Nearsightedness is diagnosed by a basic eye exam, which includes a refraction assessment and an eye health exam.
A refraction assessment determines if you have vision problems such as nearsightedness or farsightedness, astigmatism, or presbyopia. Your doctor may use various instruments and ask you to look through several lenses to test your distance and close-up vision.
Your eye doctor likely will put drops in your eyes to dilate your pupils for the eye health exam. This may make your eyes more light sensitive for a few hours after the exam. Dilation enables your doctor to see wider views inside of your eyes.
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, retinal tears and detachments, and damage to central retinal areas.
Wearing corrective lenses treats nearsightedness by counteracting the increased curvature 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. The variety of eyeglass lenses is wide and includes single vision, bifocals, trifocals and progressive multifocals.
- Contact lenses. These lenses are worn right on your eyes. They are available in a variety of materials and designs, including soft and rigid, gas permeable in combination with spherical, toric and multifocal designs. Ask your eye doctor about the pros and cons of contact lenses and what might be best for you.
Refractive surgery reduces the need for eyeglasses and contact lenses. Your eye surgeon uses a laser beam to reshape the cornea, which results in a decreased nearsighted prescription. 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 inner layers of your cornea 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 ultra-thin flap only in the cornea's outer protective cover (epithelium). He or she then uses a laser to reshape the cornea's outer layers, 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. The epithelium is not replaced, but will grow back naturally, conforming to your cornea's new shape.
Talk with your doctor about the possible side effects, as this procedure is not reversible. Refractive surgery is not recommended until your nearsighted prescription is stable.
Treatments to slow or stop progression of nearsightedness
Researchers and clinical practitioners continue to seek more-effective approaches to stop nearsightedness from getting worse over time. Therapies that show the most promise to date include:
- The topical medication, atropine. Topical atropine drops are commonly used to dilate the pupil of the eye, often as part of eye exams or before and after eye surgery. Atropine eyedrops in various doses may also help slow the progression of nearsightedness. The exact mechanism for this effect is unknown.
- Increased time outside. Spending time outdoors during adolescence and your early adult years may decrease the lifetime risk of nearsightedness. Researchers think exposure to the sun's ultraviolet (UV) rays may change the molecular structure of the sclera and cornea and help maintain a normal shape.
- Dual focus contact lenses. A new type of dual focus contact lens has been shown to slow the progression of nearsightedness in children between 8 and 12 years old.
- Orthokeratology. In this procedure, you wear rigid, gas permeable contact lenses for several hours a day until the curvature of your eye evens out. Then you wear the lenses less frequently to maintain the new shape. If you discontinue this treatment, your eyes return to their former shape. There is evidence that this lens does slow down the elongation of the nearsighted eyeball, which decreases myopia.
Lifestyle and home remedies
You can't prevent nearsightedness at this time. Some studies suggest you may be able to slow its progression though. You can, however, help protect your eyes and your vision by following these tips:
- Have your eyes checked. Do this regularly even if you see well.
- Control chronic health conditions. Certain conditions, such as diabetes and high blood pressure, can affect your vision if you don't receive proper treatment.
- Protect your eyes from the sun. Wear sunglasses that block ultraviolet (UV) radiation.
- Prevent eye injuries. Wear protective eyewear when doing certain things, such as playing sports, mowing the lawn, painting or using other products with toxic fumes.
- Eat healthy foods. Try to eat plenty of leafy greens, other vegetables and fruits. And studies show that your eyes benefit if you also include in your diet fish high in omega-3 fatty acids, such as tuna and salmon.
- Don't smoke. Just as smoking isn't good for the rest of your body, smoking can adversely affect your eye health as well.
- Use the right corrective lenses. The right lenses optimize your vision. Having regular exams will ensure that your prescription is correct. There is evidence that wearing a prescription that is too weak (undercorrecting) can increase the development of nearsightedness.
- Use good lighting. Turn up or add light for better vision.
- Reduce eyestrain. Look away from your computer or near-task work, including reading, every 20 minutes — for 20 seconds — at something 20 feet away.
- See your doctor immediately if you experience any of these symptoms: Sudden loss of vision in one eye with or without pain; sudden hazy or blurred vision; double vision; or you see flashes of light, black spots or halos around lights. This may represent a serious medical or eye condition.
Preparing for your appointment
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 a 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.
No matter which type of eye specialist you choose, here's some information to help you get ready for your appointment.
What you can do
- If you already wear glasses, bring them with you to your appointment. Your doctor has a device that measures your current glasses prescription. If you wear contacts, bring to your appointment an empty contact lens box from each eye.
- 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 doctor.
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 doctor 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?