Light must refract in a certain way to reach the retinas correctly so that a person’s eyes can see things clearly. Myopia, also known as nearsightedness or shortsightedness, refers to a vision condition in which a longer eye shape or an incorrect curvature of one or both corneas results in a person seeing clearly only at short distances because refractive errors cause light to fall short of the retinas. Sometimes this problem is compounded by other defects that make anything seen at a distance through one or both eyes appear blurrier or doubled. For example, a person with myopia might also have an eye-related muscle control problem that turns the eye inward (esotropia) or outward (exotropia) or an eye and brain communication problem that makes an eye drift as seen with “lazy eye” or amblyopia.
A wide range of non-invasive and invasive treatment options for myopia and associated defects and conditions have been developed through the centuries. With growing advances in technology in recent years, these treatments have become more precise and safer. Any person with access to these treatments can enjoy a level of visual improvement and control via assistive technologies never before experienced in human history. If you have started to have difficulties seeing distant objects clearly or your sight has worsened with aging or injury, it’s time to speak with your vision specialist about these options:
1. Eyeglasses
Eyeglasses are one of humanity’s oldest myopia treatment tools. Known also as glasses, corrective lenses and spectacles, eyeglasses utilize a lens system that refracts and focuses light a few millimeters from the surface of the eyes in ways that help artificially correct natural refractive errors. It’s currently believed that eyeglasses were first used in Italy some time during the 1280’s. Prior to that time, many people had no choice but to accept their myopia as a permanent disability. In fact, some people had visual impairment that made distant objects so blurry that extreme myopia was thought of as a type of blindness.
Those with nearsightedness so severe that they had difficulties seeing anything unless it was held close to their eyes utilized reading stones made of gemstones, crystals or glass pieces to make it easier to see things at any distance and magnify text. These days, modern eyeglasses provide similar assistance, but they’re designed with two lenses made of glass or plastic and a metal or plastic frame designed with pads that rest on the nose and arms that rest on the ears. The lenses can also be treated with special coatings that make them scratch-resistant, anti-reflective to reduce glare from computers and bright lights, block harmful UV rays and transition from clear to a color to double as sunglasses. Frames come in a wide range of styles, including heavier thick plastic and metal frames that completely surround the lenses and thin metal ones that consist only of arms attached to the sides of the lenses that connect over the nose bridge with a small metal bar.
For those who can’t handle heavy frames, lightweight metal full and partial frame designs and Pince-nez designs that rest on the nose or feature a nose clip without the support of arms are also available. It’s important to keep in mind that these alternative options, especially Pince-nez, might not work well for all-day use since they can fall off easily, for example, in a windy situation. To be fitted for eyeglasses, an optometrist tests your eyes in various ways to determine the type of corrections you need for your lenses.
Once you pick a frame style and lens shape that you feel best matches your facial features and personal preferences, you should receive your glasses either that same day if your optometrist has a lab onsite or between a few business days and two weeks. If you can’t afford prescription glasses, many affordable over-the-counter, non-prescription options have been made available to the public. You can find a variety of inexpensive magnifying devices, including non-RX reading glasses known as “cheaters” and theater-style binocular spectacles.
2. Contact Lenses
As their name suggests, contact lenses are another type of corrective “lens-based” tool that corrects myopia by refracting and focusing light as needed for the individual patient back to the eyes. Instead of wearing eyeglasses and dealing with their weight on your nose or misplacing them, you wear contact lenses directly on your eyes: The concave shape of contact lenses makes it possible for each contact lens to fit onto the rounded surface of each eye.
The first contact lenses created through experiments in the 1880’s were difficult to use because they were made of thin glass and contained design and surface flaws. Around the 1960’s, better lenses that combined glass and plastic gained popularity because they were lighter and took up less space on the eye, but those also had a major design flaw. They prevented the eyes from getting enough oxygen. Since then, though, a wide range of lens designs have been invented that make contacts for the most part a healthy, user-friendly and convenient alternative to eyeglasses. Some lenses can even specifically deal with other eye conditions like astigmatism, for example. If you decide to go with contacts, keep in mind that you must take them out before bedtime or use “extended wear” ones.
