Your Guide to Nearsightedness Levels and Progression

There are two types of nearsightedness: high myopia and low myopia.

As the name suggests, low myopia is considered mild nearsightedness. Officially, it means that a person requires less than 3 diopters — a unit of measure used to denote magnification — to bring an object into focus. Depending on the severity, a person with low myopia may only need glasses when driving or working on tasks that require looking from a distance.

By contrast, someone with high myopia could fall into one of two categories.

• Moderate nearsightedness requires 3 to 6 diopters to correct the vision problem.
• Severe nearsightedness (which also qualifies as high myopia) requires 6 or more diopters for correction.

Unlike a person with low myopia, moderate or severe nearsightedness will usually require some form of corrective vision aid (glasses or contacts) to be worn throughout the day — not just for certain tasks.

The steps you can take to slow myopic progression depend on the age of the person. While only surgery can reverse myopia, there are options to prevent your vision from deteriorating significantly.

Preventing progression in children and teens

Of all the groups, prevention is most likely to be effective in children and teens. If you have a child with nearsightedness, there are several options to talk with your doctor about:

• Regulate screen time: Spending time outside and off of screens is one of the best ways to slow myopia from worsening. They may recommend reducing overall screen time or trying light-free tablet options to reduce eyestrain.
• Prescription eye drops: Research suggests that low concentration (0.01%) atropine eye drops used every day can help to prevent myopia from progressing when used for several years. One study suggests that roughly 80% of children that use the drops do experience a slowed progression of myopia.
• Orthokeratology (ortho-k): This treatment uses hard contact lenses to force the cornea to flatten slightly, with a proven history of slowing progression. Yet, because these contacts must be worn even while sleeping, there’s a risk of infection — especially if a child or teen doesn’t clean them properly as needed.
• Peripheral defocus contact lenses: These contact lenses are specifically designed for children between the ages of 6 and 12. This lens features different areas of focus, helping to sharpen vision in the center and intentionally blurring peripheral vision. The purposeful peripheral blurring is believed to aid in slowing nearsightedness progression.

It’s important to keep in mind that if your child is diagnosed with nearsightedness at a young age, you should expect myopia to progress as they age. However, in most cases, their prescription will stabilize once they reach their 20s.

Preventing progression in adults

For adults, the best form of prevention is usually going to include corrective surgery. Most people are familiar with LASIK, a refractive surgery that corrects the existing cornea’s shape to improve a person’s vision. But other corrective surgeries exist.

Photorefractive keratectomy (PRK) is a surgery that’s similar to LASIK in that a laser is used to reshape the cornea. However, it differs in that the top flap that covers the cornea is completely removed.

Individuals with severe nearsightedness might not be good candidates for traditional refractive surgeries. In these scenarios, either refractive lens exchange (RLE) or phakic intraocular lenses (IOLs) surgeries can be performed.

Technically, “legally blind” qualification stars with a prescription that is 20/200 or worse. This means that you need to be at least 20 feet away from an object that a person with normal vision could see at 200 feet away.

But to be diagnosed as legally blind, there’s a caveat. This diagnosis means that even when you’re given corrective lenses, you still can’t achieve the 20/200 benchmark.

For myopia, this would fall within the severe nearsightedness subcategory under the high myopia diagnosis.

Nearsightedness and disability

Nearsightedness can be frustrating at times, but in most cases, it doesn’t qualify as a disability. But, as with any other condition, there are caveats.

If a person also is experiencing more extreme associated symptoms such as retinal detachment, their vision worsens to the point that they were diagnosed as legally blind, or experienced total vision loss, that person could apply for disability support.

This means that a person who wants to remain employed can require their place of work to provide reasonable accommodations such as visual aids or accessibility support. Additionally, that person could apply for Social Security Disability Insurance (SSDI) assuming that they had worked enough before their disability to qualify to receive financial assistance.

Nearsightedness is a very common vision problem that impacts roughly 41% of Americans. For most people, opting for glasses or contacts is more than sufficient to see clearly.

In children, nearsightedness has more preventive solutions ranging from reduced screen time to eye drops and specialty contact lenses. In adults, aside from glasses or contacts, surgery tends to be the best solution.

Although most people won’t experience nearsightedness that progresses to becoming legally blind, the Americans with Disabilities Act (ADA) requires that places of business, as well as employers, provide reasonable accommodations. Additionally, know that if you’re legally blind, you may be eligible for financial assistance through the Social Security Administration.