The title of this article is meant to have two meanings.  Nearsightedness, known scientifically as myopia, is typically used to describe a person’s inability to see clearly in the distance.  It can also be a metaphor for an individual not considering the long term effects of a choice before making it.  I’m hoping that this article will help you see your child’s nearsighted problem with a long term perspective.

We know the percentage of people that are nearsighted is increasing in our population, and that there are more nearsighted people today than ever before. There are even some ethnic groups where nearly half the population is nearsighted! Why is this important?  We know that nearsightedness has some major drawbacks. It requires affected people to rely on glasses or contact lenses in order to see better. Depending on the degree of nearsightedness there is also significant functional disability that goes with the condition.  For example, highly nearsighted people cannot see themselves in the mirror at normal distances, drive, go to the beach or even walk around the block comfortably  without optical correction.  But, most importantly, nearsighted individuals are more likely to suffer vision loss as they get older – they are more at risk for sight threatening conditions such as glaucoma, retinal detachment, and a type of macular degeneration called degenerative myopia. I think I speak for everyone when I say “no thank you” to any of those!

Nearsightedness commonly presents between ages 9-16 and may continue to progress until the mid 20s.  The natural growth of the body, and with it the eyes, is the driving force behind nearsightedness.  Generally, the larger the eye the more nearsighted the individual.  Additionally there is a strong hereditary component – if you are nearsighted chances are your child will be as well.  

You might be wondering, why are there more people suffering from myopia now than in the past?  There are a few reasons.  First, people are spending less and less time outdoors.  Interestingly enough, studies have shown that spending 1-2 hours a day outside can help protect against nearsightedness.  Second, the prominence of electronic devices in our society means people are spending more and more time looking at near focus objects – which is a trigger for myopia progression.

Recent research shows that if we catch nearsightedness early enough we can significantly slow its progression.  So how can we do that?  There are a variety of effective options available to us.  A multifocal pair of glasses has been shown to decrease the progression of nearsightedness by 30-40%. Certain types of multifocal contact lenses can decrease the progression by up to 50%.  The solution that has the biggest effect seems to be corneal reshaping or orthokeratology – reducing myopia progression by an average of 60%.  This type of lens is worn while you sleep and reshapes the cornea in a way that the vision is clear during the day without the use of vision correction.  All of the above procedures are shown to reduce the growth rate of the eye, and thus the degree of nearsightedness, by causing a subtle and specific defocus of the peripheral vision.   There is one other option that uses the medication atropine to slow nearsighted progression.  This method fell out of favor because of side effects of the drug; however, it has resurfaced due to recent studies which show that it is still effective even in very small doses – small enough doses where negative effects are minimal or not seen at all. It is yet to be seen whether combining the above treatments can create an even greater effect.  We have to remember that once the eye is grown, the medical risks associated with myopia cannot be reversed – so the key is prevention.  Even LASIK surgery, while it does improve the sight, does not reduce these risks.

This brings me around full circle to the title of the article.  Don’t be so nearsighted! We have a limited window of opportunity with our children to help decrease their risk of potentially sight threatening conditions; a window that is mostly closed by a child’s early 20’s.  Parents and eye care providers have the unique opportunity to not only help children see better, but also to prevent the eye health consequences that a traditional treatment ignores.  We encourage parents to consider taking a farsighted look at their children’s nearsighted eyes.  At last we can help decrease our children’s risks associated with becoming more nearsighted.  Why not make that choice?

-Dean Amundsen, O.D.