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Short-sightedness Q&As

Published by Bupa's health information team, December 2008.

Answers to questions about short-sightedness

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

 

Does reading in poor light or getting too close to a book or computer screen when I'm reading cause short-sightedness?

It's possible. You are more likely to be short-sighted if it runs in your family or if you were born prematurely. However, it's also possible that doing a lot of reading or close-up work, especially when you are a child or young adult, may mean you are more likely to develop short-sightedness.

Explanation

There are a number of different reasons why you might develop short-sightedness, some of which can be treated.

Researchers have found that if you're short-sighted, your children are likely to have a condition that means they have a higher risk of developing short-sightedness. If you have one parent who is short-sighted, there is a one in three chance you will also be short-sighted. If both of your parents are short-sighted, there is a one in two chance you will be too.

Researchers have found that the number of people who are short-sighted differs depending on ethnic background. For example, around eight in every 10 people of Asian origin are short-sighted, whereas only three in every 10 people of European origin are.

There is also an increasing amount of evidence to show that how you use your eyes when you're a child and a young adult can affect your sight in the future. Children and young adults who read a lot or do a lot of close-up work, for example using a computer, may be more likely to develop short-sightedness. Research also shows that people who work in jobs that need them to read a lot, for example lawyers and doctors, are more likely to be short-sighted. The reasons why this happens aren't fully understood.

Babies who are born earlier than usual and who are underweight at birth are more likely to develop short-sightedness. This will happen in as many as one in every two babies who are born prematurely.

Further information

Sources

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Can you tell me more about laser surgery?

Laser surgery permanently changes the shape of the cornea in your eye which means that after the operation you should be able to see well without wearing glasses or contact lenses. There are three main kinds of laser surgery for short-sightedness and your surgeon will help you to choose the best one for you.

Explanation

Your cornea is the clear layer that covers the surface of the eye in front of your iris - the coloured part. Laser surgery for short-sightedness makes the middle of your cornea flatter than the outside. This refocuses light and helps you to see things in the distance more clearly. The instruments used for laser surgery don't actually enter your eye so the risk of infection or damage is very low.

Laser surgery for short-sightedness is safe and works well but it's not suitable for everyone. It may not be right for you if:

  • your sight has changed a lot in the previous two or three years
  • you have other eye conditions such as cataracts or glaucoma
  • you have certain medical conditions including diabetes or rheumatoid arthritis

Your surgeon will be able to advise you.

There are three main kinds of surgery for short-sightedness. These are:

  • photorefractive keratectomy (PRK)
  • laser epithelial keratomileusis (LASEK)
  • laser in situ keratomileusis (LASIK)

All three types of laser surgery work equally well and there is no real difference in how well you're able to see once you have recovered from surgery.

Before you have surgery you will need to see an ophthalmologist (a doctor who specialises in eye health and surgery) who will examine you to make sure surgery is right for you and to decide which type would suit you best. At this first appointment your surgeon will carry out a number of tests looking at the structure of your eye, how well you see in low light and how your eye is shaped. If you wear soft lenses, you shouldn't wear them for a day before your appointment so your surgeon can see your eyes in their usual state. If you wear gas permeable or hard lenses, you need to leave them out for seven days before your appointment. You will be given eye drops which could make everything blurred for a while, so check with your surgeon whether you will be able to drive home.

Laser surgery is a quick operation - you will probably be at the clinic for about an hour. Take someone who can make sure you get home safely. Don't wear make-up and bring sunglasses to wear when you leave. You will need to remove your contact lenses for a few days before your surgery, as you did before your first appointment, otherwise your surgeon may not be able to do the operation.

Your surgeon will give you local anaesthetic eye drops so that you won't feel anything during the operation. The surgery takes a few minutes and you will be awake throughout. Afterwards your surgeon will give you eye drops to prevent infection and reduce any redness and swelling. You will need to use these for about a week. You will be asked to wear a plastic eye shield for the next 24 hours and every night for a week to protect your eye. You will need to use artificial tears for some time after your operation - how long will depend on your eyes and the surgery you had. Your surgeon will be able to advise you.

How quickly you recover and how long it takes for your eyesight to adjust depends on what kind of surgery you have. Most people have very little pain or discomfort after their operation and go back to work and their usual activities within a few days. Whatever procedure you have you will need to wear tinted glasses with ultraviolet protection for three months after your operation. It might take up to two weeks for you to be able to drive. If you're in any doubt about driving, please contact your motor insurer so that you're aware of their recommendations, and always follow your surgeon's advice.

