Myopia Progression in Adults: Causes and Solutions

Q: Myopia Progression in Adults: Causes and Solutions

Hello： Regarding your recent eye condition, I would like to offer some suggestions. <br><br>1. <br>The situation you mentioned, where "vision tends to stabilize and not increase significantly after adulthood," generally holds true. <br>However, in cases like yours, where there is

Concerns about the increase in myopia levels among adults who use their eyes intensively?

Hello Dr.
Gao,
Due to my academic work, I have developed a routine of high-intensity eye use—approximately 6 hours of close reading of academic journals and about 3 hours of computer work daily.
Additionally, I have poor eyesight (over -500 diopters in both eyes at the time of my university graduation), so I pay special attention to my eye health.
During a recent routine check-up, the optometrist mentioned that even at the age of 30, my myopia seems to be continuing to increase: -50 diopters in the left eye and -100 diopters in the right eye (with the left eye being the primary one).
Since my last prescription was 5 years ago, this averages to an increase of about 10 diopters per year in the left eye and 20 diopters per year in the right eye.
Although the subsequent fundus examination did not reveal any retinal or macular degeneration, if this trend continues, I may be approaching high myopia (over -1000 diopters).

I would like to ask you, Dr.
Gao:
1.
I have heard that "vision usually stabilizes in adulthood and is less likely to worsen," so why does my myopia continue to increase? Is this phenomenon related to my initially high degree of myopia and my extensive near work?
2.
Due to my work commitments, I may not be able to follow the ophthalmologist's advice to take a 10-minute break every 30 minutes of screen time.
Would it be feasible to take a 5-minute break after every 45 minutes of eye use? Additionally, when looking into the distance, should I do so without my glasses or can I wear them?
3.
The optometrist mentioned a type of lens that can help control myopia in adults, but it requires special ordering and is quite expensive, and we did not discuss it further.
However, I found that these lenses seem to be primarily used for children or school-aged children to control myopia, with less application in adults.
I would like to know if, as an adult with high myopia, I could also achieve myopia control through the use of these specialized lenses?
I apologize for the many questions and appreciate your guidance! Thank you!

Min Yong, 30~39 year old female. Ask Date: 2024/01/09

Dr. Gao Pilin reply Ophthalmology

Hello: Regarding your recent eye condition, I would like to offer some suggestions.

1.
The situation you mentioned, where "vision tends to stabilize and not increase significantly after adulthood," generally holds true.
However, in cases like yours, where there is high visual demand and already significant myopia, the continued increase in myopia may be related to your genetic predisposition, prolonged intense near work, and hereditary factors.
After adulthood, the growth rate of the eyeball slows down, but extended periods of near work can still affect the eye's accommodation and growth, leading to a continued increase in myopia.
2.
Considering the nature of your work, I understand that taking a 10-minute break every 30 minutes may not be feasible.
Nevertheless, taking a 5-minute break every 45 minutes is an improvement, but it is still best to pay more attention to resting your eyes.
Additionally, when gazing into the distance, there is no need to remove your glasses; you can keep them on.
However, it is beneficial to pause your work periodically and focus on distant objects to help relax your eyes.
3.
Regarding the control of myopia progression, there are special lenses known as orthokeratology lenses that can help manage the increase in myopia to some extent.
Although these lenses are typically used for children or adolescents, they can also have a certain degree of effectiveness in adults.
Alternatively, you might consider getting a pair of reading glasses, which is a more cost-effective and efficient method.

Reply Date: 2024/01/09

More Info

Myopia, or nearsightedness, is a common refractive error that can progress over time, even into adulthood. Your situation, where you have a significant degree of myopia and are experiencing an increase in your prescription, is not uncommon, especially given your high visual demands due to academic work. Let's address your questions one by one.

1. Continued Myopia Progression in Adulthood: While it is often said that myopia stabilizes in adulthood, this is not universally true. Factors such as the initial severity of myopia, genetic predisposition, and environmental influences can all contribute to continued progression. In your case, having a baseline of over 500 degrees of myopia and engaging in high-intensity near work likely plays a significant role in your ongoing increase in myopia. Studies have shown that prolonged near work can lead to changes in the eye's shape, contributing to worsening myopia.
2. Resting Your Eyes: The recommendation of taking breaks every 30 minutes is based on the idea of reducing eye strain and allowing your eyes to relax. If your work schedule does not permit this, taking a break every 45 minutes is certainly better than not taking breaks at all. During these breaks, it is beneficial to look at something far away, ideally at least 20 feet away, for about 20 seconds. This practice, often referred to as the "20-20-20 rule," helps reduce eye strain. You can do this while wearing your glasses; the key is to focus on a distant object, which allows the eye muscles to relax.

3. Myopia Control Lenses: There are specialized lenses designed to slow the progression of myopia, primarily used in children and adolescents. These include orthokeratology lenses, multifocal lenses, and certain types of soft contact lenses. While the primary focus of these lenses is on younger populations, some studies suggest that they may also provide benefits for adults, particularly those with high myopia. However, the effectiveness can vary, and it is essential to consult with an eye care professional who specializes in myopia management to discuss your specific situation and whether these lenses could be appropriate for you.

In addition to these points, it's crucial to maintain regular eye examinations to monitor your vision and eye health, especially given your history of high myopia. Your eye care provider can offer personalized advice and treatment options based on your specific needs and lifestyle.

Lastly, consider incorporating lifestyle changes to reduce eye strain, such as ensuring proper lighting while reading or working, using larger text sizes on screens, and maintaining an appropriate distance from your reading material. These adjustments can help mitigate the progression of myopia and improve your overall visual comfort.

In summary, while myopia can stabilize in adulthood for some, factors like high initial myopia and extensive near work can lead to continued progression. Implementing regular breaks, considering specialized lenses, and maintaining good eye care practices can help manage your condition effectively. Always consult with your eye care professional for tailored advice and treatment options.

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