Short answer: myopia, or nearsightedness, is thought to come from a mix of inherited traits and everyday habits, mainly long stretches of close-up work and too little time outdoors, and its exact cause is still not fully understood.
What does it mean to have nearsightedness?
Myopia is the medical name for nearsightedness. You can see near objects clearly but have trouble with distant ones, like road signs that only come into focus when you are a few feet away, according to Cleveland Clinic’s myopia overview. Common signs include blurred distance vision, headaches, eye strain, squinting, and tiredness when driving. The overview (last updated October 2023) cites one estimate that more than 40% of people in the U.S. are nearsighted, and says the number is rising, especially among school-aged children.
Bilateral simply means both eyes. If you or your child are nearsighted in both eyes, ask your eye doctor for a reading for each eye.
What causes myopia?
Cleveland Clinic says eye experts are still unsure of the exact cause and believe it is a mix of hereditary and environmental factors. Its listed risk factors are a family history of myopia, lots of close-up work such as reading or screens, not spending much time outdoors, and ethnicity, since some groups have higher rates. In myopia, light focuses in front of the retina instead of on it.
Time outdoors gets the most attention. A 2021 review, IMI Prevention of Myopia and Its Progression, calls encouraging schoolchildren to spend more time outdoors an important strategy and the safest one compared with other measures. A 2023 review of inflammation and myopia explores how inflammation may contribute to the eye growing too long, one of several lines of research into the mechanism.
How is myopia diagnosed?
An eye care provider diagnoses myopia with a standard eye exam. According to Cleveland Clinic, the exam tests visual acuity with an eye chart, uses a lighted retinoscope to measure how the retina reflects light, and often uses a phoropter, an instrument that places a series of lenses in front of your eyes to find the lens strength you need.
For children, Cleveland Clinic describes the following schedule:
- A first eye exam before age 1, if possible, and a repeat before kindergarten.
- Vision screenings at ages 3 to 5 using eye charts, pictures, letters or the tumbling E game.
- Screenings before first grade and every two years after that.
Most children are diagnosed between ages 3 and 12. If your child squints a lot or holds things close to their face, book an eye exam.
Does myopia ever go away?
No. Cleveland Clinic says myopia is a condition that doesn’t go away, and that glasses, contact lenses or surgery correct it. It usually appears in childhood, can worsen in early childhood, and tends to level off by the end of the teen years.
What causes myopia to worsen in children and adults?
In children, the main driver is growth. Cleveland Clinic says myopia can get worse during the growth spurts of the pre-teen and teen years and usually levels off around age 20. A 2023 Cochrane review of myopia control in children notes that myopia is usually detected before age 10 and can progress rapidly.
In adults, Cleveland Clinic says a diagnosis can come later in life, usually because of visual stress or a disease such as diabetes or cataracts. Visual stress comes from long periods of up-close work, which can leave the focusing muscles stuck in what the clinic calls ‘near gear.’
Some changes need a prompt call to an eye doctor. If you notice sudden nearsightedness, new floaters or flashes of light, shadows, or sudden vision loss in one eye, contact an eye care provider right away to rule out a more serious condition. Cleveland Clinic notes that some conditions, like retinal detachment, are medical emergencies.
Does myopia get worse without glasses?
Going without glasses will not make distance vision clearer. Harvard Health’s article on eye exercises says that in none of these cases have glasses or contacts weakened the eyes, and that the stronger prescriptions people need over time reflect how nearsightedness progresses early in life. Wearing lenses weaker than you need is not a fix either. The 2023 Cochrane review found little or no evidence that undercorrected single-vision glasses slowed progression in children.
Can myopia be fixed or cured?
There is no cure for myopia, according to Cleveland Clinic. Two separate goals matter: correcting the blur so you can see clearly, and, in children, slowing how fast myopia progresses. The options below serve one goal or the other, and some serve both.
Your options side by side
Each option below has research or a clinical source behind it, along with who it suits and its limits. Averages from trials describe groups of children, not what any one child will see.
