Myopia

By Dr. Khang Ta

Published March 16, 2025

Myopia, or short-sightedness, is a common refractive condition affecting around 25% of Australians.1 Often developing in childhood or adolescence, myopia can progress and lead to higher risks of vision complications if not managed early and effectively.

DEFINITION

Myopia is a refractive error where light focuses in front of the retina instead of directly on it, causing distant objects to appear blurred while close objects remain clear. This condition typically progresses over time, and high myopia can lead to structural eye changes.

SYMPTOMS

Symptoms of myopia may include:

  • Blurry vision when looking at distant objects.
  • The need to squint or partially close the eyelids to see clearly.
  • Headaches.
  • Eyestrain.
  • Excessive blinking.
  • Eye rubbing

CAUSES AND RISK FACTORS

Myopia is driven by both genetic and environmental factors. Key risk factors include:

  • Genetics: Family history of myopia.
  • Environmental influences: Limited time outdoors and prolonged near work, such as screen use and reading.
  • Early onset: The earlier myopia begins, the higher the risk of rapid progression.

LONG-TERM CONSIDERATIONS

In addition to the inconvenience of blurred vision and reliance on corrective lenses, high myopia can lead to a number of serious long-term complications later in life.2 Long-term sequelae of myopia include:

  • Myopic macular degeneration.
  • Retinal detachment.
  • Cataracts.
  • Glaucoma.

Early management is crucial for slowing progression and reducing the likelihood of complications.

MANAGEMENT AND TREATMENT

The management of myopia has undergone substantial advancements in recent years, with an emphasis not only on refractive correction but also on evidence-based therapies aimed at mitigating myopia progression. This dual approach is essential to minimising the risk of long-term complications associated with high myopia. Current management strategies include:

  • Orthokeratology (Ortho-K): Specialty contact lenses worn overnight that temporarily reshape the cornea, providing clear vision during the day without the need for glasses or lenses. Ortho-K has also shown promising results in slowing myopia progression in children.
  • Myopia Controlling Spectacles: Advanced optical designs modify peripheral defocus, which is thought to contribute to myopia progression. By altering how light focuses on the peripheral retina, these lenses help reduce the eye’s tendency to elongate, which is a primary factor in myopia progression.
  • Multifocal and Dual-Focus Contact Lenses: Designed to correct distance vision while also altering peripheral defocus, these lenses have been shown to help slow myopia progression in younger patients.
  • Pharmaceutical Treatments: Low-dose atropine eye drops have been effective in reducing the progression of myopia in children and adolescents. This treatment is often combined with other strategies for enhanced results.
  • Environmental and Behavioural Modifications: Increasing time spent outdoors and managing near-work activities, such as prolonged screen use or reading at close distances, have both been associated with a reduced risk of myopia progression.

  1. Australian Institute of Health and Welfare. (2021). Eye health. Retrieved from https://www.aihw.gov.au/reports/eye-health/eye-health/contents/summary
  2. Annechien E. G. Haarman, Clair A. et al. The Complications of Myopia: A Review and Meta-Analysis. Invest. Ophthalmol. Vis. Sci. 2020;61(4):49.