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Short-sightedness


Expert reviewer, Professor Simon Taylor, Consultant Ophthalmic Surgeon
Next review due, March 2021

Short-sightedness (also called near-sightedness) is a common problem. Doctors call it myopia. About one in four adults are short-sighted. If you’re short-sighted, you can’t focus on distant objects, but can see close objects clearly.

A man wearing glasses

About short-sightedness

Your eye has a clear window at the front (the cornea). At the back, it has a lining made of light-sensitive nerve cells (the retina). Your lens is between the two. When you look at something, light rays from the object pass into your eye through your cornea, through your lens and to your retina at the back of your eye. In a healthy eye, your cornea and lens bend the light so that it hits the retina when it is exactly in focus. Your cornea bends the light towards your retina and your lens ‘fine tunes’ it so that the focus is just right.

If you are short-sighted, you can't focus clearly on distant objects. Light from them focuses in front of your retina, 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. It usually starts developing between the ages of eight and 12. Your eyes continue to grow during childhood and short-sightedness keeps on developing until they’re fully grown. It is unlikely to develop after that, so it usually occurs before the age of 20. In the UK, around one in eight children under 13 and one in four adults are short-sighted.

Opticians measure the focusing power of a lens in dioptres (D). The higher the number, the more short-sighted you are. Mild short-sightedness scores up to 3D. Moderate is 3D to 6D and 6D or over is high.

Symptoms of short-sightedness

If you’re short-sighted, you will be able to see close objects clearly, but distant objects will appear fuzzy or blurred. You might notice that you narrow your eyes 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:

  • frowning or narrowing their eyes
  • rubbing their eyes
  • sitting close to the TV
  • having trouble seeing the blackboard or whiteboard at school

Other symptoms may include eyestrain and sometimes headaches, but this is uncommon.

As the eyes keep growing during the childhood or teenage years, the level of short-sightedness will change. Children will need to have their eyes tested regularly in case their glasses or contact lens prescription has changed. Short-sightedness will usually stop progressing by the early 20s.

Causes of short-sightedness

We don’t know exactly why some people develop short-sightedness. But it does tend to run in families. If one or both of your parents are short-sighted, you are more likely to have it too. Other things that can increase the likelihood of short sight include:

  • being born prematurely or being underweight at birth
  • doing lots of close-up work, such as using a computer, tablet or phone, or sewing or reading
  • other eye conditions called hazy cornea (corneal dystrophy) or hazy lens (cataract)
  • some conditions where growth is abnormal, such as Marfan’s syndrome

If you are already short-sighted, doing a lot of close work may make it worse.

There is also a condition called accommodative spasm, where focusing the eyes at a very short distance for a long time makes it difficult to focus clearly in the distance. This usually gets better after you’ve rested your eyes. But if you do a lot of close work very often, it can become permanent. If you have accommodative spasm regularly, your doctor may refer you to an orthopist (a health professional specialising in eye problems) who can suggest exercises that could help.

Diagnosis of short-sightedness

If you or your child are straining to see things in the distance, you should book an appointment with an optometrist (often called an optician) to have your eyes tested. This is a registered health professional who examines eyes, tests sight and dispenses glasses and contact lenses. Eye examinations are usually quick and painless, and for some people, including children and the over 60s, they are free. See our FAQ section for more information on who is entitled to a free eye test.

In order to diagnose short-sightedness, your optometrist will usually ask you to read a standard chart (called a Snellen chart). The chart has large letters at the top and small letters at the bottom. For young children, letters can be replaced by pictures. Just check in advance that the optometrist is happy measuring a young child, as not all optometrists specialise in doing this.

It's important for everyone to have regular eye tests. As well as diagnosing any vision problems, they can reveal other serious illnesses, such as glaucoma (an eye condition caused by a build-up of pressure in the eye), diabetes or high blood pressure. Having an eye examination is an important part of looking after your health. You should have an eye examination every two years, even if you have no problems with your vision.

You may need to have eye examinations more often as you get older or if you have:

  • a condition that may affect your sight, such as diabetes or glaucoma
  • a close relative who has a condition that may affect his or her sight, such as diabetes or glaucoma

Adults who are short-sighted may be able to have two yearly eye tests, as short sight doesn’t generally change quickly in adults. Your optometrist may suggest yearly eye tests if you wear contact lenses.

Children who are at particular risk of short sight, or who have already been diagnosed with short sight, should have their eyes examined at least once a year. If both parents have short sight, they may need to have an eye test more often, as they can become increasingly short-sighted more quickly – check with their optometrist.

See your optometrist if you’re concerned about your vision or your existing eye condition seems to have changed.

Treatment of short-sightedness

Glasses and contact lenses

Short-sightedness can usually be corrected by wearing glasses or contact lenses. The lens focuses light in the right place on your retina.

If you're mildly short-sighted, you may only need to wear glasses or contact lenses occasionally, such as when you're driving or watching TV.

