Myopia

Myopia, commonly known as short-sightedness or near-sightedness, is one of the most common vision conditions in the world. People with myopia can see nearby objects clearly but struggle to focus on things in the distance, such as a road sign, a classroom whiteboard, or a face across the room. It typically begins in childhood and, if left unmanaged, can progress significantly through teenage years.

Beyond the daily inconvenience of blurred distance vision, higher degrees of myopia are associated with an increased risk of serious eye conditions later in life, including retinal detachment, glaucoma and myopic macular degeneration. Understanding what myopia is, what causes it, and what can be done to slow its progression is more important than ever.

Myopia occurs when the eyeball grows slightly too long from front to back, or when the cornea (the clear front surface of the eye) is too steeply curved. In either case, light entering the eye focuses in front of the retina rather than directly on it, producing a blurry image of objects in the distance. The condition is a refractive error – a problem with how the eye bends light – rather than a disease of the eye itself.

Myopia and hyperopia are often confused. Both are refractive errors, but they work in opposite ways: myopia makes distant objects blurry while nearby ones stay clear, whereas hyperopia (long-sightedness) makes nearby objects blurry while distance vision remains clearer. Both can be corrected with glasses or contact lenses, but they require different prescriptions. Myopia lenses are concave (thinner in the middle); hyperopia lenses are convex (thicker in the middle).

Myopia disease is a term sometimes used to describe high myopia or ‘pathological myopia’ – a more severe form where the degree of short-sightedness is so great that it causes structural changes in the eye. These include stretching and thinning of the retina, which significantly increases the risk of complications such as retinal detachment, macular degeneration and glaucoma. Pathological myopia can lead to permanent vision loss if not carefully monitored.

Myopia tends to run in families, and having one or both myopic parents significantly increases a child’s risk. Environmental factors also play a major role: children who spend more time indoors on near-focused tasks – reading, screens, study – and less time outdoors are more likely to develop myopia. Research from Specsavers found that myopia diagnoses in Australian children increased from 24.6% in 2017 to 28.8% in 2022,¹ and the average age of first diagnosis fell from 14.6 years to 13.3 years over the same period. Globally, researchers project that nearly half the world’s population will be myopic by 2050.²

Myopia rates are rising rapidly, and children are at the centre of the trend. In Australia, an estimated 36% of the population is currently affected, with forecasts suggesting this will reach 55% by 2050, which is higher than the global average.³ According to a retrospective review of more than 2.6 million Specsavers patient records, the rate of myopia diagnoses in Australian children under 18 increased from 24.6% in 2017 to 28.8% in 2022, while the average age of first diagnosis fell from 14.6 years to 13.3 years over the same period.¹ This downward shift in age of onset is particularly concerning: the earlier myopia develops, the more likely it is to progress to high myopia in adulthood.

The drivers of this rise are largely environmental. Children today spend more time indoors on screens and less time in natural light, which are both established risk factors for myopia. Reduced outdoor time removes the protective effect that sunlight and viewing distant objects provides for developing eyes. Globally, researchers project that nearly 5 billion people will be myopic by 2050,² and the Australia and New Zealand Child Myopia Working Group warns that, without widespread myopia management, Australia alone could have 4.1 million people living with high myopia by that date.³

Myopia symptoms usually become noticeable when a child begins school and struggles to read what’s on the board. In adults, the condition may already be corrected, or it may develop or worsen in the 20s. Common signs of myopia include:

Blurred distance vision – difficulty seeing clearly at a distance, such as road signs, noticeboards or the television from across the room.

Squinting to see distant objects – squinting temporarily changes the shape of the eye and can sharpen the image slightly. If a child squints frequently to see things in the distance, it is a strong indicator of myopia.

Eye strain and headaches – straining to focus on distant objects can cause fatigue, discomfort or headaches, particularly after activities such as driving or watching a screen from a distance.

Sitting closer to screens or the front of a classroom – children with undiagnosed myopia will often move closer to a board, screen or book to compensate for blurred vision. This is one of the most common early behavioural signs.

Difficulty driving, especially at night – blurred vision at a distance makes identifying signs, signals and hazards on the road more difficult, and night driving can be particularly challenging for people with uncorrected myopia.

Rubbing the eyes – children who frequently rub their eyes may be reacting to visual fatigue caused by straining to see. While this can have other causes, it is worth noting alongside other signs.

Needing a stronger glasses prescription each visit – in children, myopia often progresses year on year, requiring increasingly strong prescriptions. Rapid progression is a sign the condition needs active management, not just correction.

Difficulty with sports or outdoor activities – poor distance vision can affect a child’s ability to track a ball, read play signals or navigate outdoor environments, sometimes impacting their confidence and willingness to participate.

Myopia cannot be cured, but it can be effectively corrected with prescription glasses or contact lenses, which redirect light so it focuses on the retina rather than in front of it. For adults whose prescription has stabilised, laser eye surgery may be an option, though not everyone is a suitable candidate.

In children, the focus is increasingly on slowing myopia progression rather than simply correcting it. This is known as myopia management, and a range of evidence-based options are now available. An optometrist can assess which approach is most appropriate based on the child’s age, degree of myopia and rate of progression.

Simple lifestyle changes can also help. Spending more time outdoors — ideally at least two hours a day — is associated with a lower risk of developing myopia, and taking regular breaks from prolonged near-focused tasks such as reading and screen use can reduce eye strain. Early detection through regular eye examinations remains key: the sooner myopia is identified, the more opportunity there is to intervene before it progresses to higher levels.

¹ Specsavers. Myopia diagnoses in Australian children, retrospective review 2017–2022. Available at: https://www.specsavers.com.au/news/myopia-changes-in-prevalence-and-treatment-rates

² Holden BA, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016;123(5):1036–1042. Available at: https://pubmed.ncbi.nlm.nih.gov/26875007/

³ Australia and New Zealand Child Myopia Working Group. Child Myopia Report 2022/23. Available at: https://www.optometry.org.au/wp-content/uploads/National_news_images/2022/November/Reducing-the-Risk-to-Vision_Myopia-Report-202223.pdf