Nearsightedness? .
What’s that? Does it say I can see near but not far away or vice versa?
Then they have this other name, myopia....
What’s that? Does it say I can see near but not far away or vice versa?
Then they have this other name, myopia....
Nearsightedness definition
The American Optometric Association says nearsightedness means you can see near objects clearly, but far objects blurry. It emphasizes, what the eye can do rather than what it cannot do. For more than 90% of nearsighted people this is correct. Yet, some can be so nearsighted that they can’t see at near vision either!
Another term for nearsightedness is myopia, which means small or a short eye. It derived from nearsighted people squinting to see distant objects, giving the appearance of a small eye.
The American Optometric Association says nearsightedness means you can see near objects clearly, but far objects blurry. It emphasizes, what the eye can do rather than what it cannot do. For more than 90% of nearsighted people this is correct. Yet, some can be so nearsighted that they can’t see at near vision either!
Another term for nearsightedness is myopia, which means small or a short eye. It derived from nearsighted people squinting to see distant objects, giving the appearance of a small eye.
To be accurate, myopia is a condition where our eyes are overly strong in power making images out of focus the further they are from our eyes.
Most think myopic eyes are weak. A camera requires a stronger lens for close-ups and you can see up close. Thus, your eyes are strong in power, not weak! The weakness miss-conception probably came because most farsighted people do outdoor activities that require more strength and stamina. Thus, they are physically stronger like the cowboy. |
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- The cowboy probably isn't a bookworm like the Ichabod Crane from Washington Irving's The Legend of Sleepy Hollow on the left. . Yet, Ichabod has stronger eyes! You have strong eyes if you have myopia!
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What Causes Nearsightedness? That is controversial with two theories, either nature or nurture. It is either inherited or the environment of books and computers caused it. The first theory proposed was inheritance Whether nature or nurture, it is a fact nearsightedness did not become common until the occurrence of two events. One was the library allowing more people to read more books. The other was the industrial revolution where people moved from the farms to the factories in the cities.During that time people were fascinated with genetics from Gregor Mendel’s discoveries (pd1923). George Washington Carver was an American who studied genetics also. Since hair color, and eye color were inherited, why not eye conditions? Through assumption, that was accepted then and exists today. The Berkeley Optometry School is so convinced its genetics, they keep tweaking their myopia study to preserve their belief. They even changed the centuries old definition of myopia.! The shape of the eye is a factor in myopia. The longer the eye, the more nearsighted it is. It makes images fall before rather than on the retina resulting in a blur. (See the introduction illustration above.) This seems to support the nature (genetic) camp. Their hallmark, assumes our eye is short at birth and lengthens as the body grows. A potentially myopic baby has a longer eye to start rather than the shorter farsighted eye of which babies started. With growth the eye becomes myopic since it was not short to start. It worsens until growth ends at 13 for girls and 18 for boys. The second theory proposes excessive near centered activities like reading and today’s digital activities elongates the eye. William Bates(Photo: PD)1923 Whipikedi)a ), a Columbia University Ophthalmologist, proposed our six strong eye muscles operating under stress squeeze and elongate the eye. If kept up, the shape remains, rendering you myopic. He devised stress relieving techniques that worked but took hours. Because medicine solidly embraced genetics that was popular at the time, his work was criticized. |
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A.M.Skeffington, the father of Developmental Optometry, stated nearsightedness is the response of the organism to the socially compulsive near centered task. At the time he meant reading under stress causes nearsightedness. Today he would have included digital.
The inheritance hallmark falls apart.
More modern measurements bring earlier assumptions to be just that, assumptions. At birth the eye is 95% fully grown. That is not much room for growth of any baby’s eyes, The genetic theory to be true, would have to find many myopic babies. There aren’t today and never have been. It escapes me how that was overlooked in their theory.
Photo: PD 1923 Whipikedia
The West Point study proved fully grown adults become nearsighted from their book studies. Francis Young at Washington University made apes nearsighted by exposing them to near point puzzles. The twin separation studies were dishonored realizing the environment in all US cities are virtually identical.
A study by the National Eye Institute shows the prevalence of myopia grew from 25 percent of the U.S. population (ages 12 to 54) in 1971-1972 to a whopping 41.6 percent in 1999-2004. Inheritance can’t explain that. Yet, Berkeley tried as they invented latent myopia!
