Eye health resource
Common Questions About Myopia
What causes myopia, is it hereditary, how is it diagnosed, and can progression be slowed? Get clear answers about nearsightedness and current myopia-management options.
Reviewed for accuracy by Justin Bazan, OD on .
Myopia, or nearsightedness, means distance vision is blurry because light focuses in front of the retina rather than directly on it. It often begins during childhood and can progress as the eye grows.
Correcting myopia and managing its progression are related but different goals. Glasses and ordinary contact lenses can make vision clear. Myopia management is intended to slow how quickly nearsightedness increases over time.
Is Myopia Hereditary?
Genetics clearly matters. A child with one or two myopic parents has a higher risk of becoming myopic, although family history does not determine the outcome by itself.
Environment also matters. Less time outdoors and patterns of intensive near work are associated with myopia development and progression. Myopia is best understood as the result of multiple genetic and environmental influences rather than a single cause such as reading, screens, or “eye strain.”
What Are the Symptoms of Myopia?
The classic symptom is difficulty seeing far-away objects clearly. Children may also:
- squint to see the board, television, signs, or distant faces;
- move closer to screens or the front of a classroom;
- report blur at distance while reading remains clear; or
- not complain at all because their blurry distance vision feels normal to them.
Headaches or eye fatigue can occur for many reasons and are not specific to myopia. A comprehensive eye exam is the best way to determine whether a refractive error is present.
How Is Myopia Diagnosed?
An eye exam measures visual acuity and refractive error and also evaluates the health of the eyes. In children, the doctor may use objective techniques such as retinoscopy and may recommend dilating drops when relaxing the child's focusing system will help obtain a more reliable prescription.
The prescription is measured in diopters. A minus sign indicates myopic lens power.
Do Glasses Make Myopia Worse?
No. Properly prescribed glasses correct blurry vision; they do not weaken the eyes or cause myopia to progress. Intentionally undercorrecting a child's myopia is not a recommended strategy for slowing progression.
Can Myopia Progression Be Slowed?
Yes, evidence-based treatments can slow progression in many children, although no method can guarantee that myopia will stop completely.
Park Slope Eye's current myopia-management options include:
- Ortho-K — specially designed rigid contact lenses worn overnight to temporarily reshape the corneal surface and provide daytime vision while also serving as a myopia-management strategy.
- Low-dose atropine — prescription eye drops that may be used off-label in the United States to help slow progression in appropriate children.
- Appropriate soft multifocal or myopia-control contact lenses — selected based on the child's prescription, age, eye health, and ability to wear contact lenses safely.
The best option depends on the child, how quickly the prescription is changing, eye health, lifestyle, family preferences, and the ability to follow the treatment and follow-up plan.
Does Spending More Time Outdoors Help?
More outdoor time is associated with a lower risk of developing myopia and is a healthy habit for children. For a child who is already becoming more nearsighted, outdoor time is still worthwhile but should not be presented as a replacement for an indicated myopia-management treatment.
What About LASIK?
LASIK and PRK can reduce dependence on glasses or contact lenses in appropriately selected adults after the prescription has stabilized, but refractive surgery does not turn back the childhood eye growth that produced myopia and is not a pediatric myopia-control treatment.
Park Slope Eye provides LASIK and PRK co-management; the surgery itself is performed by an ophthalmic surgeon.
Why Does Myopia Management Matter?
Higher levels of myopia are associated with greater lifetime risk of problems such as retinal detachment, myopic macular degeneration, glaucoma, and cataract. Slowing progression can reduce how myopic a child ultimately becomes, even when treatment does not stop progression entirely.
If your child is nearsighted or the prescription has been changing, book an appointment to discuss whether myopia management is appropriate.
Originally published . Substantially updated .