Sudden Myopia Changes: Eyeglasses vs. Contact Lenses - Ophthalmology

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Sudden changes in myopia, especially in young individuals, can be concerning and often lead to questions about the underlying causes and the differences in vision correction between eyeglasses and contact lenses. In your case, you have experienced a noticeable increase in myopia and astigmatism, with a significant difference in visual acuity between your eyeglasses and contact lenses. Let's delve into these issues.


Understanding Myopia Changes
Myopia, or nearsightedness, is a common refractive error where distant objects appear blurry while close objects can be seen clearly. The condition is often progressive, particularly in children and adolescents, as their eyes continue to grow. The increase in myopia can be attributed to several factors:
1. Genetics: A family history of myopia can predispose individuals to develop the condition.

2. Environmental Factors: Increased screen time, lack of outdoor activities, and prolonged near work (like reading or studying) can contribute to the progression of myopia.

3. Eye Growth: As you mentioned, your eye doctor noted that your axial length is increasing, which is a common indicator of myopia progression. The elongation of the eyeball can lead to increased myopia.


Differences Between Eyeglasses and Contact Lenses
The disparity in visual acuity between your eyeglasses and contact lenses can be attributed to several factors:
1. Fitting and Position: Contact lenses sit directly on the cornea, providing a different optical experience compared to eyeglasses, which are positioned further away from the eye. This can affect how light is focused on the retina.

2. Lens Design: Contact lenses, especially those designed for myopia control, may have specific designs that help reduce the progression of myopia. Eyeglasses, on the other hand, may not provide the same level of correction or may not be as effective in managing peripheral vision.

3. Adaptation: Some individuals adapt better to contact lenses than eyeglasses, leading to a subjective feeling of better vision with contacts.


Is the Increase in Myopia Normal for Adolescents?
In adolescents, a certain degree of myopia progression is expected, particularly during growth spurts. However, the rate of increase can vary widely among individuals. A change of 0.5 diopters or more within a year is not uncommon, but significant increases should be monitored closely. Regular eye exams are crucial to track changes and adjust prescriptions as necessary.


Recommendations for Management
1. Regular Eye Exams: Continue your routine eye check-ups. If you notice rapid changes, discuss these with your eye care provider. They may recommend more frequent visits or additional tests.

2. Myopia Control Options: Discuss with your eye doctor about options for myopia control, such as orthokeratology (overnight contact lenses that reshape the cornea) or multifocal contact lenses.

3. Lifestyle Modifications: Encourage outdoor activities and reduce screen time. The American Academy of Ophthalmology suggests spending at least two hours outdoors daily to help slow the progression of myopia.

4. Proper Use of Lenses: Ensure that you are using your contact lenses as prescribed, including hygiene practices to avoid complications.

In conclusion, while some increase in myopia can be normal during adolescence, significant changes warrant close monitoring and possibly intervention. The differences in visual acuity between eyeglasses and contact lenses can be explained by their optical properties and fitting. Regular consultations with your eye care professional will help manage your vision effectively and address any concerns you may have.