Myopia

Disease Description (Causes and Symptoms)

• Definition summary: Myopia is a condition in which images of distant objects are focused in front of the retina due to increased eyeball length (axial length) or excessive refractive power, making it difficult to see things far away.
• Causes and pathophysiology: Genetic predisposition, environmental factors (prolonged near work, smartphone and computer use, insufficient outdoor activity), and certain nutritional and metabolic factors (e.g., a suggested association with hyperinsulinemia) act in combination. Axial elongation of the eyeball prevents light from focusing accurately on the retina.
• Main symptoms: Primarily reduced distance vision (distant objects appear blurry), squinting, turning the head to see, headaches, and eye fatigue. In severe myopia, floaters (spots that appear to drift) and photopsia (flashes of light) may occur — floaters and photopsia may be signs of a retinal tear or detachment and require immediate medical attention.
• Diagnosis: Refraction testing (objective and subjective refraction), visual acuity testing, and fundus examination (to check retinal condition in cases of high myopia). Regular examinations are recommended for children (before and during the early stages of school entry, etc.).

Treatment Methods

• Corrective treatment (standard)
  • Glasses (concave lenses): The most basic and safest corrective method.
  • Contact lenses: An option for children and adults (management and infection risks should be considered).
• Slowing progression (methods for slowing myopia progression in children and adolescents)
  • Low-dose atropine eye drops (e.g., 0.01%) — there is evidence for suppressing myopia progression in children (the dosage and side effects require consultation with a specialist).
  • Multifocal or dual-focus design contact lenses and orthokeratology (overnight lenses): Some studies have reported effects in slowing myopia progression.
  • Lifestyle interventions: Increase outdoor activity time (1–2 hours per day is recommended), and take breaks at intervals during prolonged near work (such as the 20-20-20 rule).
• Surgical treatment (adults, after completion of eyeball development)
  • Laser refractive surgery (LASIK, PRK, etc.): Corrects refractive errors by changing the shape of the cornea.
  • Phakic IOL implantation: May be considered for high myopia.
  • A specialist must determine the indications and limitations for surgery.
• Precautions and risk of complications
  • High myopia increases the risk of complications such as retinal detachment, retinal tears, and retinal atrophy (myopic maculopathy).
  • Contact lens use carries a risk of infection and corneal ulcers, while using glasses with an inappropriate prescription may cause eye fatigue.
  • Medications (e.g., atropine) may cause side effects such as pupil dilation, reduced near vision, and light sensitivity or glare.
  • Visit an ophthalmologist immediately if symptoms such as sudden floaters, photopsia, or visual field defects occur.

Checklist Before an Outpatient Visit (Including Items to Bring and Example Questions)

• Items to bring (recommended)
  • The glasses and contact lenses currently being worn (and, if possible, the prescription or lens information)
  • A list of medications currently being taken (including eye drops) and a history of allergies
  • Results of previous ophthalmic surgeries and examinations (fundus photographs, visual acuity records, refraction records, etc., if available)
  • A record of when symptoms began and how they have changed (changes in vision, headache frequency, presence of floaters, etc.)
  • Lifestyle information (average screen time, reading distance and duration, outdoor activity time)
• Materials to show the doctor during the outpatient visit
  • Recent visual acuity measurements (if self-measured) and eyeglass prescription (if available)
• Example questions before the outpatient visit (helpful to ask during the consultation)
  • "Are there any problems with my current vision or eyeglass prescription?"
  • "What examinations are needed to accurately assess the degree of myopia progression (such as a fundus examination or refraction test)?"
  • "What treatment do you recommend to slow myopia progression (such as low-dose atropine or orthokeratology)?"

General Example Questions to Ask the Doctor

• "What are the expected effects and side effects of this medication (or treatment)?"
• "How high is my (or my child's) risk of myopia progression (or what is the prognosis)?"
• "How often should my glasses or contact lens prescription be checked?"
• "When would be the appropriate time for surgery (laser or phakic IOL implantation)? What are the risks of surgery?"

Examples of Condition-Specific Questions

• For children and adolescents: "Which method is more suitable for slowing my child's myopia progression, low-dose atropine or orthokeratology? What are the expected effects and side effects?"
• For patients with high myopia: "Considering the condition of my eyes (axial length and retinal condition), what follow-up interval and examinations (fundus examination, OCT, etc.) are recommended to reduce the risk of retinal complications (retinal tears and detachment)?"

(All treatment and examination decisions should be made in consultation with an ophthalmology specialist and tailored to the individual's condition.)