| Option | What the research or source says | Who it suits | Limits and side effects |
|---|---|---|---|
| Standard glasses or contact lenses | Cleveland Clinic calls glasses the most popular way to correct myopia. Some people find contacts give sharper, wider distance vision. | Children and adults | Correct blur. Contacts need more care to keep clean. |
| Multifocal glasses | In the 2023 Cochrane review, about 0.14 diopters less change at one year and 0.19 at two years than controls, with the eyeball growing about 0.06 mm less at one year. | Children in the trials | Smallest average effects among the options that reduced progression at one year in that review. |
| Multifocal soft contact lenses | About 0.26 diopters less change at one year and 0.30 at two years; eyeball growth about 0.11 mm less at one year and 0.15 mm less at two years. | Children in the trials | Requires contact lens care, which Cleveland Clinic notes takes more attention. |
| Orthokeratology (overnight lenses) | Cleveland Clinic describes lenses worn to bed to reshape the cornea temporarily. Eye growth was about 0.19 mm less at one year and 0.28 mm less at two years in the Cochrane review. | Some people with mild myopia, per Cleveland Clinic | Worn overnight. Ask your eye doctor about the care routine. |
| Low-dose atropine eye drops (several strengths were tested) | About 0.38 diopters less change at one year and 0.24 at two years in the low-dose groups, with eye growth about 0.13 mm and 0.16 mm less. Higher strengths showed larger average effects. | Children; the 2021 review says the risk-to-benefit balance depends on age, health and lifestyle | Side effects listed in the 2021 review: a slightly reduced focusing range, slight pupil enlargement, and risk of an allergic reaction. The Cochrane review found adverse events were not consistently reported in trials. Talk with your eye doctor before starting or stopping any drops. |
| Eye exercises or vision therapy | Harvard Health says self-directed exercise programs have not been tested in randomized trials, though practiced faithfully, exercises may help delay the need for glasses in some people. WebMD reports a 2013 American Academy of Ophthalmology report saying natural vision correction does not help nearsightedness. | Vision therapy is for cases where focusing muscle spasms cause myopia, per Cleveland Clinic | Exercises will not eliminate nearsightedness, according to Harvard Health. Vision therapy is not appropriate for everyone. |
| LASIK, LASEK or PRK surgery | Cleveland Clinic calls LASIK the most common surgery for nearsightedness. PRK is used for mild or moderate nearsightedness and can suit people with thinner corneas. | Adults; Cleveland Clinic notes rare exceptions for children | A LASIK clinic’s blog lists infection, healing problems and vision loss as risks. A full exam comes first. This page has no independent figures on how often these happen, so ask the surgeon for the risks specific to your eyes and for a written quote. |
| Phakic intraocular lenses | Cleveland Clinic says these are placed inside the eye, just in front of the natural lens. | People with high myopia, or corneas too thin for LASIK or PRK | This is surgery. Discuss it with an eye surgeon. |
| More time outdoors | The 2021 IMI review calls encouraging schoolchildren to spend more time outdoors the safest strategy, aligned with healthy-lifestyle goals such as obesity prevention. | Children and teens | Aimed at reducing how often myopia develops. It does not correct existing myopia. |
Costs depend on the clinic, the lenses, drops or surgery you choose, and the follow-up included. Prices change, so check current prices directly with your eye doctor and ask for a written quote that lists the exam, the lenses or drops, and follow-up visits. Check your plan for what it covers.
No single option is right for everyone. The trial results come from children, surgery is listed for adults, and the right choice depends on your age, your eyes and your daily life. An eye doctor can measure your eyes and walk you through the trade-offs.
Is myopia a visual disability?
Myopia on its own is usually corrected with glasses, contacts or surgery. A LASIK clinic’s blog says it is not considered a disability for that reason, but it can progress to conditions such as cataracts, glaucoma or macular degeneration, which may limit driving, work or hobbies. Whether a condition counts as a disability depends on the program or law asking, and each sets its own definition. If you are applying for a benefit, ask that agency what documentation it requires. The clinic’s blog notes that benefit claims usually start with documentation from an eye exam.
What is high myopia?
Cleveland Clinic divides myopia into simple myopia and pathologic myopia. Simple myopia is usually managed well with glasses or contacts. Pathologic myopia, which Cleveland Clinic notes is a newer name for degenerative myopia, can leave vision that does not clear even with correction. A 2016 review, Pathologic Myopia, says it is the only type of myopia that causes loss of best-corrected visual acuity, mainly through complications such as myopic maculopathy and optic neuropathy. Cleveland Clinic says high myopia happens when the eyeball is too long or the cornea too steep, and lists cataracts, glaucoma, optic neuropathy, unwanted blood vessels in the eye, and retinal detachment as possible complications.
The 2021 IMI review calls progression to high myopia the main modifiable risk factor for pathologic myopia. High myopia usually stops getting worse between ages 20 and 30, according to Cleveland Clinic, and regular eye exams matter most for people with high or pathologic myopia. Ask your eye doctor what your number means for your risk.
What causes farsightedness?
Farsightedness is a different refractive error. Harvard Health’s eye exercise article lists it alongside nearsightedness, astigmatism and presbyopia. For what causes it, read the National Eye Institute’s refractive errors page or ask your eye doctor.
Autism, IQ and other questions this page does not cover
This page does not cover links between myopia and autism, IQ, or tunneling in autism. For those questions, ask your pediatrician or eye doctor what the research shows, and bring the specific claim you read.
What to ask your eye doctor
- What is my prescription for each eye, and has it changed since my last exam?
- Is my child’s myopia progressing, and how often should we check it?
- Which options fit my age and eyes, and what are their side effects?
- Can you give me a written quote covering the exam, lenses or drops, and follow-up?
- Which symptoms mean I should come in right away?
Eye questions and whole-body questions often get mixed up in searches. If the fog you notice is in your thinking rather than your eyesight, our brain fog after 40 guide covers that separately. If a supplement is part of what you are weighing for your health, our page on does melatonin cause cancer explains how to read side-effect research.
By HealthDataConsortium.org Research Team
This article is for general information purposes only and does not constitute medical advice. Consult your doctor or qualified healthcare provider before making changes to your health routine.
