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6 High Myopia Treatment Options

By Stefanie Sandler Billette, MS, ACE-CHC
High myopia can put you at risk for sight-threatening diseases, but there are treatment options that may help.

According to a 2019 article published in Community Eye Health Journal, high myopia occurs when a person's myopia, or nearsightedness, requires -5 diopters or more of correction. A diopter is the unit that measures the focusing power of a prescription lens. A negative diopter reading indicates nearsightedness, and the higher the negative number, the thicker your lenses will be. High myopia increases the risk of blinding eye conditions, including glaucoma, cataract, retinal detachment, and macular degeneration, so treatment is recommended. The following are high myopia treatment options.

LASIK Eye Surgery

LASIK (laser-assisted in situ keratomileusis) is a type of refractive eye surgery that gives almost immediate results, according to the Mayo Clinic. Cleveland Clinic notes that the procedure uses a laser to create a flap in "the outer layer of the cornea to reshape the layers underneath, resulting in fast healing time with minimal discomfort."

“When considering LASIK, it’s important to keep in mind that this treatment will not prevent eyes from getting worse, so it’s best to make sure your eyes have stopped growing,” Nathan Bonilla-Warford, OD, an optometrist in Tampa, Fla., tells WebMD Connect to Care. Bonilla-Warford says LASIK is not recommended for children for this reason.

Photorefractive Keratectomy (PRK)

PRK uses a laser to reshape the cornea, according to the Cleveland Clinic. Doctors perform the procedure on the surface of the cornea rather than underneath it. According to the American Academy of Ophthalmology, PRK may be a better option than LASIK for patients with dry eyes or thin corneas. However, PRK is not recommended for people with very high myopia (greater than -10 diopters).

Small Incision Lenticule Extraction (SMILE)

According to the American Academy of Ophthalmology, SMILE is a newer type of laser refractive surgery that is approved by the Food and Drug Administration (FDA) to treat mild nearsightedness and astigmatism. The procedure has also been studied and used to treat high myopia. Your doctor may recommend SMILE over LASIK or PRK if you have an active lifestyle.

Phakic Intraocular Lenses (IOLs)

Phakic IOLs are artificial lenses that are implanted in front of or behind your iris, according to the FDA. The procedure does not remove your natural lenses. 

A 2020 study published in theJournal of Refractive Surgery suggests that IOLs for high myopia are more effective than SMILE and have fewer side effects. However, phakic lenses are not recommended for patients under 21.

Orthokeratology (Ortho-K)

According to the American Academy of Ophthalmology, orthokeratology involves using specially fitted rigid contact lenses that reshape your corneas to improve nearsightedness. Patients usually wear the lenses at night, so glasses or contacts are not necessary during the day. Although vision correction is temporary, the treatment is often compared to dental braces.

Orthokeratology is an option for all ages, and you can adjust your prescription as needed. This treatment may involve multiple visits to an eye doctor over several months.

Clear Lens Extraction (CLE), or Refractive Lens Exchange (RLE)

According to the American Academy of Ophthalmology, CLE replaces your eye’s natural lens with an IOL. It's also known as refractive lens exchange (RLE). Doctors often recommend this procedure over LASIK for patients with severe farsightedness.

A 2020 study published in theIndian Journal of Ophthalmology suggests that CLE may be a good option for correcting high myopia if you are not a good candidate for phakic intraocular lenses.

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