What should I do if I have severe myopia?

If you have high myopia—typically defined as a refractive error of −6.00 diopters or more—it’s important to recognize that this is not just a vision correction issue but a condition requiring ongoing ophthalmologic monitoring. High myopia increases the risk of serious sight-threatening complications, including posterior vitreous detachment, retinal tears and detachments, myopic maculopathy (such as choroidal neovascularization or macular atrophy), glaucoma, and early-onset cataracts. Therefore, comprehensive dilated eye examinations should be performed annually—or more frequently if clinically indicated—to assess retinal integrity, optic nerve health, intraocular pressure, and macular structure.

Corrective options include spectacles, contact lenses (including specialty soft or rigid gas-permeable lenses), and, in select cases, refractive surgery such as LASIK or SMILE—but only after careful evaluation confirms stable refraction, adequate corneal thickness, and absence of contraindications like progressive axial elongation or significant retinal pathology. Importantly, refractive surgery does not reduce the long-term ocular risks associated with high myopia; it only addresses optical correction.

Lifestyle and preventive strategies also play a role: consistent outdoor activity during childhood and adolescence may help slow myopia progression, while avoiding excessive near work without breaks (e.g., following the 20-20-20 rule) supports visual comfort. For children and adolescents with rapidly progressing myopia, evidence-based interventions—including low-dose atropine eye drops, orthokeratology (overnight rigid contact lenses), or multifocal soft contact lenses—may be considered under the guidance of a pediatric ophthalmologist or optometrist specializing in myopia control.

Patients with high myopia should be counseled on warning signs requiring urgent evaluation: sudden onset of new floaters, flashing lights (photopsia), a curtain-like shadow in the peripheral or central visual field, or abrupt decline in visual acuity. Prompt assessment can prevent irreversible vision loss. Regular follow-up with an ophthalmologist ensures timely detection and management of complications, preserving functional vision over the lifespan.