Risks associated with contact lenses include red eye, infection and eye injury. If you suffer with moderate-to-severe allergies or have sensitive eyes, you might discover that contact lenses cause too much discomfort to be a viable alternative. To receive contacts, you simply inform your optometrist of your choice after your regular eye exam and they will perform a contact lens exam and provide you with trial lenses if you’re a good match for contacts. Once the trial period ends, you can then order your lenses. Wait times vary between a few business days and several weeks.
3. Ortho-K Or CRT
Ortho-K, also known as Orthokeratology or Corneal Refractive Therapy (CRT), is a myopia treatment that involves reshaping the cornea of one or both eyes through the use of rigid contact lenses. Placing lenses against the cornea causes corneal eye tissue to grow into the matching shape needed to improve a person’s vision. They can also help correct astigmatism. As with standard contact lenses, Ortho-K/CRT became part of the myopia treatment market around the 1960’s.
That said, the procedure wasn’t well-received because the technologies at the time weren’t advanced enough to make it possible for designers to achieve the precision needed to make the therapy work with every patient. Ortho-K/CRT lenses today are more lightweight and provide greater lens surface shape precision. That said, Ortho-K/CRT isn’t a long-term, permanent solution to correcting myopia. Tissues change shape over time as new cells grow. Use of Ortho-K/CRT lenses overnight a few days a week can typically give you daytime near-perfect or perfect vision, but you must continue the treatment for the rest of your life. As with normal contacts, these contacts might not prove to be a comfortable for some people based on their other health issues.
4. Laser Procedures
Since myopia typically occurs from poor curvature of the cornea, a specialist can use surgery to alter the cornea’s shape and correct this problem. Several outpatient laser procedures exist, including Laser In Situ Keratectomy or LASIK, Laser Epithelial Keratomileusis or LASEK and Photorefractive Keratectomy or PRK. With all of these procedures, alteration of the cornea happens by removing some of the corneal tissue. The primary differences between these laser surgery methods involve how the tissue is accessed and the tools used in the procedure. Not everyone can have laser treatment.
Some people have complex or severe eye or visual problems that can’t be corrected with a laser surgical method or other health problems that make them poor candidates for laser treatment. Your overall health is taken into consideration beforehand. Also, if you use computers a lot, you might have to stop usage for a while before surgery because your eyes might experience small movements from eye strain that can make accuracy during this type of procedure difficult. Risks associated with laser myopia procedures include infection, eye inflammation, dry eye syndrome and other complications that adversely affect your vision temporarily or permanently with disturbances, new or increased astigmatism or vision loss.
5. Other Refractive Procedures
For those with mild myopia, insertion of a plastic ring known as an intracorneal ring segment into the eye to reshape the cornea is another option. This treatment offers immediate results, but does carry with it similar risks as laser procedures. Another common myopia solution is implantation of acrylic or silicone phakic intraocular lenses that act like permanent contact lenses. They’re often the primary alternative when a laser procedure won’t provide the desired outcome or a person doesn’t want to deal with the risky side of laser treatment. Although typically associated with cataract surgery, IOL lenses in general have been used to treat myopia and astigmatism since the 1990’s.
They can even be used to treat farsightedness. Unlike cataract lens replacement, phakic IOL lenses for myopia don’t require the replacement of the original lenses. Instead, they’re implanted on top of the originals. Beyond infection risks, IOL lens implantation can result in retina detachment and other problems because of human errors made during lens measurement and placement. Another issue with these lenses is that the eyes might have difficulty, depending on the type of lenses, with focusing between far and near objects.
6. Vision Therapy
Sometimes the best solution to myopia is for a child or adult to change how they use and maintain their eyes on a daily basis. Vision therapy is similar to physical therapy in that a person is taught by a vision therapy specialist, often in conjunction with eyeglasses or contacts, how to use exercises and other techniques to straighten the position of the eyes and improve their coordination and movement. This treatment is typically used with patients who have esotropia, exotropia or amblyopia and conventional therapies like glasses and lenses failed to work on their own. Initially an orthoptist or optometrist provides therapy in their office and then gives you in-home exercises and instructions for behavioral and lifestyle changes.
Vision therapists also look at neurological causes of vision problems. You might be asked to see a neurologist as well. Your specific treatment will be based on your symptoms, diagnostic tests results and the preferences of your specialist. For example, your specialist might recommend the use of a patch, also known as an eye occluder, to cover a healthy eye to improve muscle movement control with an eye that is weak in this area.
