Some people say that when you become an adult, your eyes will be shaped and your myopia will not increase. Is this true? The answer is no, myopia is not exclusive to teenagers, adults still have myopia, and the proportion is not low.
Why, let's talk to you today!
01, myopia is not exclusive to minors
For example, in 2007, a study of myopia in adults from Portugal showed that during the three-year study period, even in adulthood, 5% of people still developed new myopia [1]
In 2022, a longer-tracking study of myopia in adults over an 8-year period was published in JAMA Ophthalmology. The study found that 14 percent of adults who were not previously myopic were found to be myopic after eight years, and 0.7 percent developed high myopia after eight years of experience [2].
Not to mention for people who were previously nearsighted, with a total of 37.8% of the population experiencing a continuous increase in myopia over the past 8 years.
In addition, other studies also support the brutal fact that myopia is not exclusive to minors, even adults!
02, What is myopia in adults?
Some people may wonder, what is the cause of myopia in adults? Could it be that this group of people read too much? The answer is really no, so here is a thing that is often misunderstood: reading causes myopia.
It is estimated that in the eyes of most people, reading can be called the first factor of myopia, after all, in our observation, myopia mainly appears in the student group, and if you communicate with the teacher or observe carefully, it is easy to find that with the longer you read, the higher the proportion of myopia, this firm evidence will make many people feel that reading is the primary factor of myopia.
However, in fact, the relationship between reading and myopia is probably similar to the logic of drowning after eating popsicles, which only sees the correlation and ignores the root cause behind it: unhealthy eyes. For example, many parents will also complain about their children playing with mobile phones, and they will say that playing with mobile phones can cause myopia.
In fact, such a statement is somewhat close to the truth, that is: it is not important what you see with your eyes, but how you use your eyes is the key to myopia.
For example, a multi-population study of different eye patterns was investigated and as many as 213,857 people were included in the study, including both eye patterns such as homework, watching television, and watching computers, as well as changes in eye time [3].
The results we can see that whether it is writing homework, watching TV or watching computers, myopia will appear, of course, this study is earlier, smart phones are not particularly popular, I estimate that if it is left today, this survey is a mobile phone, tablet and the like. All of these methods lead to a high percentage of myopia, all of which are significant.
However, if the difference is discussed, it may be that the length of time becomes a particularly critical factor, for example, the proportion of poor vision is nearly a quarter higher than that of writing for less than half an hour (83.56% vs 67.35%). A similar situation exists when looking at a computer screen.
It can be seen that in fact, what kind of screen or homework is not the main factor, but unhealthy eye use is the core factor. Because of this, for adults, myopia is by no means the fact that they read more, which is also supported by research that there is no direct correlation between myopia and educational attainment in adults [2].
That being the case, why do adults still have myopia?
03, Why do adults still have myopia?
The answer is still the same as before, unhealthy eyes.
On the one hand, it's the age of screens. It can be said that the screen has become one of the most important and common devices we currently have, whether it is a computer screen at work, or a mobile phone for daily leisure and entertainment, a tablet, etc., and even many times, work arrangements and meetings are completed on the mobile phone, so that for us, it is almost difficult to complete a lot of work without a screen, especially for adults, our time using the screen has greatly increased.
On the other hand, adults may still be relatively weak in self-discipline in this regard. Compared with teachers and parents in primary and secondary schools, adults are more free and more able to control their own choices, so many people are more indulgent, such as brushing their mobile phones for a long time, playing games, etc., and even staring at them for hours, which can be seen from the fact that many people have extremely high requirements for mobile phone battery life. Of course, there are also unavoidable situations, such as working in front of a computer, where many people have to stay for hours at a time.
The result of the combination of these factors is that adults cannot avoid myopia or worsen myopia. However, there is a saying that adults should pay more attention to myopia than minors.
On the one hand, adults need to take on the basic responsibility of providing for their families, unlike minors, who only need to study, and adults are mainly responsible for maintaining the operation of the whole family, and if myopia is not dealt with in time, then it may affect work.
On the other hand, myopia is particularly important for safety, especially traffic safety. Only adults can drive motor vehicles, and the impact of motor vehicles on road safety is primary, once myopia often affects driving safety, in today's road accidents have recently become a common factor leading to accidents and deaths, in this case, myopia does not correct driving motor vehicles, in fact, the safety hazards left are not small. Because of this, adults should pay more attention to the problem of myopia.
04. How can we solve the problem of adult myopia?
So how can we solve the problem of myopia in adults? The simplest strategy is naturally to wear lenses to correct it. In fact, the principle is very simple, it is to use a concave lens to adjust the path of light into the eye, so that the final image falls correctly on the retina.
Lenses for myopia correction, such as glasses and contact lenses, are the mainstream choices because the glasses themselves are easy to wear and easy to replace.
