Myopia myths and treatments for short sightedness
- Myopia, also called short-sightedness or near-sightedness, typically develops in childhood and worsens until the late teens or early adulthood. It is a lifelong condition which cannot be cured, and has impacts on quality of life and long-term eye health.
- The childhood visual environment can influence myopia, with the key factors being not enough time spent outdoors and too much time spent on screens or reading.
- Treatment options are available to slow myopia progression in children and teenagers.
In this article
Rates of myopia are increasing around the world in children and teenagers, and with more awareness can come some less accurate information. This can be confusing for parents of kids with myopia, and for people with myopia too. This article looks at some key myopia myths, maybe's and facts to help with understanding the options to treat childhood myopia.
Myopia is an eye condition which causes blurred far vision, and is also known as short-sightedness or near-sightedness. Once myopia develops in children and teenagers, it typically deteriorates every few to several months. In most cases, this worsening continues until the late teens or even early 20s.1 This is called progressive myopia, which is a significant concern to quality of life in children and teenagers, and also poses risks to long-term eye health.2
Myopia can be cured
Myopia occurs when the eyes grow too quickly and too long in childhood, faster than the normal expected rate for healthy visual development.3 Myopia can continue worsening into the teens and even early adulthood.1,4 Once this excessive eye growth has commenced, myopia control treatment options can be prescribed to slow it down but the growth cannot be stopped or reversed.5 This means there is no cure for myopia – only ways to correct the blurred far away vision which comes with it.
Examples of when myopia may seem to be ‘cured’, but is only just ‘corrected’, include ortho-k contact lenses and laser eye surgery. Ortho-k is a special type of rigid breathable contact lens which is worn overnight while sleeping, and removed upon waking.
Overnight, ortho-k gently reshapes the surface of the eye so that no glasses or contact lenses need to be worn during the day. The effect is temporary, so the ortho-k lenses need to be worn each night to maintain the vision correction effect. This can make it seem as though the myopia is fixed, but in fact it’s just been corrected – if you stop wearing your ortho-k lenses overnight while sleeping, the correction will regress and you’ll need normal glasses or contact lenses to see during waking hours again.6
In the same way, but as a permanent fix, laser eye surgery (LASIK) can also do away with the need for vision correction, so the person doesn’t need to wear glasses or contact lenses again. It corrects myopia, but doesn’t cure it, because it doesn’t shorten the length of the eyeball. It's the length of the eyeball and the stretching which has occurred in the development and progression which is most closely linked to risk of eye diseases associated with myopia.2 This means the health risks of myopia remain the same, even if vision is now perfect.
There is no treatment that can reverse myopia once it has developed because the eyeball length cannot be reduced or shrunk back. Sometimes, though, a prescription can reduce from one eye examination to the next, due to accuracy of the measurement process.
Sometimes a person may have had their glasses made too strong for them. When a more accurate refraction (measure for glasses) is undertaken, the numbers in the prescription can reduce. This can appear like an improvement in myopia when it is in fact due to measurement error. This can be a common observation in children when auto-refraction machines are used to test vision instead of by an expert optometrist or eye doctor using best-practice techniques.7
Eye exercises cure myopia
Daily 'eye exercises' which involve massaging acupressure points around the eyes have been a common practice in China for decades, recommended as policy in schools. Research has shown, though, that these have no impact on reducing myopia in children or on the stability of their vision over time.8
One study even found that children and teenagers who regularly performed the exercises were more likely to have impaired vision and/or to have myopia.9
This doesn't necessarily mean that the exercises cause harm - perhaps kids with vision issues are more interested in doing the exercises - but it definitely indicates that they're not helpful in protecting vision in children and teenagers.
One clinical trial treated teenagers and young adults (14 to 22 years) with myopia using special soft contact lenses and vision training (eye exercises) to improve the flexibility of the eyes' focussing system. While the eye exercises worked to make the focussing system respond more quickly to changes in focus distance,10 there was no effect on slowing progression of myopia.11
Eye exercises can't cure myopia, but sometimes specific vision training eye exercises are prescribed for eye muscle coordination issues.
There is strong evidence for specific types of vision training (eye exercises) to improve specific eye muscle coordination issues.12 Qualified eye care practitioners such as orthoptists, optometrists and ophthalmologists will prescribe and supervise these vision training programs.
While there are links between particular types of eye muscle coordination issues (binocular vision dysfunctions) and myopia, there is no research to yet link fixing the dysfunction with altering the development of myopia.13
Pressing on your eyes shortens the eyeball
This claim dates back over many centuries – it is believed that the ancient Chinese slept with sandbags or small weights on their eyes overnight to improve their vision for the morning. It has continued in the belief that if your distance vision was blurred, you could ‘push down on your eyes with your palms’ to make the eyeball lengthening go away and cure myopia.
This advice is wrong, and is potentially dangerous, as pushing on your eye can dramatically increase the pressure in your eye, like pushing on a balloon, potentially damaging the eye structures. Avoid rubbing and pressing your eyes - if done frequently this can cause long term eye health damage and even impact vision.14
On the positive note, this ancient Chinese concept is somewhat like how ortho-k works to temporarily correct vision during the day – but by using very gentle fluid pressure between a contact lens and the eye surface, not the blunt pressure of a sandbag or a hand.
