Nearsightedness

Diagnosis

Nearsightedness is diagnosed through a basic eye exam. Your eye care specialist will review your medical history and ask about any medications being used.

Visual acuity test

A visual acuity test measures how clearly you can see at a distance. One eye is covered while reading an eye chart with letters or symbols of different sizes, then the test is repeated for the other eye. Special charts are available for very young children.

Phoroptor test

This test uses a device with multiple lenses. You read an eye chart while looking through the lenses to help determine the correct prescription for vision correction.

Other tests of eye health

Your eye care specialist may check:

• Pupil response to light
• Eye movement
• Peripheral vision
• Eye pressure
• Condition of the cornea, pupil, lens, and eyelids

Exam of the inner eye

A special lens with light may be used to examine the retina and optic nerve. Eye drops are applied to dilate the pupils, which makes your eyes sensitive to light for a few hours. Temporary or personal sunglasses are recommended after the exam.

Treatment

Treatment for nearsightedness focuses on improving vision with corrective lenses or refractive surgery, and monitoring for complications like glaucoma, cataracts, and retinal detachment.

Prescription lenses

Corrective lenses help focus light on the retina and include:

• Eyeglasses: Simple and safe, can also correct multiple refractive errors
• Contact lenses: Placed directly on the cornea, suitable for single or multiple refractive errors

Refractive surgery

Surgery reshapes the cornea to reduce dependence on glasses or contacts. Options include:

• LASIK: Creates a thin corneal flap and uses a laser to reshape the cornea
• LASEK: Creates an ultrathin flap in the epithelium, then reshapes the cornea with a laser
• PRK: Removes the epithelium completely, then reshapes the cornea with a laser
• SMILE: Removes a small disk-shaped piece of the cornea through a tiny incision, no flap needed

Surgery is usually recommended only when nearsightedness has stabilized. Your surgeon will discuss benefits and risks.

Treatments to slow or stop progression

Methods to slow progression, especially in children and adolescents, include:

• Atropine eye drops: Low doses may reduce progression
• Increased outdoor time: Exposure to daylight may lower risk of nearsightedness
• Dual focus contact lenses: Can slow progression in some patients
• Orthokeratology: Nightly rigid lenses reshape the cornea temporarily, slowing progression during the day