We do know children became nearsighted in the fourth grade as their reading volume went way up when they switched from learning to read to reading to learn. The volume of books read increased dramatically. Unfortunately, today kindergartners become myopic as we force high level stressful learning at earlier ages.
A.M.Skeffington, the father of Developmental Optometry, stated nearsightedness is the response of the organism to the socially compulsive near centered task. At the time he meant reading under stress causes nearsightedness. Today he would have included digital.
The inheritance hallmark falls apart.
More modern measurements bring earlier assumptions to be just that, assumptions. At birth the eye is 95% fully grown. That is not much room for growth of any baby’s eyes, The genetic theory to be true, would have to find many myopic babies. There aren’t today and never have been. It escapes me how that was overlooked in their theory.
Photo: PD 1923 Whipikedia
The West Point study proved fully grown adults become nearsighted from their book studies. Francis Young at Washington University made apes nearsighted by exposing them to near point puzzles. The twin separation studies were dishonored realizing the environment in all US cities are virtually identical.
A study by the National Eye Institute shows the prevalence of myopia grew from 25 percent of the U.S. population (ages 12 to 54) in 1971-1972 to a whopping 41.6 percent in 1999-2004. Inheritance can’t explain that. Yet, Berkeley tried as they invented latent myopia!
We do know children became nearsighted in the fourth grade as their reading volume went way up when they switched from learning to read to reading to learn. The volume of books read increased dramatically. Unfortunately, today kindergartners become myopic as we force high level stressful learning at earlier ages.
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What is the typical treatment?
Compensative eyeglasses are given to reduce the power of the eyes to give clarity at 20 feet. Most people who wear glasses full time are nearsighted. In a 1961 study it was found that 91% of people prescribed glasses became worse within one year. It is easier to prevent than treat. We provide lens therapy in the form of prescriptive eyestrain reducing lenses used for reading, desk work, and digital activities. It’s highly successful in prevention. For those who already are nearsighted, weaker prescriptions for near activities are helpful. We have a brochure on lens therapy or you can go to Lens Therapy. |
Anti-reflection coating and a light blue tint boosts lens therapy. The blue-light blocking lenses have not yet been fully investigated but show promise. As an example, we rely on blue light to awaken in the morning. Prescribing blue blockers in glasses worn full time is not a good idea. However, for those desiring blue-blocker’s, they’re available..
Visual hygiene
There are many guidelines to reduce eyestrain too numerous to list here. Advice such as correct computer screen placement and frequent breaks from close work can be found at 7 steps to protect your children's vision from the rigors of the classroom in our Teacher Parent section..
What about LASIK?
LASIK is not a cure but a compensation. It is no different from prescribing stronger and stronger glasses. You are simply carving your prescription in your eye rather than a piece of plastic. Yes, it is common for the eyes to become more nearsighted requiring surgery again. For the right person it has value. Our LASIK patients are closely followed and receive lens therapy to keep them from the knife again. Look to studies and articles under: LASIK to get the whole story of this valuable procedure for the right person.
Orthokeratology is an answer.
This is fitting a rigid contact lens to mold the shape of your eye like LASIK does but without surgery. It is similar to orthodontics and requires a retainer.
Long-term Atropine drops
This medication-based approach raises concerns that extend beyond the management of nearsightedness. Its long-term effects on overall health have not yet been fully studied. With that in mind, I was surprised to see respected colleagues—each of whom has undergone extensive training in anatomy, physiology, pharmacology, physics, and vision science—support the use of a pharmacological, invasive intervention. Thoughtful consideration and continued research seem warranted before such an approach is widely embraced.
Visual hygiene
There are many guidelines to reduce eyestrain too numerous to list here. Advice such as correct computer screen placement and frequent breaks from close work can be found at 7 steps to protect your children's vision from the rigors of the classroom in our Teacher Parent section..
What about LASIK?
LASIK is not a cure but a compensation. It is no different from prescribing stronger and stronger glasses. You are simply carving your prescription in your eye rather than a piece of plastic. Yes, it is common for the eyes to become more nearsighted requiring surgery again. For the right person it has value. Our LASIK patients are closely followed and receive lens therapy to keep them from the knife again. Look to studies and articles under: LASIK to get the whole story of this valuable procedure for the right person.
