Myopia (Nearsightedness)

Warsaw · Krakow · Vienna · Zurich

Myopia (nearsightedness) causes distant objects to become blurry, and everyday activities require squinting or reaching for glasses. The higher the refractive error, the harder it is to see clearly even from a short distance.
Modern correction methods can effectively restore visual acuity and quality of life without limitations.

Myopia in Brief

Myopia (nearsightedness) is the most common refractive error—the eye is too long relative to its refractive power.The image forms in front of the retina, so distant objects are blurry, while near vision is good.
It does not reverse on its own, but in adults it usually stabilizes.A prerequisite for laser surgery is a stable refractive error—refraction should not have changed for at least one year.
It is most commonly corrected by laser using the FemtoLASIK or SmartSight method.The procedure takes 15–20 minutes for both eyes and is performed under topical anesthesia; prices start at 10,000 PLN for both eyes.
For very high myopia or thin corneas, a phakic ICL lens may be safer.Which option is suitable is determined by corneal tomography during the qualification examination.

SwissLaser in numbers: over 25,000 procedures performed by the chief surgeon · clinics in Krakow, Warsaw, Vienna, and Zurich · Google: 5.0 (169 reviews, Krakow) and 4.9 (256 reviews, Warsaw)

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Preliminary Qualification

How We Correct Myopia – Method Comparison

Method	For Whom	Price
SmartSight Nova	up to -10 D (astigmatism up to 5 D), flapless, best night vision	15,000 PLN for both eyes
SmartSight	up to -10 D, flapless method, less dry eye	13,600 PLN for both eyes
FemtoLASIK	up to -10 D, gold standard, fast recovery	11,000 PLN for both eyes
Trans-PRK	up to -6 D, thin cornea, no-touch method	10,000 PLN for both eyes
ICL EVO/EVO+ Lenses	up to -20 D, when laser is insufficient; for younger patients, as the natural lens remains in place; fully reversible	11,000 PLN per eye
Lens Replacement (RLE)	from approximately age 55 or with cataracts; corrects refractive error and eliminates future cataracts	11,000 PLN per eye

Myopia is one of the most common refractive errors.

It is estimated that 2.1 billion people worldwide have myopia—by 2030 there will be 3.5 billion.

What Is Myopia (Nearsightedness)?

Myopia (nearsightedness) is a refractive error in which parallel light rays entering the eye focus not on the retina, but in front of it. A nearsighted person sees distant objects unclearly and must constantly squint to sharpen the image. The higher the myopia, the shorter the distance from which one can see clearly. With very mild myopia (-1/-2 diopters), wearing corrective glasses or lenses is not always necessary; however, when the error is higher, even reading text from a standard distance becomes difficult—letters in a book or newspaper blur and must be brought very close to the eyes.

Depending on the degree of severity, it is divided into:

low—also called school myopia, up to -3 D,
moderate—between -3 D and -6 D (according to some sources between -3 D and -8 D)
high—above -6 D (according to some sources above -8 D)

Why Myopia Should Not Be Ignored

Until recently, it was said that with low myopia it is better not to wear glasses so that “the eye does not become lazy and continues to work.” Today this view is considered incorrect—uncorrected myopia causes not only blurred distance vision (which is sufficiently troublesome in itself), but also frontal headaches and dizziness, a sense of spatial disorientation, poorer vision at dusk and at night. Constant rubbing and squinting can also cause tearing, burning, and even conjunctival inflammation. The contemporary approach to treating myopia recommends full correction of the refractive error. It has been proven that non-correction or under-correction (correction with lenses that are too weak) leads to faster progression of myopia.

How Is Myopia Diagnosed?

After an initial interview, an optometrist or ophthalmologist will perform skiascopy or refractometry.

Skiascopy (retinoscopy)—involves projecting a beam of light onto the fundus and observing the direction of movement of the red reflex from the fundus within the pupil. The examination uses special bars (rulers) or a Hess wheel with lenses of varying power. To perform the examination, it is necessary to pharmacologically paralyze the ciliary muscle responsible for accommodation.

Refractometry (“computerized vision test”)—a computer-controlled examination of refractive error that uses the principle of skiascopy. After the examination, a printout is obtained with the value of the spherical error (myopia) and/or astigmatism.

