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Short-sightedness


Expert reviewer, Professor Simon Taylor, Consultant Ophthalmic Surgeon
Next review due October 2023

Short-sightedness (also called near-sightedness) is a common problem where you can’t focus on distant objects, but can see close objects clearly. The medical name for this is myopia.

A man wearing glasses

About short-sightedness

Different parts of our eye help us to focus on objects properly. Your cornea (the clear outer layer at the front of your eye) bends light rays towards your retina at the back of your eye. Your lens, which sits behind your pupil, changes in shape to ‘fine tune’ the image so that the focus is just right.

If you’re short-sighted, light from distant objects focuses at a point in front of your retina rather than directly on it. This is either because your cornea is too curved or your eyeball is too long. If the light rays aren’t clearly focused on your retina, the objects you see look fuzzy or blurred. Close-up objects don't look blurry, because the light rays from them focus in the right place on your retina.

Short-sightedness is very common. In the UK, around one in four adults are short-sighted. It’s often discovered in childhood, between the ages of eight and 12. As your eyes continue to grow during childhood, short-sightedness tends to get worse until your eye stops growing. It usually settles down by the time you’re 20, although it is possible to develop short-sightedness as an adult.

Causes of short-sightedness

Most people who are short-sighted have eyeballs that are longer than normal. It’s not always clear why some people develop short-sightedness, but there are some things that seem to increase your risk.

  • It tends to run in families, so if one or both of your parents are short-sighted, you’re more likely to have it too.
  • Being of east-Asian ethnic origin.
  • Children who do a lot of close-up work, such as using a computer, tablet or phone, are more likely to become short-sighted. If you’re already short-sighted, doing this type of close work may make it worse.
  • There’s some evidence that not spending much time outdoors as a child may increase the risk of becoming short-sighted in later life.

Symptoms of short-sightedness

If you’re short-sighted, you’ll be able to see close objects clearly but distant objects will appear fuzzy or blurred. You might notice that you narrow your eyes or squint to make far away objects seem clearer.

Young children may not realise they have blurred vision. Signs that your child may be short-sighted include:

  • squinting or narrowing their eyes
  • rubbing their eyes or turning their head
  • sitting close to the TV
  • having trouble seeing the blackboard or whiteboard at school – this might start to affect learning or behaviour too

Other symptoms may include sore, tired, red and watery eyes and sometimes headaches.

If you or your child strain to see things in the distance, you should book an eye-test with an optician (also known as an optometrist). This is a registered health professional who examines eyes, tests sight and dispenses glasses and contact lenses.

Having an eye test

It's important for everyone to have regular eye tests. You should have an eye examination every two years, even if you have no problems with your vision. Always go for a test sooner if you notice changes in your vision or are having any problems. Some people are entitled to free eye tests, including children and people over 60. See our FAQ section for more information.

At your eye test, your optician will ask about your general health and any problems you’re having with your eyes or vision. They’ll examine your eyes to check how healthy they look, and may take photographs or scans too. They’ll assess both your distance and near vision.

Distance vision (how well you can see things far away) is usually assessed by asking you to read letters on a standard chart. The chart is called a Snellen chart; it has large letters at the top and small letters at the bottom. For young children, letters can be replaced by pictures or shapes. If you need to book an appointment for a young child, mention the child’s age when you book. This is important so you can be certain that the optician is able to do an eye test for a young child.

Opticians measure the focusing power of your eye in dioptres (D). If you’re short-sighted, this will be a minus number. Your optician will give you a prescription with this measurement at the end of your test. A score between 0 and –3D is classified as mild, –3D to –6D is moderate and over –6D -is severe/high myopia.

If you’re short-sighted, your optician will tell you how often you should have your eyes checked. This may continue to be every two years for adults. For children, recommended frequency of testing could be every six months because children’s vision can change very quickly.

Treatment of short-sightedness

Glasses and contact lenses

Short-sightedness can usually be corrected by wearing glasses or contact lenses. The lenses in your glasses or contact lenses focus light in the right place on your retina. If you're mildly short-sighted, you may only need to wear glasses or contact lenses for specific purposes such as driving or watching TV.

You may prefer to wear contact lenses for cosmetic or practical reasons (for instance, if you’re taking part in certain sports). Some people also find that their vision is clearer with contact lenses.

The different types of contact lens fall into two main groups.

  • Soft lenses. These are flexible and mould to the shape of your eye. Depending on the type, they can be used for a day, a fortnight or a month, then you throw them away.
  • Rigid gas permeable (RGP) lenses. These aren’t so flexible and don’t mould to your eye. You keep and reuse them for longer periods of time. They can take a bit of getting used to, but they’re useful for people with certain specific eye problems.