If you have PRK surgery, it will usually take between one and three months for your sight to become stable and your short-sightedness to go. If you have LASIK or LASEK, this usually happens sooner - within about a month of your operation. However, you may find it takes much longer and it can take up to nine months for your short-sightedness to disappear. It's important to know that not everyone gets the improvement in their sight that they expect after laser surgery.

Further information

Sources

  • Photorefractive (laser) surgery for the correction of refractive errors. National Institute for Health and Clinical Excellence (NICE), 2006. www.nice.org.uk, accessed 26 June 2008
  • A patients' guide to excimer laser refractive surgery. The Royal College of Ophthalmologists. www.rcophth.ac.uk, accessed 26 June 2008
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What are the risks of having laser surgery compared to wearing contact lenses?

The main risk with contact lenses is infection but this can be prevented by looking after your lenses and your eyes properly. Laser surgery may not give you the improvement in your sight that you expect and there is a small risk of new eye problems and infection.

Explanation

Every operation has risks as well as benefits. It's important to think carefully about whether laser surgery is right for you and whether the benefits outweigh the risks compared to wearing contact lenses. Your optometrist or ophthalmologist will be able to give you more information.

People usually wear contact lenses because, unlike glasses, they can't be seen. Many people find that they can see better with contact lenses compared to glasses because the lenses sit directly on the eye. This means there are no spaces around the lenses that aren't in focus, unlike with glasses.

There are many different kinds of contact lens available, some you use daily and then throw away, others you clean each night and use again. Some contact lenses can also be worn for longer periods of time. It's important to have regular check-ups with your optometrist to make sure that your eyes are healthy and that you're using the best lenses for your needs.

The main risk with contact lenses is infection. If you go to sleep wearing your contact lenses, you have a greater risk of eye infection than if you take them out. Gas permeable lenses and daily disposable lenses have a very low risk of infection. It's important that you care for and store your lenses properly to prevent infection. You can help reduce the risk of an eye infection by:

  • disinfecting re-usable lenses in between using them - this usually means soaking them in a special solution overnight
  • never using the same disinfecting solution twice - always throw it away after you have used it
  • rinsing your storage case and leaving it open to dry every day
  • using a new storage case every month
  • cleaning your storage case once a week using a clean toothbrush and contact lens solution
  • not sleeping in your contact lenses unless your optometrist or ophthalmologist has told you to
  • always washing your hands before you touch your lenses
  • seeing your GP or optometrist immediately if you have red or sore eyes and you think you might have an infection
  • only using contact lens solution to clean your lenses rather than tap water or saliva
  • not wearing your contact lenses when you go swimming if you aren't wearing goggles

Laser surgery for short-sightedness is safe and works well but it's not suitable for everyone. It doesn't always work completely first time and you might end up having the operation done more than once.

You can have laser surgery on both eyes at the same time. Although the risk of serious side-effects to both eyes is very rare, it does sometimes happen. This means you could have permanent sight problems affecting your ability to work, read or drive. Talk to your surgeon about the benefits and risks of surgery. The main benefit of laser surgery is that you should be able to see well without wearing contact lenses or glasses. Some of the main risks are listed here.

  • Surgery may not give you the improvement in your sight that you expected. Research has shown that if you have mild or moderate short-sightedness and you have LASEK or LASIK surgery, you're likely to get a good result with your sight improved compared to wearing glasses. However, five out of every 1,000 people who have PRK have worse eyesight afterwards than they had before the surgery. If you're very short-sighted, you're more likely to find your sight gets worse after surgery than people who have mild or moderate short-sightedness.
  • Some people who have laser surgery develop other sight problems after the operation, most of them to do with seeing at night. You might find that you can't see very well in dim light, that objects have a halo of light around them at night and that sometimes you have problems with glare. You may also find that your sight is hazy. These problems can affect your ability to drive at night but usually only last for four to six weeks. However, a few people find they have long-term problems. LASIK has the lowest risk of these problems.
  • A small number of people get an infection in their cornea following LASIK surgery. This is about the same number of people who get infections from wearing contact lenses.
  • Ectasia is a medical term which means that the middle part of your cornea starts to bulge outwards. It happens because too much of the cornea is removed during surgery making it too thin. This can be a serious problem and may mean you lose the sight in that eye. Ectasia happens to about two in every 1,000 people who have laser surgery.

Further information

Sources

  • Contact lens care. The College of Optometrists. www.college-optometrists.org, accessed 26 June 2008
  • Photorefractive (laser) surgery for the correction of refractive errors. National Institute for Health and Clinical Excellence (NICE), 2006. www.nice.org.uk
  • Source. www.rcophth.ac.uk accessed 26 June 2008
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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: December 2008

 

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