Can I really slow or stop my eyes from getting worse?
This is a plan to keep myopia from getting worse or perhaps prevent it from ever starting. It is not a plan on how to cure myopia. True myopia (nearsightedness) means that the eyeball has grown too long. That physical change can not be reversed - we can't make the eyeball shorter without cutting part of it off. So your goal is to keep from getting worse. The earlier (younger) you start, the better chance for success.
This Action Plan may not be the best plan for you or your doctor's plan. It is not the plan of all the researchers whose work is discussed on the site. Researchers by definition must be conservative. Clinically, it's past time to be so conservative that no action is taken. It's time for patients and doctors to actually start controlling myopia. There are no guarantees and your eyes may not respond as well as expected. But there is help available.
I'm a clinician and I've seen thousands of people with myopia. The problem is getting worse every year and regular glasses are part of the problem. There are options that make sense and are low risk. Two of the actions (diet and outdoor time) have many other benefits and can be started at any time. They should be part of your life and those of anyone who is serious about preventing the progression of myopia.
You may first want to read other pages on this site to familiarize yourself with current knowledge about myopia control, progression and prevention. Be aware that although there are significant negative issues associated with myopia (costs of lifetime treatment, increased risk (although small) of eye disease and blindness, inconvenience), these issues are not life threatening and have been generally managed with glasses for over a century. However, current research indicates we are probably making the problem worse with glasses and the problems are accelerating for other reasons as well.
Interestingly, there are those who consider myopia a useful adaptation to the modern world's demands for clear vision for objects within arm's reach, especially for those over forty who naturally lose their ability to auto-focus their eyes for objects close to them. These people may consider their myopia useful and do not want to get rid of it.
The opposing camp wants to prevent the need for lenses for everyday activities such as school, sports, driving and other activities. I'm in that camp. Your first decision is thus whether you actually want to do anything to prevent, stop or slow the process of myopia. I think the reasonable plan is that a child's vision should be kept as clear as possible. If it is possible to keep a person's vision at a low level of myopia, whether by specialized prescription lenses, outdoor activities or other treatments, there can be a freedom from lenses for periods of time (such as a weekend trip) that are not as possible with higher levels of myopia.
In general, the goal is to keep a myope from becoming more myopic. There are significant lifestyle differences between a person with low amounts of myopia and one with higher amounts. A person with low myopia, such as -.75 diopters (the unit of lens power) or better, is only marginally inconvenienced in many situations. They often will not be full-time glasses wearers, using them only for seeing the board at school or driving at night. That is significantly different than a person with higher levels of myopia who needs glasses to recognize a face across the table or needs to pick up the alarm clock to see what time it is. Many of the treatment options are aimed at keeping a person at the lower levels.
The treatment options below are given as recommendations. They are not the right choice for everyone which is why the first step is to find a doctor to help you.
1. FIND THE RIGHT DOCTOR
You need to find a doctor who is willing to discuss myopia prevention with you. Many are not. It is not unusual to have a doctor tell you "You either have the genes for myopia or you don't. Just wear the glasses and I'll see you next year." I'm here to say that your doctor should offer you better options.
2. HAVE YOUR EYES EXAMINED
You need an eye exam. You need an eye exam at an age before you can even read this web site. Research is showing that specific findings during an eye exam identify those who are most helped by treatment. Eye exams are also useful because blurred vision does not mean you have myopia. There are many other reasons for blurred vision that require treatment. People with clear vision also can have significant eye problems. Don't try to guess what you have. Find out.
3. SPEND TIME OUTDOORS
Children should strive to be outdoors at least two hours a day. We do not know if this is the critical amount of time, but children who were outdoors at least that long did not progress in their myopia as quickly. Participation in sports or other strenuous activities is not the requirement as indoor sports such as basketball do not give the same protection. Studies indicate that the activity might best be focused on distant objects, such as when bike riding, as opposed to near activities like playing cards. Just play outside instead of watching TV or computer screens.
4. HEALTHY DIET
There are no studies directly linking diet and myopia. There is a lot of research showing diet is responsible for, or at least makes worse, many disease processes. There is a good theory based on many studies that high carbohydrate diets could make myopia worse. Children should have a nutritional diet without excess calories and with adequate nutrients.
Do not quickly jump over these last two items (outdoor time and nutrition) looking for something more "real". Lifestyle changes can have huge impacts on the quality of life and health. Many of our illnesses have their roots in our sedentary, indoor lifestyles combined with refined foods. You've read that before. How many times in how many places will you have to read it to believe it? It's true. Take action. You can read more about nutrition as a treatment under the Treatments-Environment-Nutrition menu item.
Ortho-K (orthokeratology) is currently the best prescription lens device for correction and myopia prevention based on freedom from glasses or contact lenses during the day and a high success rate compared to other techniques. Ask your doctor if they provide these services. You can read more about orthokeratology under the Treatments-Lenses-Orthokeratology menu.
An informational site about ortho-k combined with a search function to find ortho-k doctors by zip code is at OrthoKDoctors.com.
5b. BIFOCAL CONTACT LENS
If ortho-k is not an option, soft bifocal, center-far contact lenses are the next best option. Companies will probably soon be marketing specialized contact lenses for myopia control but bifocal lenses appear to work somewhat for now. They require lens wear during the day. You can read more about bifocal contacts under the Treatments-Lenses-Bifocal Contact Lenses menu.
5c. SPECIAL GLASSES
If neither ortho-k or bifocal contact lenses are an option, glasses are necessary for clear distance vision if you accept what some have called the "cultural imperative" for clarity. That means that our culture requires clear distance vision. Certainly school work and driving require clear distance vision.
At this time bifocal glasses (clear distant vision on top, reading vision on the bottom) or progressive addition lenses (PALs) (bifocals without a line and with variable power extending to the bottom for reading) may have a slight advantage for some specific conditions associated with myopia. Studies have recently come out on both sides of this issue. You can read about these additional options under the Treatments menu. Glasses have the disadvantage of often not staying centered in front of the eyes which creates treatment difficulties. Most of the lenses cause a necessary peripheral distortion as part of their design and it becomes useful for clarity sometimes to look under/above/around the distortion or the lenses just slip out of position, reducing their effectiveness for myopia control.
Lens makers are coming out with specially designed myopia control lenses for glasses, currently only available in Asia. Reports are of moderate effectiveness.
Fill out the history questionnaire that asks questions about your personal history of myopia, when glasses were first prescribed, when they are worn, etc. Then take it with you to the doctor's appointment.
TAKE ACTION NOW
The average increase in myopia for those who are progressing is about .37 diopters/year. That means a child with low myopia in the third grade most likely won't be able to read the big "E" on the eye chart without glasses by the time they get to high school. Low levels of myopia and the opportunity they afford for more effective treatment are often missed quickly as the change is usually most rapid in the first year or two. There are advantages at any level but there is no advantage in waiting.