Causes of Myopia

In the vast majority of cases, myopia is associated with abnormal eye structure. We distinguish the following types of myopia:

axial—caused by an excessively long eyeball and increases as it elongates and stretches at the posterior pole of the sclera, choroid, and retina. At birth, every child’s eyes have so-called physiological hyperopia (the light beam focuses behind the retina), which gradually decreases as the eyeball lengthens, achieving emmetropia (emmetropization). Sometimes the process of eyeball elongation continues further, leading to myopia.
lenticular (curvature)—caused by excessive curvature (convexity) of the lens, its swelling, or a change in its refractive power
corneal—results from excessive curvature of the cornea

How Does Axial Myopia Develop?

Axial myopia, which is most common in the population, increases gradually until eye growth is complete (i.e., until approximately age 21). Accelerated growth occurs during puberty, then slows down. Typically, the error increases by 0.5 D to 1 D per year.

Types of Myopia: School and Refractive

In medical terminology, two more terms exist: school myopia and refractive myopia. The first refers to mild myopia appearing around age 10–12 and potentially increasing due to constant accommodative strain and excessive near work—when a child reads too much, studies, or looks at a television, smartphone, or computer screen. Refractive myopia, on the other hand, is not directly related to eye anatomy but to the refractive index of the lens—the lens refracts incoming rays too strongly. Refractive myopia can result from developing diabetes or cataracts.

Eye Exercises for Nearsighted Individuals

High myopia, most often genetically determined, can cause degenerative changes in the eye, so from the moment of diagnosis the patient should be under constant ophthalmological supervision. At the beginning, when we are still dealing with mild myopia, the doctor may recommend various exercises and lifestyle changes. These include:

Frequent outdoor time—research results indicate that 2–3 hours of outdoor time daily contribute to slowing myopia progression. This is most likely related to reduced need for accommodation, pupil constriction in brighter lighting (better depth of field), and the direct effect of light exposure (release of the retinal transmitter dopamine, known as an inhibitor of eyeball growth under certain conditions). The key is not the type of activity, but the fact that it takes place in daylight.
Observing visual hygiene principles: reading in a seated position, holding text at an appropriate distance, good lighting of the workspace, taking breaks during prolonged near work.
Repeating accommodation-relaxing exercises several times a day, such as loosely gazing at a distant chosen object for several minutes.

Myopia and Astigmatism

Myopia may be accompanied by astigmatism, a refractive error in which the eye’s optical system cannot properly focus light rays on the retina. Parallel light rays refract in two different planes (e.g., vertical and horizontal), resulting in image blur, distortion and waviness, and poor contrast. When both errors occur together, sphero-cylindrical spectacle lenses or toric contact lenses are used.

Methods of Correcting Myopia

Glasses and soft contact lenses: a nearsighted person needs concave diverging lenses, i.e., “minus” lenses. Glasses should be selected appropriately for the refractive error—under-correction is not recommended. An optometrist or ophthalmologist selects lenses with the lowest possible power in which the patient sees optimally. Soft contact lenses correct the error better at moderate and high values—they do not disturb the field of vision (in glasses one sees well only straight ahead) and do not reduce the size of objects, making it easier, for example, to drive a car. There are scientific reports that the use of soft contact lenses in children slows or halts myopia progression. It is believed that the pressure of the lens on the outer layers of the cornea causes it to flatten. In addition, contact lenses reduce accommodation and slightly reduce intraocular pressure, which is one of the factors influencing eyeball length growth.
Orthokeratology/orthocorrection: involves correcting myopia using rigid highly gas-permeable lenses with reverse geometry, worn overnight. During this time, the lenses change the shape (flatten) the anterior surface of the cornea, allowing clear vision during the day without glasses. Orthocorrection can be used for myopia from 1 D to 5 D.
Laser methods: in individuals with stabilized refractive error, laser surgery can be undertaken. During laser myopia treatment, the central part of the cornea is flattened to reduce refractive power.

lasers

Laser Vision Correction Procedures

LASEK/PRK

The procedure involves deflecting (LASEK) or removing (PRK) the upper cellular layer of the cornea (epithelium), then appropriately reshaping the underlying corneal tissue using an excimer laser.The goal of the procedure is to appropriately reshape the central corneal surface with the laser beam so that it focuses the image precisely on the retinal surface.

