Light coming into the eye is focussed to a point on the retina by the cornea (the clear structure on the front of the eye) and the lens inside the eye. If the focussing power of the eye is too strong for the length of the eye, or if the eye is too long for its focussing power, the light comes to a focus in front of the retina and by the time it reaches the retina, it is diverging again and so it is out of focus or blurry (see diagram).
We currently correct myopia by putting glasses in front of or contact lenses on the eyes that defocus, or diverge the light a little, so that it can come to a point focus on the retina. Surgically, we can remove some of the cornea with laser to reduce its focussing power (LASIK). Or we can remove the lens of the eye and replace it with a weaker lens (lens extraction and intraocular lens implant).
What causes myopia?
Some people are born with myopia, either because the combined power of the cornea and lens to focus light is too strong, or because the eye is too long (congenital myopia).
More commonly, myopia comes on later in life, often in the teenage years (acquired myopia).
So what happens?
Our eyes are spherical and designed to see clearly in the distance, with all the muscles in and around the eyes relaxed. To see up close, the internal muscles contract, changing the position and shape of the lens inside the eye so it can focus more strongly.
No-one teaches us how to see. When we are babies, we see and feel everything, the whole world around us, but we cannot really focus clearly on things to begin with. Our eyes simply receive light and the shapes of our loved ones and other things around us.
As we grow and learn to focus, to develop sharper close vision, some of us do this with a degree of tension in the muscles around the eyes, and if this tension is sustained, it can gradually pull the eye into a more elongated shape, hence inducing myopia.
There is definitely an acquired element to myopia, as it can come on later in life and can be progressive. Myopia is now developing at younger and younger ages, and the incidence of myopia worldwide is increasing as we spend more and more time focussed in on our screens and close work. In some south-east Asian countries, nearly all the young men are now myopic, and this has changed within a very short time, much too short to blame our genes, and definitely related to environmental factors, particularly the intensity of schoolwork from a very young age, trying to do well to please our parents and teachers, our dependence on small screens, and spending much more time indoors.
So if we can create myopia, can we reverse it?
If we address myopia in the early stages, there may be a reversible element, especially in children and young people. On a physical level, teaching children to relax their eye muscles in between contracting them for close work can help. Palming exercises, where you close your eyes gently, feeling the warmth of your lids and the roundness of your eyeballs, cover your eyes with your cupped palms, and breathe gently, allowing yourself to relax into and enjoy the warmth of your palms and resting your eyes, can certainly help the eye muscles (and you) to relax. Varying your focus, by gazing in the far distance, and in the middle distance, as well as up close if you spend hours on a computer, can help to keep the muscles moving and supple, rather than fixed in one position. Getting up and moving around and going outside in the sunshine and enjoying nature can help your eyes and your whole body too.
On a deeper level, allowing children to grow up to be just who they are and to celebrate that, without our imposition of how we want or need them to be for us, so that they don’t feel they need to try so hard to fulfil our expectations, our unmet needs and desires, to be someone or something for us, will go a long way to reducing the tension they feel, that can be reflected in their eyes.
Allowing yourself to appreciate you just as you are, without needing or trying to be anyone other than you, and to open up to people, life and the world around you, can open up your vision too, so your gaze is less focussed on a single point, and becomes more open, relaxed and spherical.
Allowing yourself to receive light and life, allowing life to come to you, just as it is, rather than projecting out onto the world what you want to see and narrowing your focus in onto only what you are interested in, will open up your eyes and your perception of yourself, others and life.
Staying open to the big picture of life, and people and the world around you, not just focussed in on your own life, your own problems, your own desires, also allows you to stay open and spherical as a person, as a being, and this will be reflected in your eyes.
Dr Anne Malatt is an eye specialist, or ophthalmologist. She trained as a medical doctor at the University of Melbourne and the Royal Melbourne Hospital for eight years, and then trained for a further five years at the Royal Victorian Eye and Ear Hospital as a specialist in diseases and surgery of the eye. She undertook postgraduate research, and has a Master of Surgery degree from the University of Melbourne. She is a Fellow of the Royal Australian and New Zealand College of Ophthalmologists and the Royal Australasian College of Surgeons.
Anne has been in specialist public and private practice since 1992 and participates in continuing medical education, surgical audit and peer review programmes, to maintain and improve her clinical skills. As well as her commitment to professional development, she is committed to her development as a person and a member of the community, for she sees life as one whole, of which her work is a great part.