Taking vitamins can cure myopia
Vitamins are used in healthcare to treat some eye conditions. Age-related macular degeneration (AMD), a condition which can cause central-vision blindness and mainly occurs in the elderly, can have its progression slowed by taking a very specific dose of some vitamins. This is only for AMD though, and if taken incorrectly and not under the direction of a professional these vitamins can negatively impact the health of some people.15
There is no current vitamin that prevents or cures myopia, and all vitamins and supplements should only be taken under the advice of your healthcare professional.
One study from Denmark, published in 2008, found that a caffeine-derivative tablet called 7-methylxanthine (7-MX) had a very small effect on slowing eye growth in children with myopia.16 It is only available in Denmark, and a larger follow-up study published in 2022 again showed only minor effects to slow myopia progression.17
7-MX has not been investigated in any other countries and the effects to slow myopia progression are much smaller than the currently available spectacle, contact lens and atropine eye drop treatment options for myopia control.
Read more about effective options to slow myopia progression in children and teenagers in our article Which is the best option for myopia control?
Contact lenses are dangerous for children
There are numerous benefits for children and teenagers who wear contact lenses, such as improving their satisfaction with their vision, their appearance, and ability to participate in activities of school and sport.18
Contact lenses can have a very high safety profile when they are worn correctly and under the supervision of a qualified contact lens optician, optometrist or ophthalmologist. Children aged 8 to 12 years actually appear to be safer soft contact lens wearers than teenagers and adults, with a lower risk of eye infection. This is likely due to parental supervision and support.19
The risk of an eye infection when wearing contact lenses ranges from 1 in 1,000 to 1 in 5,000 per year, depending on the type of contact lens. Even when not wearing contact lenses, there is a risk of eye infection, which is around 1 in 7,000 per year. These are not frequent occurrences - learn more in our article How can I make contact lens wear and ortho-k as safe as possible?
Smartphones are making kids short-sighted
With rates of myopia (short-sightedness or near-sightedness) increasing worldwide,20 there is a clear link being shown between a child's visual environment and risk of myopia. This encompasses how much time they spend outdoors, as well as what they do when indoors - time spent on screen time and close work like reading.21
A large analysis study published in 2020 stated that there was no clear link between myopia and digital screen use.22 A newer study published in 2022 did find a link, even more so when digital hand-held devices were combined with computer use.23 This newer study included some objective data, which is measured independently of a child or parent's opinion of their screen time. By comparison, all older studies use subjective data, being responses from surveys.
Another study also found a link between heavier smartphone use and myopia, with the largest impact found in children under age 10.24
Sunlight protects against myopia
To finish on a positive note - increasing time spent outdoors can help protect children's eyes from developing myopia, even if they have a lot of screen time. Kids and teens don't have to be playing sport to get the benefit of time spent outdoors, as it appears to be about the brightness of the light, not physical activity.21
The goal is to aim for an average of two hours per day spent outdoors for kids and teens. Being sun safe is still important. Read more about the benefits of outdoor time, sun protection and guidelines for physical activity in kids in our article All about outdoor time.
- Hou W, Norton TT, Hyman L, Gwiazda J; COMET Group. Axial Elongation in Myopic Children and its Association With Myopia Progression in the Correction of Myopia Evaluation Trial. Eye Contact Lens. 2018 Jul;44(4):248-259.
- Tideman JW, Snabel MC, Tedja MS, van Rijn GA, Wong KT, Kuijpers RW, Vingerling JR, Hofman A, Buitendijk GH, Keunen JE, Boon CJ, Geerards AJ, Luyten GP, Verhoeven VJ, Klaver CC. Association of Axial Length With Risk of Uncorrectable Visual Impairment for Europeans With Myopia. JAMA Ophthalmol. 2016 Dec 1;134(12):1355-1363.
- Mutti DO, Hayes JR, Mitchell GL, Jones LA, Moeschberger ML, Cotter SA, Kleinstein RN, Manny RE, Twelker JD, Zadnik K; CLEERE Study Group. Refractive error, axial length, and relative peripheral refractive error before and after the onset of myopia. Invest Ophthalmol Vis Sci. 2007 Jun;48(6):2510-9. doi: 10.1167/iovs.06-0562.
- Lee SS, Lingham G, Sanfilippo PG, Hammond CJ, Saw SM, Guggenheim JA, Yazar S, Mackey DA. Incidence and Progression of Myopia in Early Adulthood. JAMA Ophthalmol. 2022 Feb 1;140(2):162-169.
- Gifford KL, Richdale K, Kang P, Aller TA, Lam CS, Liu YM, Michaud L, Mulder J, Orr JB, Rose KA, Saunders KJ, Seidel D, Tideman JWL, Sankaridurg P. IMI - Clinical Management Guidelines Report. Invest Ophthalmol Vis Sci. 2019 Feb 28;60(3):M184-M203.