Of course, contact lenses can also be used, compared to eyeglasses, because they are attached to the surface of the eyeball, so they basically do not affect the appearance, and have become the choice of many people. In addition, orthokeratology lenses (OK lenses) also exist, because they are medical devices, there are currently strict restrictions on their use, and you must follow your doctor's instructions.
All of the above are strategies to temporarily solve myopia, and if you want to solve myopia fundamentally, then you have to take surgery. The reason why we are myopic is essentially that the change of the eye axis causes the image that originally fell on the retina to run to the front of the retina, so we are nearsighted.
Because of this, the correction of myopia is also carried out for this aspect of the structure, although theoretically there are two possibilities of cornea and lens, but because the lens itself is relatively flexible, and also assumes the role of adjustment, once replaced, it will lose the infinite zoom adjustment of our eyes.
Therefore, myopia correction surgery can only be performed on rigid corneas, which is also the most commonly used corneal refractive surgery.
05, Why is corneal refractive surgery commonly used?
Why is this so? The answer lies in the lack of understanding of the cornea in the past. For a long time, our perception of the cornea tends to be a simple rigid structure, so it is often done in a one-size-fits-all manner.
However, in reality, the cornea is not the same, and the details are very irregular. In fact, the cornea is more like a topographic map, with uneven details that vary from person to person, plus each person's refractive power, astigmatism, and corneal irregularities, so everyone has unique corneal information.
In this case, if the traditional one-size-fits-all is adopted, then it will lead to some people with good correction results and some people with worse correction results. Because of this, corneal correction also needs to be accompanied by improvements in refractive techniques [4,5].
From the basic treatment of the earliest 1.0 era, considering that the two eyes are completely consistent and synchronized, the 2.0 version of wavefront guidance was introduced to deal with the wavefront difference of the eyeball. With the deepening of corneal understanding, corneal topography-guided 3.0 corrective surgery has emerged, which can better customize the treatment of cornea conditions in different people and is more targeted [6,7].
Now, with the improvement of optical technology and algorithms, myopia surgery has entered the era of whole-eye customized treatment. [6.7] This technique is more personalized and more perfect, as it directly customizes a realistic 3D model of the eyeball for each person's eyes [6.7].
The answer is: first, the whole eye data collection is carried out, which can not only collect corneal data, but also pass light through our cornea, anterior chamber, lens and axial path, so as to completely explore our eyes and light paths, and finally give a real 3D model of the eye [6.7].
With this basic model, the next step is to give a customized optimal corneal cutting profile [6.7].
The next step is to import the corresponding data into the excimer laser machine, which then cuts the cornea according to the optimal corneal cutting parameters given by the big data and the new algorithm. In addition, during the later surgical process, the excimer laser will also accurately capture the micro-dynamics of the eye to ensure the cutting position [7,8,9].
Under this fine and precise operation, the accuracy and reliability of the operation can be guaranteed to the greatest extent, and efforts are made to reduce the probability of problems in myopia surgery and improve the safety of surgery.
But then again, whether it is the measure of wearing corrective lenses or the radical curation of corneal refractive surgery, it is for the current situation. The formation of myopia is also a habitual problem, for example, studies have found that less outdoor activities are highly correlated with myopia, and many people overuse their eyes to exacerbate myopia.
Because of this, you must adjust your habits, such as not using your eyes for a long time and increasing outdoor activities, so that your vision can be maintained in a better state.
1 Jorge J, Almeida JB, Parafita MA. Refractive, biometric and topographic changes among Portuguese university science students: a 3-year longitudinal study. Ophthalmic Physiol Opt. 2007; 27(3):287-294.
2 Lee, Samantha Sze-Yee, Gareth Lingham, Paul G. Sanfilippo, Christopher J. Hammond, Seang-Mei Saw, Jeremy A. Guggenheim, Seyhan Yazar, and David A. Mackey. "Incidence and progression of myopia in early adulthood." JAMA ophthalmology 140, no. 2 (2022): 162-169.
3 Tao Ran, Wang Zhenghe, Dong Bin, and Ma Jun. "The Effect of Watching Different Screens on Students' Poor Eyesight." CHINESE JOURNAL OF SCHOOL HEALTH 40, No. 9 (2019): 1369-1372.
4 Schumacher, Silvia, Michael Mrochen, Jeremy Wernli, Michael Bueeler, and Theo Seiler. "Optimization model for UV-riboflavin corneal cross-linking." Investigative Ophthalmology & Visual Science 53, no. 2 (2012): 762-769.
5 SIMON, DANIEL, SILVIA SCHUMACHER, and MICHAEL MROCHEN. "Ray Tracing: the Future of Refractive Surgery."
6 Donitzky, Christof, and M. D. Theo Seiler. "Optical ray tracing for the calculation of optimized corneal ablation profiles in refractive treatment planning." Journal of Refractive Surgery 24, no. 4 (2008): S446.
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