Myopia myths and treatments for short sightedness

• Myopia, also called short-sightedness or near-sightedness, typically develops in childhood and worsens until the late teens or early adulthood. It is a lifelong condition which cannot be cured, and has impacts on quality of life and long-term eye health.
• The childhood visual environment can influence myopia, with the key factors being not enough time spent outdoors and too much time spent on screens or reading.
• Treatment options are available to slow myopia progression in children and teenagers.

Myopia is an eye condition which causes blurred far vision, and is also known as short-sightedness or near-sightedness. Once myopia develops in children and teenagers, it typically deteriorates every few to several months. In most cases, this worsening continues until the late teens or even early 20s.¹ This is called progressive myopia, which is a significant concern to quality of life in children and teenagers, and also poses risks to long-term eye health.²

Myopia occurs when the eyes grow too quickly and too long in childhood, faster than the normal expected rate for healthy visual development.³ Myopia can continue worsening into the teens and even early adulthood.^1,4 Once this excessive eye growth has commenced, myopia control treatment options can be prescribed to slow it down but the growth cannot be stopped or reversed.⁵ This means there is no cure for myopia – only ways to correct the blurred far away vision which comes with it.

Examples of when myopia may seem to be ‘cured’, but is only just ‘corrected’, include ortho-k contact lenses and laser eye surgery. Ortho-k is a special type of rigid breathable contact lens which is worn overnight while sleeping, and removed upon waking.

Overnight, ortho-k gently reshapes the surface of the eye so that no glasses or contact lenses need to be worn during the day. The effect is temporary, so the ortho-k lenses need to be worn each night to maintain the vision correction effect. This can make it seem as though the myopia is fixed, but in fact it’s just been corrected – if you stop wearing your ortho-k lenses overnight while sleeping, the correction will regress and you’ll need normal glasses or contact lenses to see during waking hours again.⁶

In the same way, but as a permanent fix, laser eye surgery (LASIK) can also do away with the need for vision correction, so the person doesn’t need to wear glasses or contact lenses again. It corrects myopia, but doesn’t cure it, because it doesn’t shorten the length of the eyeball. It's the length of the eyeball and the stretching which has occurred in the development and progression which is most closely linked to risk of eye diseases associated with myopia.² This means the health risks of myopia remain the same, even if vision is now perfect.

Sometimes a person may have had their glasses made too strong for them. When a more accurate refraction (measure for glasses) is undertaken, the numbers in the prescription can reduce. This can appear like an improvement in myopia when it is in fact due to measurement error. This can be a common observation in children when auto-refraction machines are used to test vision instead of by an expert optometrist or eye doctor using best-practice techniques.⁷

Daily 'eye exercises' which involve massaging acupressure points around the eyes have been a common practice in China for decades, recommended as policy in schools. Research has shown, though, that these have no impact on reducing myopia in children or on the stability of their vision over time.⁸

One study even found that children and teenagers who regularly performed the exercises were more likely to have impaired vision and/or to have myopia.⁹

This doesn't necessarily mean that the exercises cause harm - perhaps kids with vision issues are more interested in doing the exercises - but it definitely indicates that they're not helpful in protecting vision in children and teenagers.

One clinical trial treated teenagers and young adults (14 to 22 years) with myopia using special soft contact lenses and vision training (eye exercises) to improve the flexibility of the eyes' focussing system. While the eye exercises worked to make the focussing system respond more quickly to changes in focus distance,¹⁰ there was no effect on slowing progression of myopia.¹¹

There is strong evidence for specific types of vision training (eye exercises) to improve specific eye muscle coordination issues.¹² Qualified eye care practitioners such as orthoptists, optometrists and ophthalmologists will prescribe and supervise these vision training programs.

While there are links between particular types of eye muscle coordination issues (binocular vision dysfunctions) and myopia, there is no research to yet link fixing the dysfunction with altering the development of myopia.¹³

This claim dates back over many centuries – it is believed that the ancient Chinese slept with sandbags or small weights on their eyes overnight to improve their vision for the morning. It has continued in the belief that if your distance vision was blurred, you could ‘push down on your eyes with your palms’ to make the eyeball lengthening go away and cure myopia.

This advice is wrong, and is potentially dangerous, as pushing on your eye can dramatically increase the pressure in your eye, like pushing on a balloon, potentially damaging the eye structures. Avoid rubbing and pressing your eyes - if done frequently this can cause long term eye health damage and even impact vision.¹⁴

On the positive note, this ancient Chinese concept is somewhat like how ortho-k works to temporarily correct vision during the day – but by using very gentle fluid pressure between a contact lens and the eye surface, not the blunt pressure of a sandbag or a hand.

Vitamins are used in healthcare to treat some eye conditions. Age-related macular degeneration (AMD), a condition which can cause central-vision blindness and mainly occurs in the elderly, can have its progression slowed by taking a very specific dose of some vitamins. This is only for AMD though, and if taken incorrectly and not under the direction of a professional these vitamins can negatively impact the health of some people.¹⁵

There is no current vitamin that prevents or cures myopia, and all vitamins and supplements should only be taken under the advice of your healthcare professional.

One study from Denmark, published in 2008, found that a caffeine-derivative tablet called 7-methylxanthine (7-MX) had a very small effect on slowing eye growth in children with myopia.¹⁶ It is only available in Denmark, and a larger follow-up study published in 2022 again showed only minor effects to slow myopia progression.¹⁷

7-MX has not been investigated in any other countries and the effects to slow myopia progression are much smaller than the currently available spectacle, contact lens and atropine eye drop treatment options for myopia control.

There are numerous benefits for children and teenagers who wear contact lenses, such as improving their satisfaction with their vision, their appearance, and ability to participate in activities of school and sport.¹⁸

Contact lenses can have a very high safety profile when they are worn correctly and under the supervision of a qualified contact lens optician, optometrist or ophthalmologist. Children aged 8 to 12 years actually appear to be safer soft contact lens wearers than teenagers and adults, with a lower risk of eye infection. This is likely due to parental supervision and support.¹⁹

The risk of an eye infection when wearing contact lenses ranges from 1 in 1,000 to 1 in 5,000 per year, depending on the type of contact lens. Even when not wearing contact lenses, there is a risk of eye infection, which is around 1 in 7,000 per year. These are not frequent occurrences - learn more in our article How can I make contact lens wear and ortho-k as safe as possible?

With rates of myopia (short-sightedness or near-sightedness) increasing worldwide,²⁰ there is a clear link being shown between a child's visual environment and risk of myopia. This encompasses how much time they spend outdoors, as well as what they do when indoors - time spent on screen time and close work like reading.²¹

A large analysis study published in 2020 stated that there was no clear link between myopia and digital screen use.²² A newer study published in 2022 did find a link, even more so when digital hand-held devices were combined with computer use.²³ This newer study included some objective data, which is measured independently of a child or parent's opinion of their screen time. By comparison, all older studies use subjective data, being responses from surveys.

Another study also found a link between heavier smartphone use and myopia, with the largest impact found in children under age 10.²⁴

To finish on a positive note - increasing time spent outdoors can help protect children's eyes from developing myopia, even if they have a lot of screen time. Kids and teens don't have to be playing sport to get the benefit of time spent outdoors, as it appears to be about the brightness of the light, not physical activity.²¹

The goal is to aim for an average of two hours per day spent outdoors for kids and teens. Being sun safe is still important. Read more about the benefits of outdoor time, sun protection and guidelines for physical activity in kids in our article All about outdoor time.