- Vincent SJ, Cho P, Chan KY, Fadel D, Ghorbani-Mojarrad N, González-Méijome JM, Johnson L, Kang P, Michaud L, Simard P, Jones L. CLEAR - Orthokeratology. Cont Lens Anterior Eye. 2021 Apr;44(2):240-269.
- Kang MT, Jan C, Li S, Yusufu M, Liang X, Cao K, Liu LR, Li H, Wang N, Congdon N. Prevalence and risk factors of pseudomyopia in a Chinese children population: the Anyang Childhood Eye Study. Br J Ophthalmol. 2021 Sep;105(9):1216-1221.
- Boswell M, Wang H, Jan C, Gian Y, Congdon NG, Rozelle S. Effect of Chinese Eye Exercises on Change in Visual Acuity and Eyeglasses Wear Among School-aged Children in Rural China. Invest Ophthalmol Vis Sci. 2019;60(9):3895.
- Huang J, Chen Q, Du K, Guan H. Does Performing the Chinese Eye Exercises Help Protect Children's Vision? - New Evidence from Primary Schools in Rural Northwestern China. Risk Manag Healthc Policy. 2020 Nov 3;13:2425-2438.
- Allen PM, Radhakrishnan H, Rae S, Calver RI, Theagarayan BP, Nelson P, Osuobeni E, Sailoganathan A, Price H, O'Leary DJ. Aberration control and vision training as an effective means of improving accommodation in individuals with myopia. Invest Ophthalmol Vis Sci. 2009 Nov;50(11):5120-9.
- Allen PM, Radhakrishnan H, Price H, Rae S, Theagarayan B, Calver RI, Sailoganathan A, Latham K, O'Leary DJ. A randomised clinical trial to assess the effect of a dual treatment on myopia progression: the Cambridge Anti-Myopia Study. Ophthalmic Physiol Opt. 2013 May;33(3):267-76.
- Convergence Insufficiency Treatment Trial Study Group. Randomized clinical trial of treatments for symptomatic convergence insufficiency in children. Arch Ophthalmol. 2008 Oct;126(10):1336-49.
- Logan NS, Radhakrishnan H, Cruickshank FE, Allen PM, Bandela PK, Davies LN, Hasebe S, Khanal S, Schmid KL, Vera-Diaz FA, Wolffsohn JS. IMI Accommodation and Binocular Vision in Myopia Development and Progression. Invest Ophthalmol Vis Sci. 2021 Apr 28;62(5):4.
- Najmi H, Mobarki Y, Mania K, Altowairqi B, Basehi M, Mahfouz MS, Elmahdy M. The correlation between keratoconus and eye rubbing: a review. Int J Ophthalmol. 2019 Nov 18;12(11):1775-1781.
- Chew EY, Clemons TE, Agrón E, et al. Long-term Outcomes of Adding Lutein/Zeaxanthin and ω-3 Fatty Acids to the AREDS Supplements on Age-Related Macular Degeneration Progression: AREDS2 Report 28. JAMA Ophthalmol. 2022;140(7):692–698.
- Trier K, Munk Ribel-Madsen S, Cui D, Brøgger Christensen S. Systemic 7-methylxanthine in retarding axial eye growth and myopia progression: a 36-month pilot study. J Ocul Biol Dis Infor. 2008 Dec;1(2-4):85-93.
- Trier K, Cui D, Ribel-Madsen S, Guggenheim J. Oral administration of caffeine metabolite 7-methylxanthine is associated with slowed myopia progression in Danish children. Br J Ophthalmol. 2022 Aug 22:bjophthalmol-2021-320920.
- Walline JJ, Gaume A, Jones LA, Rah MJ, Manny RE, Berntsen DA, Chitkara M, Kim A, Quinn N. Benefits of contact lens wear for children and teens. Eye Contact Lens. 2007 Nov;33(6 Pt 1):317-21.
- Bullimore MA. The Safety of Soft Contact Lenses in Children. Optom Vis Sci. 2017;94(6):638-646.
- Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, Wong TY, Naduvilath TJ, Resnikoff S. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology. 2016 May;123(5):1036-42.
- Morgan IG, Wu PC, Ostrin LA, Tideman JWL, Yam JC, Lan W, Baraas RC, He X, Sankaridurg P, Saw SM, French AN, Rose KA, Guggenheim JA. IMI Risk Factors for Myopia. Invest Ophthalmol Vis Sci. 2021 Apr 28;62(5):3.
- Lanca C, Saw SM. The association between digital screen time and myopia: A systematic review. Ophthalmic Physiol Opt. 2020 Mar;40(2):216-229.
- Foreman J, Salim AT, Praveen A, Fonseka D, Ting DSW, Guang He M, Bourne RRA, Crowston J, Wong TY, Dirani M. Association between digital smart device use and myopia: a systematic review and meta-analysis. Lancet Digit Health. 2021 Dec;3(12):e806-e818
- Harrington SC, Stack J, O'Dwyer V. Risk factors associated with myopia in schoolchildren in Ireland. Br J Ophthalmol. 2019 Dec;103(12):1803-1809.