Consequences of Long-Term Myopia Without Glasses: What You Need to Know

What are the consequences of long-term myopia without wearing glasses?

Hello Dr.
Tsai: I have been nearsighted since I was 10 years old, and my current prescription is -2.50 in the left eye and -2.75 in the right eye, with astigmatism of -0.50 in both.
I only wear glasses for non-essential activities like watching TV, attending classes, or reading bus stop signs; I do not wear them at work either.
I have become accustomed to living with my nearsightedness without glasses, and it does not significantly affect my daily life.

I have read various opinions online, and the responses are quite polarized.
Some people believe that nearsighted individuals must wear glasses to prevent their prescription from worsening, while others, like myself, feel that their degree of myopia is not severe.
Although my prescription has increased from -1.20/-1.25 with -0.50 astigmatism to -2.50/-2.75 with -0.50 astigmatism, I do not have issues with strabismus.

I previously went seven months without using any digital devices (TV, smartphone, computer), but now I use them almost daily, even in the dark, and I have become accustomed to it.
In non-essential situations, I no longer squint.
Should I continue to wear glasses to prevent my prescription from worsening? I have seen some refer to my approach as "fogging therapy," but I am still unsure about the potential severity of this practice for my eyes.

Han, 10~19 year old female. Ask Date: 2017/03/02

Dr. Cai Wenyuan reply Ophthalmology

Hello, if your prescription is too strong, it is advisable to continue wearing glasses.
The key to eye health is simple: take adequate breaks and minimize the use of electronic devices.
Wishing you safety and health.
Sincerely, Dr.
Tsai Wen-Yuan, Director of the Department of Ophthalmology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2017/03/02

More Info

Long-term myopia, especially when left uncorrected with glasses, can lead to several significant consequences that may affect both visual acuity and overall eye health. As you have been living with myopia since the age of 10 and have developed a degree of comfort in not wearing glasses, it is essential to understand the potential risks and implications of this choice.

Consequences of Long-Term Myopia Without Glasses
1. Progression of Myopia: One of the primary concerns with untreated myopia is the potential for further progression. While your current prescription is moderate (left eye -2.50, right eye -2.75), myopia can worsen over time, especially if the eyes are subjected to prolonged near work or inadequate visual correction. Studies suggest that individuals who do not wear corrective lenses may experience a faster increase in myopia due to the eyes' continuous effort to focus on distant objects.

2. Increased Risk of Eye Conditions: High myopia is associated with an increased risk of several serious eye conditions, including:
- Retinal Detachment: The elongation of the eyeball in myopia can lead to thinning of the retina, making it more susceptible to tears and detachment.

- Glaucoma: Myopia can increase the risk of developing glaucoma, a condition that can damage the optic nerve and lead to vision loss.

- Cataracts: Individuals with high myopia may also have a higher risk of developing cataracts at an earlier age.

3. Visual Disturbances: Not wearing glasses can lead to visual disturbances, such as blurred vision, eye strain, and headaches. These symptoms can become more pronounced with prolonged activities that require visual acuity, such as reading or using digital devices.

4. Impact on Daily Activities: While you may feel comfortable navigating your daily life without glasses, there may be situations where uncorrected vision could pose risks, such as driving, especially at night or in low-light conditions. This could lead to safety concerns for yourself and others.

The Importance of Corrective Lenses
While some individuals advocate for "fogging" or "blur therapy," which involves not wearing glasses to allow the eyes to adapt, this approach is controversial and not widely supported by eye care professionals. The primary goal of corrective lenses is to provide clear vision and reduce the strain on the eyes. Wearing glasses can help maintain visual acuity and potentially slow the progression of myopia.

Recommendations
1. Regular Eye Exams: It is crucial to have regular eye examinations with an eye care professional. They can monitor your myopia progression and assess the health of your eyes, ensuring that any potential issues are addressed promptly.

2. Consider Corrective Lenses: Even if you feel comfortable without glasses, it may be beneficial to wear them during activities that require clear vision, such as driving or watching television. This can help reduce eye strain and prevent potential complications associated with uncorrected myopia.

3. Limit Screen Time: Given your history of using digital devices extensively, it is advisable to take regular breaks and practice the 20-20-20 rule: every 20 minutes, look at something 20 feet away for at least 20 seconds. This can help reduce eye fatigue.

4. Healthy Eye Habits: Engage in outdoor activities and limit prolonged near work. Studies have shown that spending time outdoors may help slow the progression of myopia in children and adolescents.

In conclusion, while you may not currently feel the need for glasses, the long-term implications of uncorrected myopia can be significant. It is essential to weigh the risks and benefits of wearing corrective lenses and to maintain regular check-ups with your eye care provider to ensure the health of your eyes and vision.

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