LASIK

A two-stage technique; the cornea is incised using a blade (microkeratome), then the corneal surface is reshaped so that it can properly focus the image on the retina.

Femto-LASIK

Using a precise femtosecond laser, the surgeon makes an incision in the cornea, creating a thin flap 0.1 mm thick. An excimer laser is used to reshape the previously exposed cornea for a few seconds, then the flap is closed again; it adheres and forms a protective corneal barrier.

Trans-PRK smart surFace

The least invasive method of laser myopia treatment. Diopter correction takes place in the first stage of the procedure, while the surgeon uses a high-precision excimer laser. PRK was once the standard method of laser eye treatment, and the LASIK method replaced it because it involved less pain. However, the LASIK technique failed in patients whose corneas were too thin or irregular. Modern Trans-PRK capabilities have contributed to optimizing the procedure at the most critical point.

Lens Surgery: When Instead of Laser

Laser reshapes the cornea and works well for patients with stable refractive error and sufficiently thick corneas. However, there are situations in which we work on the lens, not the cornea.

Phakic ICL Lenses for Younger Patients

The ICL lens is implanted in front of the natural lens, which remains in place along with full accommodation ability. Therefore, ICL is a solution for individuals over twenty-one years of age for whom laser is not an option: for myopia up to -20 D, for thin or irregular corneas, and also for dry eye syndrome. The procedure is reversible; the lens can be removed or replaced. The price is 11,000 PLN per eye, one price for each variant, including toric.

Lens Replacement from Approximately Age 55

After age fifty, the natural lens loses elasticity, and over time begins to cloud. Laser correction would then remove myopia but would not stop this process, so cataract surgery would follow in a few years. Therefore, for patients in this age group we propose replacing the natural lens with an implant that corrects myopia and simultaneously eliminates future cataracts. Depending on expectations, we select a monofocal, EDoF, or trifocal implant.

With Diagnosed Cataracts

If the lens is already clouded, cataract surgery corrects myopia at the same time: we remove the clouded lens and implant a lens calculated for your eye. Two problems are solved by one procedure. The price is 11,000 PLN per eye, the same as for lens replacement.

Which of these paths to choose results from the examination: age, corneal thickness, eyeball length, and the condition of the natural lens. That is why the qualification takes approximately 90 minutes.

Expert Commentary

Dr. med. Victor Derhartunian, FEBO, FWCRS – ophthalmic surgeon, SwissLaser Warsaw and Krakow

“I have removed the lenticule to correct myopia approximately 6,000 times. For refractive errors above -8, -10 diopters, I do not push laser—phakic ICL lens simply provides better vision quality then. Honest qualification is half the success.”

Dr. med. Victor Derhartunian, FEBO, FWCRS
– refractive surgeon, over 25,000 laser procedures

Frequently Asked Questions (FAQ)

What is myopia and how does it manifest?

Myopia (nearsightedness) is a refractive error in which light rays refract in front of the retina rather than on it—a nearsighted person sees distant objects unclearly and reflexively squints. Depending on severity, the error is divided into low (up to -3 D), moderate (from -3 to -6 D), and high (above -6 D). Uncorrected myopia can also cause headaches and dizziness, poorer vision at dusk, and tearing and burning of the eyes.

What laser methods does SwissLaser use to correct myopia?

In our clinic we perform procedures including SmartSight, Femto-LASIK, and Trans-PRK smartsurFace—the least invasive surface method, also suitable for thin corneas. During laser correction, the central part of the cornea is flattened to reduce refractive power and precisely focus the image on the retina. As a reference center for Schwind, we use modern, certified technologies.

I have very high myopia—is there a solution for me?

Yes. When the refractive error exceeds laser capabilities (usually above -8/-10 diopters) or the cornea is too thin, Visian ICL phakic lenses are an excellent alternative, allowing correction of myopia up to -20 diopters. The lens is implanted in the eye without removing the natural lens, and the procedure is fully reversible.

How does qualification for myopia correction proceed?

A prerequisite for the procedure is stabilized refractive error—axial myopia usually increases until eye growth is complete, i.e., until approximately age 21. During the qualification examination, we perform computerized refraction testing and detailed corneal diagnostics, based on which the doctor selects the optimal method—laser or lens. At the preliminary consultation, we will propose the technique appropriate for your refractive error.

