Does Myopia Get Worse with Age?

Myopia or nearsightedness simply means you can see well at near and far away distant objects appear blurry. According to the World Health Organization (WHO) there are currently 2.6 billion people worldwide who are myopic which translates to roughly 30-35% of the global population. It is predicted by 2050 nearly 50% of the world’s population will be myopic. At Refine Optometry in Palo Alto, we frequently discuss emerging data with patients and their families. Whether for children or adults, understanding how myopia progresses is important for managing its effects and protecting the eye’s long-term health.

Understanding How Eyes Develop 

At birth: Babies are born with very small hyperopic or farsighted eyes measuring roughly 16-17 millimeters in length. This short axial length causes images to focus behind the retina. 

Infancy to 1 year old: Babies grow very rapidly during their first year of life so we can expect the same with their eyes. This period of rapid growth is called emmetropization where the eye grows to roughly 19-20 millimeters by the first year of life.

Early Childhood until 10 years old: As the child continues to grow we expect their hyperopia to lessen as well. Usually by age 10, the eye reaches roughly 22-23 millimeters in length closer to the size of an adult eye where the image focuses perfectly on the retina and there is no need for any correction in vision. 

Late Childhood to Adolescence:  Our eye doctors in Palo Alto hope our patients remain emmetropic well into adolescence to avoid needing glasses. However, more commonly, we’re seeing that eyes are growing longer than average causing images to focus in front of the retina—better known as myopia or nearsightedness. For our myopic patients their axial length is measuring at 24 millimeters and longer. 

Understanding Myopia and its Impact 

We just went over how eyes normally develop. Now let’s talk to the leaders in Palo Alto Optometry to discuss what is actually happening with our patients’ eyes. Myopia can worsen with age especially now that our children are becoming myopia earlier than expected. On average the eyeball increases in size by 0.1 to 0.2mm per year; however, we’re seeing a more rapid rate of growth for our youth leading to a higher risk for myopia progression. This global trend is alarming as it means so much more than just needing thicker glasses and higher prescriptions 

Why is Myopia Happening Earlier and Continuing as we Age?

1. Increased near work: Both children and adults are spending more time with near activities such as reading, prolonged screen time or tablet use for school work and entertainment. This leads to increased near visual strain. 
2. Urban Lifestyles: Our modern lifestyle is decreasing our time outdoors. Eye doctors in Palo Alto have always advocated more outdoor time as it has a protective effect against myopia. It could be due to natural light, vitamin D or a longer horizon to relax focus. 
3. Genetics: There is a genetic factor to myopia. If both parents are myopic the child has a 50% chance or greater of also being myopic 

Why is Intervention Crucial?

When myopia onsets earlier then it has a longer time to progress. Axial lengths of 24 millimeters and longer are considered myopic and 26 millimeters and longer is considered highly myopic. As the eye continues to grow then it could lead to more complications later in life such as: 

1. Retinal detachments: When the eye grows the retina has to stretch to cover the larger eye making it thinner. Over time the more fragile retinal is more susceptible to tearing or retinal holes. 
2. Macular Degeneration:  The macula is responsible for our central sharp vision. If the retina over the macula is thinned it could lead to micro tears in the area leading to decreased vision or damage to the local vascularization supporting the macula. 
3. Glaucoma:  The larger myopic eye can start to weaken certain structures within the eye such as the optic nerve, sclera and drainage area of the eye. This could decrease the eye’s ability to maintain proper intraocular pressure. 
4. Cataracts:  The growing eye can sustain more oxidative stress leading to premature clouding of our crystalline lens. 

What Are Treatment Options?

The first step to safeguarding our eyes is to have an eye exam by the eye doctors in Palo Alto to diagnose the condition. 

For our youth: We have several myopia control interventional therapies to help slow the progression 

• MiSight Contact Lenses for Myopia Control: Are FDA approved daily soft contact lenses designed to be worn during the day to correct and control the myopia. 

• Orthokeratology Contact Lenses (CRT): Rigid lenses to be worn overnight to gently reshape the cornea to correct and control the myopia. During the day your child will not need any corrective lenses to see. 

• Low Dose Atropine Eye Drop Therapy: Atropine eye drops are instilled every night to help relax the focusing system to alleviate near strain. Glasses or contact lenses are still needed to provide correction to see distance. 
• Lifestyle Changes: At least 2 hours of outside time daily, taking breaks while on the computer, adequate lighting while indoors for school work.

“Managing myopia isn’t just about clearer vision now—it’s about protecting your child’s eye health for the future,” explains Dr. Joy Lam of Refine Optometry.

For our adults: Myopia can still often progress for our young adults in college, those pursuing higher education and more schooling, changes in jobs with increased visual demands and more. Most of the optional available for children are still viable for adults with the exception of the low dose atropine drops. 

1. MiSight Contact Lenses for Myopia Control and Orthrokeratology: We have fit many adults into both Misight and Orthokeratology. It is never too late to start!
2. Lifestyle Changes:  Adults have more time constraints and are even more limited with their time outdoors. Making a conscious effort to attempt these lifestyle changes would not only reduce risk, but also reduce eye strain. 
3. Computer or Reading Glasses: Many adults are spending the majority of time at work on the computer. In these cases, supplemental computer or reading glasses may help to reduce that near strain. 

Final Thoughts

While myopia can progress with age, proactive management can significantly reduce its impact. Whether it’s slowing progression in children with innovative treatments or maintaining stable vision in adults, early intervention and regular care are essential.

If you have questions about myopia management or want to explore options like MiSight Contact Lenses for Myopia Control, schedule an appointment with us today. At Refine Optometry, we’re here to guide you and your family toward a future of healthier vision.