Definition

Myopia, or nearsightedness, is the difficulty in seeing distant objects clearly, such as traffic signs, while nearby objects are seen more easily. This common condition can be managed with concave or minus glasses, contact lenses, or refractive surgery. Based on the lens strength needed to correct it, myopia can be categorised into:

• Mild myopia: requiring lenses up to -3.00 D (Diopters)
• Moderate myopia: requiring lenses between -3.00 to -6.00 D
• High myopia: requiring lenses more than -6.00 D

The prevalence of myopia in Indonesia among adults is 18.7%, while in elementary school children, it is 32.3%.

Causes

If the image of an object does not fall directly on the retina, we cannot see the image clearly. In myopia, nearby objects are seen clearly, but distant objects appear blurry. This can be caused by an eyeball that is too long or a cornea that is too curved, causing light to be focused in front of the retina, resulting in blurry vision.

Myopia can be inherited. Children of myopic parents may also develop it. Myopia can first be identified in children aged 8 to 12. During adolescence, body growth can worsen the condition. Myopia generally does not change significantly between the ages of 20 and 40. Myopia also occurs in adults.

Myopia stabilizes at the age of 20–30. The condition can be corrected with concave or minus glasses or contact lenses. If the patient has high myopia, they may need refractive surgery.

Risk factor

Risk factors for myopia include:

• Genetics: Myopia runs in families, especially if both parents are myopic.
• Environmental conditions: Rarely spending time outdoors.

Symptoms

Symptoms experienced by individuals with myopia include:

• Headaches
• Frequent squinting or tilting of the head
• Eye strain
• Frequent fatigue when looking at distant objects
• Difficulty reading the blackboard in school (common in children aged 8–12 years)
• Need to sit close to the blackboard or TV to see clearly
• Eye tension
• Frequent eye rubbing
• Frequent blinking

Diagnosis

Doctors can diagnose myopia with a vision sharpness test like the Snellen Chart. Generally, the blurry condition improves with concave or minus lenses. An objective examination can be done using streak retinoscopy.

Management

Myopia is corrected using glasses, contact lenses, or refractive surgery.

Glasses

If a person has myopia, an eye doctor will prescribe glasses with concave or minus lenses. The stronger the minus lens, the more powerful it is. For example, a -3.00 D lens is stronger than a -2.50 D lens.

Contact Lenses

Although not highly recommended, contact lenses can correct myopia. However, you must maintain eye and hand hygiene, especially when putting on and removing them. Unclean contact lens use can cause eye infections.

Surgery

Refractive surgery can be used to correct myopia by reshaping the curvature of your cornea. Types of refractive surgery include:

• Laser-assisted in situ keratomileusis (LASIK): This procedure uses a laser to reshape the cornea to correct myopia. LASIK recovery is quicker and more comfortable.
• Laser-assisted subepithelial keratectomy (LASEK): This procedure corrects the outer part of the cornea (corneal epithelium).
• Photorefractive keratectomy (PRK): Similar to LASEK, but involves removing the corneal epithelium to reshape the cornea. The corneal epithelium naturally regrows.
• Implantable Collamer Lens: This procedure involves inserting a lens between your natural lens and iris through a microscopic incision to improve vision clarity.

Home Care

• Regularly check your eye condition
• Monitor your overall health for conditions like diabetes and hypertension
• Use glasses with sun protection to block UV rays
• Prevent eye trauma
• Consume nutritious food
• Avoid smoking
• Use appropriate corrective lenses
• Ensure good lighting when reading or viewing
• Reduce eye strain by taking breaks while working

Complications

High myopia can increase the risk of:

• Retinal detachment: Separation of the retina from the inner eye.
• Reduced quality of life: because of difficulty performing tasks.
• Chronic headaches and eye strain.
• Safety hazards: While driving or working.
• Increased risk of other eye diseases: Such as glaucoma, cataracts, and myopic maculopathy.

Prevention

To prevent myopia, you can:

• Spend adequate time outdoors.
• Limit screen time.
• Ensure eye health before starting school.
• Maintain the cleanliness of contact lenses.

When to see a doctor?

If you have difficulty seeing distant objects, visit a nearby general doctor to check your eyes.

If you experience sudden blurriness with or without pain, double vision, light flashes, or many floating dark spots, immediately visit the nearest healthcare facility.

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