You need to be comfortable touching your eyes to use contact lenses. You also have to be committed to looking after the lenses properly. If you have reusable contact lenses (soft or RGB), you’ll have to look after them and clean them with special lens fluids after every use. Not cleaning lenses properly increases your risk of an eye infection.

Children should only wear contact lenses once they’re able to put them in and take them out safely, and look after them properly. This may be difficult for younger children. For the same reason, glasses may also be more suitable than contact lenses for older people who may have trouble looking after them.

Overnight lenses

Your optician may recommend a treatment called orthokeratology or corneal reshaping lenses. These are a special type of rigid contact lens that you wear overnight and take out during the day. They are designed to reshape your cornea temporarily reducing or correcting your short-sightedness so you can see without glasses or contact lenses the following day. These lenses carry a higher risk of infection than regular lenses, so you have to be very careful about cleaning them properly.

Your optician will tell you if these lenses are an option for you.

Surgery

Some people opt to have surgery to correct their short-sightedness rather than rely on glasses or contact lenses. Surgery to correct short-sightedness isn’t available on the NHS nor is it covered by private health insurance schemes; you’ll need to pay for the procedure. It also isn't suitable for everyone. You have to be over 18 and must have had no – or only very little – change in your prescription over the last two years.

There are several different types of surgery, but we describe the main types here.

Laser eye surgery

Laser eye surgery (also called laser refractive surgery) aims to reshape your cornea using a laser so that light rays focus correctly on your retina. There are different types of laser eye surgery but for short-sightedness the surgery involves flattening the curve of your cornea. All laser eye surgery is done using local anaesthetic eye drops, so you’ll be awake during the procedure. It generally takes about half an hour to treat both eyes.

Lens implants

Lens implants involve implanting an artificial lens into your eye to correct your sight. You can have your own lens taken out and a replacement put in. Or you can have a lens put in front of your own lens (known as a ‘Phakic’ lens). If you’re severely short-sighted, a lens implant may be a better option for you than laser eye surgery.

Deciding on surgery

As with any type of surgery, there are certain risks and complications as well as benefits associated with laser eye surgery and lens implants. While many people find their vision improves with surgery, it’s not always possible to get perfect eyesight. There’s also a risk of problems such as glare, poor night vision or dry eyes. You’ll need to see an ophthalmic surgeon to discover if surgery is right for you, and to discuss all the risks and benefits involved.

Frequently asked questions

  • Many people in the UK are entitled to a free eye examination on the NHS. But if you aren’t in any of the entitled groups, you will have to pay. You can have a free eye test if you:

    • are aged 60 or over
    • are under 16; or under 19 if you’re in full-time education
    • have diabetes or glaucoma
    • have been told by an eye specialist that you’re at risk of glaucoma
    • are over 40 with a close relative who has glaucoma
    • are registered as blind or partially sighted
    • receive some state benefits such as income support or universal credit (or your partner does)
    • are entitled to vouchers for complex lenses
    • are a prisoner on leave from prison

    Eye tests are free for everyone in Scotland.

    If you think you qualify for a free eye test, check with your optician for advice before you have your eyes tested.

    You may also be entitled for eyesight tests through your employer, if you regularly work with display screen equipment (for example, PCs, laptops, tablets or smartphones). The price of an eye test varies but is usually around £25 to £40. There are sometimes special offers so it’s worth shopping around. Check what is covered before you book - there may be extra charges for additional tests.

  • Contact lenses are generally very safe. The main risk is getting an eye infection, but you can prevent this if you look after your lenses and eyes properly.

    You can help reduce your risk of getting an eye infection by:

    • always washing and drying your hands before you touch your lenses
    • if you have reusable lenses, cleaning and storing them as you’ve been shown by your contact lens provider
    • never reusing the disinfecting solution and throwing away old solution when it’s past its sell by or use by date
    • looking after your storage case by rinsing it, cleaning it and replacing it as you’ve been advised
    • not wearing your lenses overnight (unless they are lenses designed to wear at night)
    • not letting tap water or saliva come into contact with your lenses – for instance, not showering in your lenses, cleaning them with water or licking them before you put them in
    • not wearing your lenses when swimming unless you’re wearing watertight goggles

    See your optician or GP immediately if you have red or sore eyes and you think you might have an infection. Be sure to tell them that you wear contact lenses. It's important to have regular check-ups with your optician to make sure that your eyes are healthy and you're using the best lenses for your needs.



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  • Reviewed by Pippa Coulter, Freelance Health Editor, October 2020
    Expert reviewer, Professor Simon Taylor, Consultant Ophthalmic Surgeon
    Next review due October 2023

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