Nearsightedness

Diagnosis

Diagnosing nearsightedness involves a routine eye examination. Your eye doctor will probably inquire about your medical history, including any medications you may be taking, whether for yourself or your child.

Visual acuity test: The visual acuity test assesses the clarity of your vision from a distance. While covering one eye, the eye care specialist instructs you to read an eye chart featuring letters or symbols of varying sizes. The process is then repeated with the other eye. Special charts tailored for young children are utilized for this examination.

Phoroptor test: During this test, you read an eye chart while using a device equipped with various lenses. This aids in determining the suitable prescription to address vision issues.

Other tests of eye health: Your eye care specialist will perform additional tests to assess the following:

• Pupillary response to light
• Eye movement
• The health of the cornea, pupil, lens, and eyelids
• Peripheral vision (side vision)
• Intraocular pressure

Exam of inner eye: Your eye care specialist will utilize a unique lens with a light to inspect the state of the retina and optic nerve. Drops may be applied to dilate your eyes, enhancing the view of the inner eye. Your eyes may remain sensitive to light for a few hours, so it’s advisable to wear the temporary sunglasses provided by the specialist or your own sunglasses.

Treatment

The primary objective in treating nearsightedness is to enhance vision by aiding in the proper focusing of light onto the retina, typically achieved through corrective lenses or refractive surgery. Additionally, managing nearsightedness involves consistent monitoring to detect and address potential complications such as glaucoma, cataracts, and retinal detachment.

Prescription lenses

Corrective lenses are used to address nearsightedness by compensating for the increased curvature of your cornea or the increased length of your eye.

Various types of prescription lenses include:

• Eyeglasses: A simple and safe method to enhance vision affected by nearsightedness. Eyeglass lenses can also be tailored to correct a combination of refractive errors, such as nearsightedness, astigmatism, and presbyopia.
• Contact lenses: Small, plastic disks positioned directly on the cornea. A single contact lens may address multiple refractive errors. There are diverse materials and care requirements for contact lenses, and your eye care specialist can recommend the most suitable type based on your prescription and lifestyle.

Refractive surgery

Refractive surgery is designed to minimize the reliance on eyeglasses and contact lenses by using a laser to reshape the cornea. You may still require eyeglasses occasionally even after the surgery. The following procedures are commonly employed:

• Laser-Assisted in Situ Keratomileusis (LASIK): This involves creating a thin, hinged flap in the cornea, followed by using a laser to remove corneal tissue and flatten its shape. LASIK generally results in a quicker recovery and less discomfort compared to other corneal surgeries.
• Laser-assisted Subepithelial Keratectomy (LASEK): The surgeon forms an ultrathin flap in the outer protective layer of the cornea (epithelium), applies a laser to reshape the cornea, flatten its shape, and then reinstates the epithelium.
• Photorefractive Keratectomy (PRK): This technique bears resemblance to LASEK, with the distinction that the surgeon entirely removes the epithelium before utilizing the laser to reshape the cornea. A temporary protective contact lens is placed on the cornea until the epithelium naturally regrows to conform to the new corneal shape.
• Small Incision Lenticule Extraction (SMILE): This procedure does not involve a flap or removal of the epithelium. Instead, a laser is used to cut a small disk-shaped piece of the cornea (lenticule), which is then extracted through a small corneal incision.

It’s essential to note that surgical treatments are not suitable for everyone with nearsightedness and are typically recommended when the condition has stabilized. Your surgeon will provide detailed information about the benefits and risks associated with each surgical treatment option.

Interventions aimed at decelerating or halting the progression of nearsightedness.

Researchers and clinical practitioners are actively exploring more effective strategies to impede the progression of nearsightedness in children and adolescents. Potential therapies showing promise include:

• Atropine: Atropine drops, commonly used to dilate pupils during eye exams or eye surgeries, may also have a role in slowing the progression of nearsightedness when administered in low doses.
• Increased outdoor time: Outdoor time during childhood, adolescence, and early adulthood has been associated with a potential reduction in the risk of developing nearsightedness.
• Dual focus contact lenses: Certain types of dual focus contact lenses have demonstrated some effectiveness in slowing the progression of nearsightedness.
• Orthokeratology: This involves the use of rigid contact lenses worn at night to temporarily reshape the cornea. These lenses are not worn during the day, and studies suggest that this approach may contribute to slowing the progression of nearsightedness.