Straining to See: Coping with Myopia, Hyperopia, and Astigmatism

Overview

Are you aware that the World Health Organization reported that uncorrected vision conditions, such as myopia, hyperopia and astigmatism, is one of the top causes of vision impairment worldwide (44%)?¹

Definition of myopia, hyperopia and astigmatism

Myopia is an eye condition in which objects far away cannot be seen clearly (shortsightedness), but objects close in distance can be seen clearly.¹ Contrastingly, hyperopia is an eye condition in which objects close in distance cannot be seen clearly (farsightedness), but objects far in distance can be seen clearly.¹ Astigmatism is another eye condition where objects at both far and close distances cannot be seen clearly. This may often occur in higher levels of myopia and hyperopia.¹

These conditions are collectively called refractive errors of the eyes which means they impede vision by changing the shape of the eye, causing incoming light to not focus properly on the retina, a light-responsive tissue at the back of the eyes.^1,2

Significance of managing visual health conditions

The eyes are an important sensory organ, which aids in being able to see. Refractive errors of the eyes can be managed clinically and through patient lifestyle modifications. The outcomes of having uncorrected vision conditions include; 

• Blindness
• Detachment of the retina (the light-sensing tissue) in the eye
• Impact on vision-reliant activities outside, in the workplace, and at home
• Exacerbation of signs and symptoms of uncorrected vision conditions¹

Myopia

Causes of myopia

Causes of myopia include;

• Prolonged periods of gazing at screens like televisions, phones, tablets, and computers without taking regular breaks 
• Reading a book at close distance for long periods of time without looking away 
• Genetics - if parents have refractive errors, children are likely to inherit these conditions  
• Having undergone cataract surgery 
• Diabetes 
• Staying indoors and going outside infrequently^1,3

Risk factors of myopia

In addition to the causes of myopia, certain aspects increase the likelihood of an individual developing it. These are:

• Vitamin D deficiency 
• Genetic factors - if parents have eye refractive errors, future generations are likely to inherit these conditions 
• Age - becoming a mother when aged 35 years old or over has been linked with their children being diagnosed with myopia  
• Ethnicity (being of East Asian, Native American or having Hispanic heritage)¹

Signs and symptoms of myopia 

Signs and symptoms of myopia include; 

• Blurred vision - this is particularly true for objects viewed at a far distance
• Squinting of eyes
• Feeling of heaviness in eyes
• Dry and irritated eyes
• Red and bloodshot eyes
• Eye strain 
• Headache
• Having to move closer to visualise far away objects
• Excessive blinking¹

Coping strategies to minimise myopia

To reduce the effects of myopia one should:

• Go outdoors in bright sunlight frequently - activities to do include sports, gardening, and camping. This improves dopamine and vitamin D levels, which when deficient are implicated in causing myopia. 
• Taking omega 3 fatty acid supplements/oils reduces myopia-related redness and inflammation. 
• Taking vitamin D supplements or eating eggs, fortified cereals, oily fish (salmon, herring, sardines, and mackerel) containing vitamin D.
• Using lubricating eye drops to minimise symptoms of dry and irritated eyes.
• Having regular eye exams by your optometrist and/or eye doctor. 
• Quitting smoking as tobacco smoke contains irritants and carcinogens increasing chances of eye diseases¹

Screen-related development of myopia can be prevented by; 

• Limiting gazing at screens and allowing for screen breaks between use. The 20-20-20 rule (20 second break every 20 minutes of screen use to view an object 20 feet  away) is useful.
• Using an ergonomic chair which will allow for correct posture and limit close viewing distances to screens 
• Position your desk and laptop/computer monitor at or slightly below eye level 
• Blinking exercises reduce myopia-related eye strain - ensure the upper eyelid completely covers the entire eye when blinking.^4,5

Hyperopia

Causes of hyperopia

• Genetics - hyperopia is inherited from parents to children 
• Having a shorter eyeball 
• Having a flattened cornea (the clear outer covering of the eyeball)⁶