Orthokeratology is an answer.
This is fitting a rigid contact lens to mold the shape of your eye like LASIK does but without surgery. It is similar to orthodontics and requires a retainer.
Long-term Atropine drops
This medication-based approach raises concerns that extend beyond the management of nearsightedness. Its long-term effects on overall health have not yet been fully studied. With that in mind, I was surprised to see respected colleagues—each of whom has undergone extensive training in anatomy, physiology, pharmacology, physics, and vision science—support the use of a pharmacological, invasive intervention. Thoughtful consideration and continued research seem warranted before such an approach is widely embraced.
The new kid on the block: Myopia reducing lenses
Families today are presented with many new options for managing childhood myopia, including premium lenses designed to slow its progression. These innovations are well-intended and thoughtfully developed, yet they deserve careful consideration—especially when cost and overall visual development are involved.
Families today are presented with many new options for managing childhood myopia, including premium lenses designed to slow its progression. These innovations are well-intended and thoughtfully developed, yet they deserve careful consideration—especially when cost and overall visual development are involved.
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When a child reads at a typical working distance of approximately 14 inches, the effective area of clear vision through certain specialty lenses is narrower than expected. For example, if only 30 mm of a lens is available for clear near vision, this translates to roughly 1.2 inches of usable clarity on a line of print, or about 4.8 degrees of visual field on the page. Beyond this range, children must move their head to continue reading. Normally, you do not need to move your head until 20 degrees. Premium lens kids must move their heads five times more!
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How was this calculated? Approximately 40% of a Premium lens is intentionally blurred in the peripheral zone. On a 50 mm-wide lens, this leaves a 30 mm central area providing the patient’s full prescription. At a typical reading distance of 14 inches, basic geometry shows that a 30 mm clear zone subtends only about 30.5 mm (1.2 inches) on the surface of a book for each fixation. This corresponds to a visual angle of approximately 4.8 degrees.
Frequent head movement interrupts continuous visual processing. During those moments, the brain naturally shifts reliance from visual input to auditory cues. While hearing is important, learning is most efficient when vision can lead the process. Vision information travels far faster and carries more detail than sound, making visual processing skills foundational for reading, comprehension, and academic success.
It is also worth noting that manufacturers of myopia-control lenses appropriately state that these products do not claim to halt or stop myopia progression. My concern, therefore, extends beyond myopia alone. Vision is a complex system involving tracking, focusing, teaming, and visual-motor integration—areas that developmental optometry has addressed comprehensively for decades.
New technologies are exciting, and progress is essential. At the same time, thoughtful evaluation helps ensure that we support not only eye growth but also the whole visual system on which learning depends. Sometimes, the most effective solutions are those that balance innovation with long-established principles of visual development.
As a precaution, and based on decades of intervention in myopia, I recommend preventing myopia before it happens. First, ensure that young children are engaged in tasks appropriate to their developmental readiness. That includes no digital devices until they are exposed in kindergarten, and then only tables with limited use until the teenage years. Secondly, use the lens therapy along with the appropriate vision hygiene mentioned in vision therapy.
It is also worth noting that manufacturers of myopia-control lenses appropriately state that these products do not claim to halt or stop myopia progression. My concern, therefore, extends beyond myopia alone. Vision is a complex system involving tracking, focusing, teaming, and visual-motor integration—areas that developmental optometry has addressed comprehensively for decades.
New technologies are exciting, and progress is essential. At the same time, thoughtful evaluation helps ensure that we support not only eye growth but also the whole visual system on which learning depends. Sometimes, the most effective solutions are those that balance innovation with long-established principles of visual development.
As a precaution, and based on decades of intervention in myopia, I recommend preventing myopia before it happens. First, ensure that young children are engaged in tasks appropriate to their developmental readiness. That includes no digital devices until they are exposed in kindergarten, and then only tables with limited use until the teenage years. Secondly, use the lens therapy along with the appropriate vision hygiene mentioned in vision therapy.
If you would like to look at a PDF of nearsightedness click below.
| myopia.pdf |