Addressing Severe Myopia and Astigmatism: Seeking Non-Surgical Solutions

A bunch of questions?

Hello Doctor: I have been nearsighted for a long time.
A few years ago, I got my glasses from a professional optical store, but they did not include astigmatism correction due to comfort considerations.
My astigmatism is quite severe, and my nearsightedness is also significant, around 600 to 700 degrees.
I’m not sure about the astigmatism degree (I forgot).
My glasses only have plastic lenses and are thin; they do not have photochromic or blue light blocking features! Every time I watch TV or look at something with small text on the screen, I can’t see clearly and have to adjust my glasses higher to see a little better! Clearly, my prescription has worsened! Additionally, the lenses have scratches from my previous work.
Before smartphones, my vision was corrected to around 0.8 to 0.9, but after getting a smartphone, my vision declined to about 0.6 to 0.7, and during vision tests, I still couldn’t see clearly, so 0.6 to 0.7 is likely a struggle.

Today, I was thinking that in the past, when I had nearsightedness or eye allergies, the ophthalmologist would give me dilating drops or antihistamine eye drops, but I found it bothersome to use them after a few times! I do not want to undergo refractive surgery because I fear the possibility of failure and blindness.
Moreover, there is a chance of becoming nearsighted again after the surgery! Living in a world flooded with information, everyone’s eyesight seems to be gradually deteriorating, and there are no effective remedies.
I am wondering if there are any medications that could improve my nearsightedness! If I could take something to restore my vision a bit, that would avoid surgery.
In the future, I hope that any eye problems can be resolved with medication, even if it’s not perfect, at least achieving a score of 60.
In this modern technological age, it’s not impossible for that to happen one day.
Perhaps I am being too fanciful.
Lutein or vitamin A are considered dietary supplements, and their effects are unclear or ineffective.
What should I do? Thank you for your response.

A-Yao, 30~39 year old female. Ask Date: 2019/11/16

Dr. Cai Wenyuan reply Ophthalmology

Hello, please reduce the use of electronic devices and allow your eyes to rest more.
Wishing you peace and health.
Sincerely, Dr.
Tsai Wen-Yuan, Director of the Ophthalmology Department, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2019/11/16

More Info

Addressing severe myopia and astigmatism can be quite challenging, especially when considering non-surgical solutions. Your concerns about the progression of your vision issues, particularly with severe myopia (around 600-700 degrees) and significant astigmatism, are valid. Many individuals in today's digital age experience similar problems due to increased screen time and reduced outdoor activities, which can exacerbate refractive errors.

Understanding Myopia and Astigmatism
Myopia, or nearsightedness, occurs when the eyeball is too long or the cornea is too steep, causing distant objects to appear blurry. Astigmatism arises from an irregular curvature of the cornea or lens, leading to distorted or blurred vision at all distances. Both conditions can significantly impact daily activities, especially those requiring clear vision, such as reading or using digital devices.

Non-Surgical Solutions
1. Corrective Lenses: The most common non-surgical solution for myopia and astigmatism is the use of corrective lenses. It seems that your current glasses may not adequately address your astigmatism, which could be contributing to your visual discomfort. I recommend visiting an eye care professional for a comprehensive eye exam to determine your exact prescription, including the degree of astigmatism. A properly fitted pair of glasses with the correct prescription can significantly improve your visual clarity.

2. Contact Lenses: If glasses are uncomfortable or inadequate, contact lenses may be a viable alternative. There are specialized contact lenses designed for astigmatism, known as toric lenses, which can provide clearer vision without the obstruction of frames.

3. Orthokeratology (Ortho-K): This is a non-surgical method that involves wearing specially designed rigid gas-permeable contact lenses overnight to reshape the cornea temporarily. This can reduce myopia during the day without the need for glasses or contacts.

4. Vision Therapy: Some eye care professionals offer vision therapy, which includes exercises and activities designed to improve visual skills and processing. While this may not directly reduce myopia or astigmatism, it can help improve overall visual function and comfort.

5. Pharmacological Approaches: Research is ongoing into the use of medications to slow the progression of myopia, particularly in children. Atropine eye drops, for instance, have shown promise in studies for controlling myopia progression. However, their effectiveness in adults is still under investigation, and they may not directly improve existing refractive errors.

6. Lifestyle Modifications: Increasing outdoor activities and reducing screen time can help mitigate the progression of myopia. Engaging in activities that require distance vision can be beneficial. Additionally, practicing the 20-20-20 rule—taking a 20-second break to look at something 20 feet away every 20 minutes of screen time—can help reduce eye strain.

Future Considerations
While you express concerns about surgical options, it's essential to note that modern refractive surgeries, such as LASIK or PRK, have high success rates and low complication rates. However, they are not suitable for everyone, and a thorough evaluation by an ophthalmologist is necessary to determine candidacy.

As for the potential of future pharmacological solutions, advancements in eye care are continually being made. While current options may seem limited, ongoing research may yield new treatments that could address refractive errors more effectively.

Conclusion
In summary, while there are no guaranteed medications to reverse severe myopia and astigmatism, various non-surgical options can help manage your condition and improve your quality of life. A comprehensive eye examination is crucial to determine the best course of action tailored to your specific needs. Engaging with an eye care professional who understands your concerns and can provide personalized recommendations will be invaluable in your journey toward better vision.

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