Signs and symptoms of hyperopia 

• Blurred vision at close viewing distances 
• Eye strain
• Double vision
• Dry and irritated eyes
• Red and bloodshot eyes
• Squinting of eyes^1,6

Risk factors of hyperopia

• Age - hyperopia decreases with increasing age, and is therefore more common in children 
• Genetics and family history - if parents have hyperopia, children also inherit it^1,6

Coping strategies to minimise hyperopia

• Ensuring a well-lit environment when reading or using electronic devices 
• Getting adequate hours of sleep - for adults this is 7-9 hours and for adolescents it is between 8-10 hours per day, but for children and infants it goes up to between 9-13 hours, and 12-17 hours, respectively
• Quitting smoking^1,7

Astigmatism

Causes of astigmatism

• Increased eyelid pressure - due to the upper eyelid shape 
• Tension in the muscles which control the movements of the eye
• Having a larger pupil size⁸

Risk factors of astigmatism

• Genetics - inherited from parents to children
• Age - being a newborn or infant⁸

Signs and symptoms of astigmatism 

• Headache
• Eye pain and strain
• Temporary blurriness whilst viewing objects from far and near distances
• Drowsiness
• Nausea
• Problems with focusing on objects 
• Heavy feeling in the eyes
• Frontal headache⁸

 Coping strategies to minimise astigmatism

• Managing co-existing medical conditions which may cause astigmatism by regularly visiting the doctor and optometrist 
• Taking frequent screen breaks to reduce eye strain 
• Regular eye exams to assess eye health and to recommend eyeglasses, contact lenses or surgery^4,8

Strategies to improve vision 

• Regular eye examinations by medical health professionals are required to ensure correct prescriptions of corrective lenses and other treatments are given 
• Join support groups to understand how to manage your visual health conditions
• Consuming vitamin D rich foods 
• Going outside in bright light often 
• Use the 20-20-20 rule when using screens 
• Wearing your corrective lenses (glasses and/or contact lenses) whilst using screens, driving, and doing other activities 
• Use soothing, lubricating eye drops to relieve dryness, irritation, and pain related to myopia, hyperopia and astigmatism^1,4

Future studies

New vision correction technologies

There are various refractive error correction procedures in the pipeline.⁹

These include;

• SILK, which carves and removes pieces of the cornea to change the shape of the eye with less dissection than in SMILE laser eye surgery, which allows quicker patient recovery after surgery. 
• LIRIC, an option which is less invasive than laser eye surgeries, like SMILE and LASIK, as it does not require corneal flap cutting, and has been connected with better patient postoperative recovery. 
• CLEAR which has been connected with less patient discomfort during surgery and is completed quicker. This is suitable for patients with dry eyes or those not eligible for LASIK surgery.⁹

Consulting with eye specialists regularly 

Patients must be aware that visual health conditions cannot be reversed/cured by eye exercises, but only by consulting with a doctor and optometrist who will give advice and discuss treatment options.

Summary

In summary, myopia and hyperopia are eye conditions in which shortsightedness and farsightedness occur respectively. Astigmatism can cause both shortsightedness and farsightedness. Signs,symptoms, risk factors, and coping strategies of these conditions are mentioned. Conclusively, lifestyle changes alongside regular eye exams by eye specialists are required to determine a diagnosis and provide treatment options which include corrective lenses, specific eye medicines, and surgery.

FAQs

Does straining the eyes cause myopia?

No, it does not. Eye strain is a symptom of myopia which often occurs when it is not corrected by glasses, contact lenses, surgery or lifestyle factors such as minimising the use of screens. 

What happens if you have myopia and astigmatism?

If an optometrist diagnoses a patient with myopia and astigmatism they will suggest refractive error treatment such as glasses, contact lenses or surgery, depending on the severity and causes of these eye conditions.