during the teen years, but then can stabilize in young adulthood. People with myopia may notice vision changes as they get older, but this is usually due to other eye conditions, like presbyopia, and not myopia.
Myopia doesn’t directly cause blindness. But severe myopia, also called high myopia, increases the risk of developing other eye conditions, like retinal tears, retinal detachment, cataracts, and glaucoma. These eye conditions can cause permanent vision loss.
The bottom line
Myopia, or nearsightedness, is a very common condition that causes blurry vision when looking at things at a distance. Treatment options for myopia include glasses, contact lenses, and surgery. People with severe myopia are at risk of developing other eye problems, so they should follow up with their eye doctor regularly. Making sure myopia doesn’t progress — especially in children — can help preserve vision throughout a lifetime.
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References
American Optometric Association. (n.d.). Myopia (nearsightedness).
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Cho, P. (2019). Orthokeratology for high myopia (OHM) study. ClinicalTrials.gov.
Cho, P., et al. (2024). The latest and greatest in myopia control. Optometry Times Journal.
Committee on Focus on Myopia: Pathogenesis and Rising Incidence. (2024). Myopia: Causes, prevention, and treatment of an increasingly common disease. National Academies of Sciences, Engineering, and Medicine.
CooperVision. (n.d.). MiSight 1 day.
Kramer, E. (2018). 7 things you didn’t know about ortho-k. Primary Care Optometry News.
Lingham, G., et al. (2021). Time spent outdoors in childhood is associated with reduced risk of myopia as an adult. Scientific Reports.
MedlinePlus. (2018). Nearsightedness.
Mukamal, R. (2023). What Is orthokeratology? American Academy of Ophthalmology.
Parry, N. (2016). How to use low-dose atropine to slow myopic progression in kids. EyeNet Magazine.
Seminara, L. (2018). Outdoor activity and myopia progression in children. American Academy of Ophthalmology.
WashU Medicine. (2024). Does LASIK last forever? Understanding the longevity of LASIK results. John F. Hardesty, MD Department of Ophthalmology & Visual Sciences.
