Myopia Progression: Does Eye Axis Length Stabilize After 20? - Ophthalmology

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Myopia, or nearsightedness, is a common refractive error that occurs when the eye is too long relative to its focusing power, resulting in distant objects appearing blurry. One of the key factors contributing to myopia is the elongation of the eye's axial length. Understanding the progression of myopia, particularly after the age of 20, is crucial for managing eye health.

Generally, it is believed that the axial length of the eye stabilizes after the age of 20. By this age, most individuals have completed the majority of their eye growth, and significant changes in axial length are less common. However, this does not mean that myopia cannot progress in adults. There are several factors that can contribute to continued elongation of the eye and worsening myopia even after reaching adulthood.

1. Genetic Factors: If there is a family history of high myopia, individuals may be at a higher risk for continued progression. Genetic predisposition plays a significant role in determining the likelihood of developing myopia and its severity.

2. Environmental Factors: Prolonged near work, such as extensive reading, computer use, or other activities that require close vision, can contribute to myopia progression. The modern lifestyle, which often involves significant screen time, can exacerbate this issue.

3. Health Conditions: Certain health conditions, such as diabetes, can lead to changes in vision and may contribute to myopia progression. Additionally, conditions affecting the eye, such as cataracts or retinal issues, can also influence axial length.

4. Eye Strain and Fatigue: Chronic eye strain, often resulting from excessive near work without adequate breaks, can lead to temporary increases in myopia. This is sometimes referred to as "pseudomyopia," where the eye's focusing mechanism is strained, leading to a temporary increase in myopia that may resolve with proper rest and eye care.

5. Lack of Outdoor Activity: Studies have shown that spending more time outdoors can help reduce the risk of myopia progression. Natural light exposure and the opportunity to focus on distant objects are believed to play a protective role against the development of myopia.

Regarding your question about whether myopia can develop at the age of 28, the answer is yes. While many individuals may experience stabilization of their myopia by this age, it is still possible for some to develop new myopia or experience worsening of existing myopia due to the factors mentioned above.

In summary, while the axial length of the eye typically stabilizes after the age of 20, various factors can contribute to continued myopia progression in adulthood. It is essential for individuals, especially those with a history of myopia, to have regular eye examinations and to adopt healthy visual habits, such as taking breaks during prolonged near work and spending time outdoors. If you notice any changes in your vision or have concerns about myopia progression, it is advisable to consult with an eye care professional for personalized advice and management strategies.