Pseudomyopia: Can Over-Prescribed Glasses Cause It? - Ophthalmology

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Pseudomyopia, or "false myopia," is a condition where the eye exhibits symptoms similar to myopia (nearsightedness) but does not have the structural changes typically associated with true myopia. This condition can often be caused by excessive accommodation, which is the eye's ability to focus on near objects. When a person spends prolonged periods focusing on close tasks, such as reading or using a computer, the eye muscles can become strained, leading to temporary blurriness for distant objects.
Regarding your question about whether over-prescribed glasses can cause pseudomyopia, the answer is nuanced. While wearing glasses with a prescription that is too strong may not directly cause pseudomyopia, it can contribute to eye strain and discomfort. When the prescription is stronger than necessary, the eyes may work harder to focus, leading to fatigue and potentially exacerbating the symptoms of pseudomyopia. However, it is important to note that pseudomyopia is typically a reversible condition, and the primary concern is managing the symptoms and reducing eye strain.

The use of short-acting cycloplegic agents (such as tropicamide) during a dilated fundus exam can help relax the ciliary muscle, allowing for a more accurate assessment of the refractive error. In cases of pseudomyopia, this temporary paralysis of the muscle can provide a clearer picture of the true refractive state of the eye. If the symptoms of pseudomyopia are present, a single application of a short-acting cycloplegic agent may help in determining whether the condition is indeed reversible.
If pseudomyopia persists for an extended period, such as over a year without treatment, there is a risk that it could lead to true myopia. This is particularly concerning in individuals who are already predisposed to myopia, such as those with a family history of the condition or those who engage in extensive near-vision tasks. The prolonged strain on the eye may contribute to structural changes in the eye, such as elongation of the eyeball, which is characteristic of true myopia.

To manage and potentially reverse pseudomyopia, several strategies can be employed:
1. Regular Eye Exams: Regular visits to an eye care professional can help monitor changes in vision and ensure that prescriptions are appropriate.

2. Proper Prescription: Ensuring that your glasses are accurately prescribed is crucial. If you feel that your current prescription is too strong, it is important to discuss this with your eye care provider.

3. Breaks from Near Work: Implementing the 20-20-20 rule can be beneficial. This means taking a 20-second break to look at something 20 feet away every 20 minutes of near work.

4. Adequate Lighting: Ensuring that you have proper lighting when reading or working on close tasks can reduce eye strain.

5. Eye Exercises: Some people find relief through eye exercises that help strengthen the eye muscles and improve flexibility.

6. Cycloplegic Drops: As mentioned, using cycloplegic drops under the guidance of an eye care professional can help assess the true refractive state of the eye and may provide temporary relief from symptoms.

In conclusion, while over-prescribed glasses may not directly cause pseudomyopia, they can contribute to eye strain and discomfort. Pseudomyopia is generally reversible, especially with appropriate management and care. If you have concerns about your vision or the effects of your glasses, it is essential to consult with an eye care professional who can provide personalized advice and treatment options.