Nearsightedness

DEFINITION

Nearsightedness (myopia) is a common vision condition in which you can see objects near to you clearly, but objects farther away are blurry.

Nearsightedness may develop gradually or rapidly, often worsening during childhood and adolescence. Nearsightedness tends to run in families.

A basic eye exam can confirm nearsightedness. You can easily correct the condition with eyeglasses or contact lenses. Another treatment option for nearsightedness is surgery.

CAUSES

Nearsightedness usually occurs when your eye is too long or has a cornea that’s curved too steeply. This causes the light rays entering each eye to focus in front of the retina, instead of on the retina, leading to blurry images. The exact reason for some people developing longer eyes is unknown, but it may be related to genetics or environmental conditions.

Normal vision

To focus the images it sees, your eye relies on two critical parts:

• The cornea, the clear front surface of your eye
• The crystalline lens, a clear structure inside your eye that changes shape to help focus objects

In a normally shaped eye, each of these focusing elements has a perfectly smooth curvature like the surface of a smooth rubber ball. A cornea and lens with such curvature bend (refract) all incoming light in such a way as to make a sharply focused image on the retina, at the back of your eye.

A refractive error

However, if your cornea or lens isn’t evenly and smoothly curved, light rays aren’t refracted properly, and you have a refractive error. Nearsightedness is one type of refractive error. Instead of being focused precisely on your retina, light is focused in front of your retina, resulting in a blurry appearance of distant objects.

Other refractive errors

In addition to nearsightedness, other refractive errors include:

• Farsightedness (hyperopia). This occurs when your cornea is curved too little or your eye is shorter from front to back than normal. The effect is the opposite of nearsightedness. In adults, both near and distant objects are blurred.
• Astigmatism. This occurs when your cornea or lens is curved more steeply in one direction than in another. Uncorrected astigmatism blurs your vision.

SYMPTOMS

Nearsightedness symptoms may include:

• Blurry vision when looking at distant objects
• The need to squint or partially close the eyelids to see clearly
• Headaches caused by eyestrain
• Difficulty seeing while driving a vehicle, especially at night (night myopia)

Nearsightedness is often first detected during childhood and is commonly diagnosed between the early school years through the teens. A child with nearsightedness may:

• Persistently squint
• Need to sit closer to the television, movie screen or the front of the classroom
• Seem to be unaware of distant objects
• Blink excessively
• Rub his or her eyes frequently

When to see a doctor

If your difficulty clearly seeing things that are far away is pronounced enough that you can’t perform a task as well as you wish, or if the quality of your vision detracts from your enjoyment of activities, see an eye doctor. He or she can determine the degree of your nearsightedness and advise you of your options to correct your vision.

Seek emergency medical care if you experience a sudden onset of flashes of floaters or a shadow covering part of your field of vision. These are warnings signs of retinal detachment, which is a rare complication of myopia. Retinal detachment is a medical emergency, and time is critical.

Regular eye exams

Since it may not always be readily apparent that you’re having trouble with your vision, the American Academy of Ophthalmology recommends the following intervals for regular eye exams:

Adults

If you’re at high risk of certain eye diseases, such as glaucoma, get an eye exam every two to four years up to age 40, then every one to three years between 40 and 54, and every one to two years beginning at age 55.

If you don’t wear glasses or contacts, have no symptoms of eye trouble, and are at a low risk of developing eye diseases, such as glaucoma, get an eye exam at the following intervals.

• An initial exam at 40
• Every two to four years between ages 40 and 54
• Every one to three years between ages 55 and 64
• Every one to two years beginning at age 65

If you wear glasses or contacts, you’ll likely need to have your eyes checked regularly. Ask your eye doctor how frequently you need to schedule your appointments. But, if you notice any problems with your vision, schedule an appointment with your eye doctor as soon as possible, even if you’ve recently had an eye exam. Blurred vision, for example, may suggest you need a prescription change, or it could be a sign of another problem.

Children and adolescents

Children need to be screened for eye disease and have their vision tested by a pediatrician, an ophthalmologist or another trained screener at the following ages and intervals.

• During the newborn period
• At well-child visits until school age
• During school years, every one to two years at well-child visits, or through school or public screenings