Some people prefer contact lenses to glasses because they find their vision is clearer. You need to be comfortable touching your eyes to use them. You also have to be committed to looking after the lenses properly, particularly keeping them clean. Not cleaning lenses properly increases your risk of an eye infection.

There are several types of lenses, which fall into two main groups:

  • hard lenses, also called rigid gas permeable (RGP) lenses
  • soft lenses

Depending on the type, soft lenses can be used for a day, a fortnight or a month. Then you throw them away. If you use the longer-lasting ones, you have to look after them and keep them clean with special lens fluids, as you do with hard lenses.

Because they can be fiddly to put in and take out, contact lenses are not usually recommended for children. For the same reason, glasses may also be more suitable than contact lenses for older people. Your optometrist can tell you which options are available for you.

Wearing special lenses at night

There is a newer type of treatment for short sight, called orthokeratology, or corneal reshaping lenses. You wear a special type of hard contact lens overnight and then take them out during the day. The lenses are designed to reshape your cornea temporarily, which helps light to focus on the right place on your retina. They can reduce or correct your short-sightedness for the day. With these lenses, you have a higher risk of infection than with regular lenses, so you have to be very careful about cleaning them properly.

Surgery

Laser eye surgery

Laser refractive surgery (also called laser refractive surgery) can alter the shape of your cornea using a laser, so that light rays focus on your retina. To treat short-sightedness the surgeon flattens the centre of your cornea, by removing more tissue from the centre than from the edge.

All laser eye surgery is done using local anaesthetic eye drops, so you will be awake during the procedure. It generally takes about half an hour to treat both eyes.

Children and teenagers can’t have laser eye surgery because short sight has to be stable for at least a year before you have it done. Short-sightedness generally continues to develop until around the age of 20.

Laser eye surgery works very well for most people. Many people no longer need to wear glasses afterwards, although you may need to in particular situations, such as driving at night. But there is a chance you may not have the improvement in your eyesight that you expected. About one in 10 people need a second laser eye surgery operation.

Laser eye surgery isn’t available on the NHS so is only available privately. It isn't suitable for everyone and you will need to talk to an ophthalmic surgeon to find out if it's right for you. If you choose to have laser eye surgery to correct short sight, do ask your eye surgeon to go through the pros and cons of each type of treatment, as they apply to your particular situation. It may be helpful to write down a list of questions or enquiries to take with you to your first appointment. For more information, see our page explaining laser eye surgery in more detail.

Lens implants

It is possible to have an artificial lens implanted in your eye to correct your sight. You can either have your own lens taken out and a replacement put in. Or you can have a lens put in front of your own lens. This is sometimes called a ‘Phakic’ lens implant or implantable contact lens (ICL). If you’re severely short-sighted, some types of laser eye surgery (such as photorefractive keratectomy PRK) may not be suitable for you. A lens implant may be a better option for you to try.

There are some risks and complications associated with lens implants. There is a risk that you might not see as well as you did with glasses or that your night vision is poorer. If this is the case, you may need laser surgery after your lens implant. There is also a risk of developing an eye condition called glaucoma. Your ophthalmic surgeon will usually only suggest it if you’re very short-sighted or unable to wear glasses or contact lenses, for example, if you have a disability.

Frequently asked questions

  • Many people in the UK are entitled to a free eye examination on the NHS. But if you don’t come under 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 are in full-time education
    • have diabetes or glaucoma
    • have been told by an eye specialist that you are at risk of glaucoma, or 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

    Eye tests are also free for everyone in Scotland.

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

    For those who have to pay, the price varies but is usually around £20 to £40. There are sometimes special offers so it’s worth shopping around. Check before you book though – 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.

    If you wear daily disposable lenses, you don’t have to worry about disinfecting them, but you should wash your hands thoroughly before putting them in or taking them out.

    If you wear reusable lenses, you can help reduce your risk of getting an eye infection by:

    • always washing your hands before you touch your lenses
    • disinfecting your lenses every time you take them out – this usually means soaking them in a special solution overnight
    • never reusing the disinfecting solution
    • rinsing your storage case and leaving it open to dry every day
    • cleaning your storage case once a week using a clean toothbrush and contact lens solution
    • using a new storage case every month

    Whichever type of lenses you wear, see your optometrist or GP immediately if you have red or sore eyes and you think you might have an infection. You should never:

    • go to bed with a painful red eye – see a doctor as soon as possible
    • wear your lenses overnight (unless they are lenses designed to correct short sight each night)
    • let tap water or saliva come into contact with your lenses
    • wear your lenses for swimming – there are prescription swimming goggles you can buy

    It's important to have regular check-ups with your optometrist to make sure that your eyes are healthy and that you're using the best lenses for your needs.


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  • Reviewed by Graham Pembrey, Lead Editor, Bupa Health Content Team, March 2018
    Expert reviewer Professor Simon Taylor, Consultant Ophthalmic Surgeon
    Next review due, March 2021



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