Nearsightedness

Diagnosis

Nearsightedness is diagnosed by a basic eye exam. Your eye care specialist will likely ask about your child's or your medical history and ask about any medications used.

Visual acuity test

A visual acuity test checks how sharp your vision is at a distance. You cover one eye, and the eye care specialist asks you to read an eye chart with different sized letters or symbols. Then you do the same for the other eye. Special charts are designed for very young children.

Phoroptor test

In this test you read an eye chart while looking through a device that has different lenses to help determine an appropriate prescription to correct vision problems.

Other tests of eye health

Your eye care specialist will conduct other simple tests to check the following:

• The response of your pupils to light
• Eye movement
• Side vision (peripheral vision)
• Pressure within your eye
• The condition of the cornea, pupil, lens and eyelids

Exam of inner eye

Your eye care specialist will use a special lens with a light to examine the condition of the retina and optic nerve. The specialist will likely put drops in your eyes to dilate them. This provides a better view of the inner eye. Your eyes will probably be sensitive to light for a few hours. Wear the temporary sunglasses provided by the specialist or your own sunglasses.

Treatment

The standard goal of treating nearsightedness is to improve vision by helping focus light on your retina through the use of corrective lenses or refractive surgery. Managing nearsightedness also includes regular monitoring for complications of the condition, including glaucoma, cataracts and retinal detachment.

Prescription lenses

Wearing corrective lenses treats nearsightedness by counteracting the increased curve of your cornea or the increased length of your eye. Types of prescription lenses include:

• Eyeglasses. This is a simple, safe way to sharpen vision caused by nearsightedness. Eyeglass lenses also can be designed to correct a combination of refractive errors, such as nearsighted, astigmatism and presbyopia.
• Contact lenses. Contact lenses are small, plastic disks placed directly on the cornea. A single contact lens may correct more than one refractive error. There are a variety of materials and care requirements. Your eye care specialist can recommend contact lenses that are most suitable for your prescription and lifestyle.

Refractive surgery

Refractive surgery reduces the need for eyeglasses and contact lenses. Your eye surgeon uses a laser to reshape the cornea, which results in a decreased need for nearsighted prescription lenses. Even after surgery, you may need to use eyeglasses some of the time.

• Laser-assisted in situ keratomileusis (LASIK). With this procedure, your eye surgeon makes a thin, hinged flap into your cornea. He or she then uses a laser to remove corneal tissue 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 ultrathin flap only in the cornea's outer protective cover (epithelium). He or she then uses a laser to reshape the cornea, flattening its curve, and then replaces 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. A temporary, protective contact lens covers the cornea until the epithelium grows back naturally, conforming to your cornea's new shape.
• Small incision lenticule extraction (SMILE). In this procedure, there is no 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 removed through a small corneal incision.

Surgical treatments are not an option for everyone with nearsightedness. Surgery is recommended only when nearsightedness is no longer progressing. Your surgeon will explain the benefits and risks of surgical treatment options.

Treatments to slow or stop progression of nearsightedness

Researchers and clinical practitioners continue to seek more-effective approaches to slow the progression of nearsightedness in children and adolescents. Therapies that show the most promise include:

• Atropine. Atropine drops are commonly used to dilate the pupil of the eye, often as part of eye exams or before and after eye surgery. Low doses of atropine eye drops may also help slow the progression of nearsightedness.
• Increased time outside. Spending time outdoors during childhood, adolescence and the early adult years may decrease the risk of developing nearsightedness.
• Dual focus contact lenses. A type of dual focus contact lens has shown some effect in slowing progression of nearsightedness.
• Orthokeratology. A rigid contact lens worn at night temporarily reshapes the cornea. The lens is not worn during the day. Studies have shown that this therapy may slow the progression of nearsightedness.

Lifestyle and home remedies

Steps you can take to promote good eye health and vision include the following:

• Get regular eye exams.
• Protect your eyes from the sun.
• Wear protective eyewear during sports or work that can result in eye injuries.
• Use good lighting when reading and working.
• Wear prescription lenses as directed.
• Care for prescription glasses or contact lenses as directed.
• Rest your eyes from computer or other close-up work every 20 minutes by looking at something 20 feet away for 20 seconds.
• Eat healthy foods.
• Get regular exercise.
• Control health conditions, such as high blood pressure or diabetes, that can affect your vision.
• Don't smoke.

Preparing for your appointment

Eye care specialists

You may encounter three kinds of specialists as you seek help for various eye conditions:

• Ophthalmologist. An ophthalmologist is an eye specialist with a doctor of medicine (M.D.) or a doctor of osteopathy (D.O.) degree followed by an ophthalmology residency. Ophthalmologists are trained to provide complete eye evaluations, prescribe corrective lenses, diagnose and treat common and complex eye disorders, and perform eye surgery.
• Optometrist. An optometrist has a doctor of optometry (O.D.) degree. Optometrists are trained to provide complete eye evaluations, prescribe corrective lenses, and diagnose and treat common eye disorders.
• Optician. An optician is a specialist who helps fit people for eyeglasses or contact lenses, following prescriptions from ophthalmologists and optometrists. Some states require opticians to be licensed. Opticians are not trained to diagnose or treat eye disease.

What you can do

• If you already wear glasses, bring them with you to your appointment. Your eye care specialist has a device that measures your current glasses prescription. If you wear contacts, bring an empty contact lens box from each eye to your appointment.
• List any symptoms you're experiencing, such as trouble reading up close or difficulty with night driving.
• Make a list of all medications, vitamins or supplements that you're taking.
• Create a list of questions to ask your eye care specialist.

Preparing a list of questions can help you make the most of your visit. For nearsightedness, some basic questions to ask include:

• When do I need to use corrective lenses?
• What are benefits and drawbacks to glasses?
• What are benefits and drawbacks to contacts?
• How often do you recommend that I have my eyes examined?
• Are more-permanent treatments, such as eye surgery, an option for me?
• If so, which do you recommend?
• What types of side effects are possible from these treatments?
• Will my insurance company pay for surgical procedures or a contact lens fitting?
• Do you have any brochures or other printed material that I can take home with me? What websites do you recommend?

What to expect from your doctor

Your eye care specialist may ask:

• When did you first begin experiencing symptoms?
• Does your vision improve if you squint or move objects closer (or farther) away?
• Do others in your family use glasses or contacts? Do you know how old they were when they first began having trouble with their vision?
• When did you first begin wearing glasses or contacts?
• Do you have any medical problems, such as diabetes?
• Have you started to take any new medications, supplements or herbal preparations?