How much does high myopia correction with ICL lenses cost?

Implantation of a Visian ICL EVO/EVO+ lens (also in the toric variant) costs 11,000 PLN per eye, and we perform the procedure at our clinics in Warsaw and Krakow. The qualification examination costs 400 PLN. Procedures are not reimbursed by the National Health Fund; we offer installment plans through Santander Consumer Bank.

Can uncorrected myopia worsen?

Yes—it has been proven that lack of correction or correction with lenses that are too weak leads to faster myopia progression, which is why contemporary ophthalmology recommends full correction of the refractive error. High myopia can also cause degenerative changes in the eye and requires constant ophthalmological supervision. Myopia progression in children is slowed by daily outdoor time of 2–3 hours and visual hygiene.

How does a person with myopia see?

Near clearly, far blurred—the higher the refractive error, the closer sharp vision ends. A nearsighted person with -3 D sees clearly up to approximately 33 cm, at -10 D only up to 10 cm. Distant lights blur into spots, which is why the error is most troublesome at night.

Is myopia minus?

Yes. Myopia is corrected with diverging lenses, marked with a minus sign, e.g., -2.5 D. Plus signs correct hyperopia.

Can myopia be cured?

The refractive error does not reverse on its own, and exercises or drops will not eliminate it. However, it can be permanently corrected: by laser (SmartSight, SmartSight Nova, FemtoLASIK up to approximately -10 D, Trans-PRK up to -6 D) or phakic ICL lens up to -20 D. A prerequisite is stable refractive error for at least 12 months.

Myopia in children—how to slow its progression?

Myopia usually increases until eye growth is complete, around age 21. Progression is slowed by: at least two hours daily in natural light, breaks from near work, full correction of the refractive error, and inhibition methods recommended by a pediatric ophthalmologist, such as special lenses or drops. Laser is an option only after the refractive error has stabilized.

Myopia and astigmatism—can both be corrected at once?

Yes. Most laser procedures correct myopia together with astigmatism in one profile—SmartSight Nova with eye rotation compensation up to 5 D cylinder, FemtoLASIK Wavefront up to 6 D. For high refractive error, a toric ICL lens does this.

For the curious: Myopia (ICD-10 H52.1, ICD-11 9D00.0) is a refractive error in which the eyeball is too long relative to the optical power of the cornea and lens, so the image of distant objects focuses in front of the retina. Classification: low up to −3.0 D, moderate up to −6.0 D, high above −6.0 D; high myopia increases the risk of retinal detachment and requires periodic fundus examination regardless of correction.

Sources

Holden BA, Fricke TR, Wilson DA et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology 2016;123(5):1036–1042. doi:10.1016/j.ophtha.2016.01.006
Chuck RS, Jacobs DS, Lee JK et al. Refractive Errors & Refractive Surgery Preferred Practice Pattern. Ophthalmology 2018;125(1):P1–P104. doi:10.1016/j.ophtha.2017.10.003
Kim TI, Alió Del Barrio JL, Wilkins M, Cochener B, Ang M. Refractive surgery. Lancet 2019;393(10185):2085–2098. doi:10.1016/S0140-6736(18)33209-4

When Do We Advise Against Laser Correction?

Laser myopia correction is safe precisely because we do not perform it on everyone. We advise against the procedure or propose a different method when:

the refractive error is still progressing—refraction has changed in the past year,
the cornea is too thin or irregular (including suspected keratoconus),
the patient is under approximately 21 years of age—the refractive error may still change,
during pregnancy and breastfeeding,
with very high myopia—then a phakic ICL lens may be a safer solution.

That is precisely what the qualification is for: if the procedure is not for you, you will hear it from us directly—along with a safer alternative.

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Google rating: Warsaw 4,8 (reviews: 258) · Krakow 5,0 (reviews: 171). All reviews, without selection or editing, can be read directly on Google: Warsaw · Krakow.

Myopia Explained in a Minute

Myopia is not a defect of “too strong glasses,” but an eyeball that is too long or a cornea that refracts too strongly. Below is a brief explanation of where it comes from and how it is corrected today.