Myopia

What is a myopia?

Despite the complicated-sounding name myopia can simply be referred to as near or short-sightedness. In essence, this means that the person affected by myopia will be able to see objects that are near to them more clearly however when the object is further away it will appear blurry. See the photo example below for a visual representation of myopia.

concept image of myopia with a boy furthest from the viewer unfocussed, and glasses closest to the view in focus.

What causes myopia?

The main cause for myopia is when the eyeball is too long or when the cornea (the front clear cover of the eye) has too much curvature. The result of this means that the light entering the eye can’t focus correctly, thus making distant objects appear blurry.

Research (College Optometrists) has shown that nearly one in five teenagers in the UK are now myopic. This shows that there is a high chance of a teenager having this condition. So what are the common indicators which may suggest that your child might have such a visual impairment like this?

Myopia characteristics

Complaints of blurry vision, for example not being able to see the board in the classroom
Having to be close up to screens to see them
Squinting to try to see better
Frequent eye rubbing
Frequent headaches

Managing myopia

Myopia adds various complications to the way the individual experiences the world visually. The main way in which we interact with our environment is through our vision. Someone with myopia will struggle with seeing objects at a distance.

In this modern age, an initial indicator of myopia might be a person sitting closer to the TV, or moving a device closer to their face. Minimising the distance may help the person’s ability to see, but these adjustments will cause some physical and psychological discomfort.

Imagine every situation in your day-to-day life; your perception of your world is limited by the distance you can see. As a result an inconvenience is created due to the constant readjustments to recognize objects from far away.

This may exacerbate the person’s current problems and lead to a sense of frustration. The person may also suffer from physical hindrances such as eye strain due to the instinctive adjustments made to see things at a distance.

Interview (podcast)

Liam talked to Beverly Frey, whose son Craig has severe myopia and retinal detachment.

Strategies and Tips for Managing Myopia

Take regular breaks when using technology like computers, mobile phones, and tablets. Try to take breaks every 15-20 minutes.
Try spending more time outside – myopia tends to get worse when you spend too much time focusing on activities within your close vision. Spend more time outdoors focussing on objects that are in the distance.
Wear sunglasses that block ultraviolet light when you are outside to prevent sun damage.
Make sure you eat plenty of leafy greens, vegetables, and fruit. Studies have shown that diets high in omega-3 fatty acids greatly benefit eye health. This includes foods such as tuna and salmon.
Due to having to look at screens closer, options which remove the blue light on devices can reduce strain on the eyes.

Treating Myopia

Prescription lenses: wearing corrective lenses treats nearsightedness by counteracting the increased curvature of your cornea or the increased length of your eye. This can be through wearing glasses or contact lenses. It is important to speak with your doctor about the pros and cons for each option.

Refractive surgery: refractive surgery reduces the need for prescription lenses. This works through the use of a laser beam to reshape the cornea, resulting in a decreased nearsighted prescription. Even after surgery, glasses may still be needed some of the time.

Laser-assisted in situ keratomileusis (LASIK): The eye surgeon will make a thin, hinged flap into your cornea. They then use a laser to remove inner layers of your cornea to flatten its domed shape. Recovery from LASIK surgery is usually more rapid and causes less discomfort than other corneal surgeries.
Laser-assisted subepithelial keratectomy (LASEK). The surgeon creates an extremely thin flap only in the cornea’s outer protective cover (epithelium). They then use a laser to reshape the cornea’s outer layers, flattening its curve, and then replace the epithelium.
Photorefractive keratectomy (PRK). This procedure is similar to LASEK, except the surgeon completely removes the epithelium, then uses the laser to reshape the cornea. The epithelium is not replaced, but will grow back naturally, moulding to your cornea’s new shape.

Other treatments such as atropine drops have been shown to slow the progression of myopia, and dual focus lenses have been shown to slow the progression of myopia in children between the ages of 8 and 12.

Myopia and other eye conditions: retinal detachment

Studies have shown that other conditions including retinal detachment are more common in people with myopia.

This is because people with myopia have an elongated shape to the eyeball known as axial elongation. This means that the retina is stretched and therefore can be prone to tears. People with Smith-Magenis Syndrome are at an increased risk of retinal detachment. This is due to the high frequency of myopia, combined with self-injurious head-banging, and hyperactivity.

The term ‘retinal detachment’ is used to describe when the thin layer of tissue (the retina) pulls away from the back of the eye. Tiny specks that float through your field of vision (floaters), blurred vision, and flashes of light are common warning signs. The photo below demonstrates how these symptoms might appear.

view of the sea with islands in the distance, floaters and black spots obscure vision with retinal detachment

It is important to take vision complaints seriously as children often naturally adapt to the visual impairment until their vision becomes significantly impaired.

Resources

Vision simulator

About the Author

Liam went from being able to read and write in perfect 20/20 vision, completing his GCSE examinations in 2017, to having someone else read his results a mere few months later, on results day. He suffers from Leber’s hereditary optic neuropathy (LHON), which is the acute or subacute loss of central vision predominantly affecting young adult males. There is no pain.

Liam’s Story…

I am 19 years old and still adapting to my central vision loss, writing this blog is a reminder of my adaptations over abnormality. As you read this, attempt to do so with both thumbs up in front of the centre of your eyes…. difficult right? This is reminiscent of my experience of having central vision loss.

Despite having the experience of dealing with sight loss it has taught me the fundamental coping method of having a disability. It’s the ability to adapt. Over time, and with persistence, that experience simply becomes normal. As I write this my screen is zoomed in four times. I have learned to touch type and use technology such as ‘text to speech’ that enables me to write this blog . As quickly as I lost my vision, I found I had to quickly to adapt to these changes.

With all forms of life-altering events, it does present some form of psychological torment. But in my experience, my mother felt the hardship of loss more than I did. I was caught up in adapting to my disability and spared little time thinking about the emotional consequences of the situation.

My family had a sense of hurt due to not being able to have control of the situation. I suppose nothing is harder than always being the figure who can solve problems for your child, to not being able to solve this problem. Fully understanding the problem can help with solving the emotional aspects of a disability. My adaptations ‘normalised’ my newfound disability. A combination of professional advice, along with my experience and adaptations, helped my family gain understanding and a real sense of reassurance that everything was going to be okay.