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Squinting? Headaches? How to spot and treat high myopia nearsightedness

Maybe you’ve seen your kids squinting or holding a book or device close to their face. Perhaps they sit in the front of the class at school to see better or frequently complain about headaches, eye strain, or blurry vision.

Chances are your child is among over 40% of the U.S. population with myopia, or nearsightedness. If their vision problems are moderate to severe, they might have high myopia.

Myopia is measured by the power of a lens needed to correct a patient’s vision using a unit called a diopter. Mild myopia is 0 to -1.5 diopters. When it progresses to -6 diopters or more, it’s classified as high myopia, which affects about 4% of Americans.

High myopia increases the risk of serious eye conditions later in life such as cataracts, glaucoma, and retinal detachment – and it is on the rise.

UT Southwestern's cornea specialists are experts in neurotization surgery.

Nearsightedness is a result of genetics and spending more time looking at screens, but most parents don’t need to worry about more severe vision complications.

Cases of high myopia in 2000 were estimated to be 2.7% of the world’s population, and research suggests that it will affect almost 10% of the world’s population by 2050. The spike is due in part to increased close work with the eyes, such as more screen time, heavy reading, and limited outdoor play. Over time, excessive close work makes the eyes overly accustomed to focusing on nearby objects and less able to focus far away.

While having high myopia does increase the risk of eye conditions and vision loss, getting proper treatment from a pediatric ophthalmologist allows most young patients to achieve and maintain normal vision.

What causes high myopia?

Nearsightedness happens when the eyeball is too long and egg-shaped or because the cornea – the clear front cover of the eye – is too curved. The result is that light entering the eye doesn’t focus as it should and far away objects appear blurred.

High myopia is often genetic but can develop or get worse with excessive close work. While complications with high myopia are rare, having it does increase your child’s risk of developing eye conditions such as:

  • Glaucoma, which increases pressure within the eye and can cause vision loss. High myopia can increase the risk of glaucoma by 50%.
  • Cataracts, which appear as cloudiness in the eye and block vision. People with high myopia are 17% more likely to need cataract surgery compared with less myopic peers.
  • Myopic macular degeneration, a common condition that involves tears in the retina and bleeding beneath it. People with high myopia have a sharply increased risk as they age.
  • Retinal detachment is when the retina pulls out of position, potentially causing vision loss. Having high myopia increases the risk by fivefold or more.

Related reading: Cataracts in children: Prevent vision loss with early detection and treatment

What are the treatments for high myopia?

The earlier nearsightedness is diagnosed, the better the chances are of stopping it before it gets worse. Ideally, high myopia will be diagnosed before age 12 since children’s eyes are usually done developing by age 15.

UT Southwestern's cornea specialists are experts in neurotization surgery.

Signs of high myopia

Your child may sit closer to the computer or TV or hold devices or books closer to their face to read. Other signs of nearsightedness:
- Blurred vision
- Eye strain
- Difficulty seeing at a distance
- Headaches
- Squinting
- Trouble seeing at night

If your child has high myopia, the ophthalmologist will carefully examine your child’s eyes by dilating their pupils every six months instead of every 12 months to watch for changes in the eye.

There is no surgery to correct high myopia. Some patients may also need a low dose of atropine in the form of nightly eye drops that have been shown in clinical trials to safely reduce the progression of myopia. Research has shown that multifocal contact lenses can also slow progression of myopia in children as young as age 7.

Limiting close work can help stop nearsightedness from progressing. Screens and books are part of daily life, but you can protect your eyes by following the 20-20-20 rule: After every 20 minutes of close work, take a 20-second break to relax your eyes and look at something at least 20 feet away. Playing outdoors or even gazing out the window is a great way to give the eyes a break.

Related reading: What to do if your child fails their school vision screening

Most kids with high myopia will not develop complications if they get proper, ongoing eye care. But if your child has a sudden increase in floaters, shadows, or a dark curtain in their vision, talk with their doctor right way. This could be a sign of retinal detachment that could lead to permanent vision loss.

To make an appointment for expert eye care, call 214-456-7947 or request an appointment online.