Myopia, commonly known as nearsightedness or shortsightedness, is one of the most common refractive errors of the eye. It is a vision condition in which light entering the eye focuses in front of the retina instead of directly on its surface, resulting in blurred vision when viewing distant objects. Individuals with myopia can clearly see near objects but struggle to focus on objects far away.
Globally, myopia is considered a major public health concern, affecting approximately 30% of the world’s population, and this prevalence is projected to rise to over 50% by 2050 if preventive measures are not implemented. The rapid increase in myopia rates, especially among children and young adults, is strongly linked to environmental, behavioral, and genetic factors. Nurses, as front-line healthcare providers, play an essential role in patient education, early detection, behavioral modification, and development of care plans tailored to individuals with myopia.
Understanding Myopia
Myopia occurs due to abnormalities in the shape of the eye. The condition typically arises when the eyeball becomes too long (axial myopia) or when the cornea has too much curvature. These structural changes cause the refracted light to fall in front of the retina rather than directly on it, resulting in blurred distance vision.
Types of Myopia
- Simple Myopia: Mild refractive error, usually corrected with glasses or contact lenses.
- High Myopia: Severe refractive error requiring strong corrective lenses; associated with increased risks of retinal damage and glaucoma.
- Pathologic Myopia: Progressive condition involving degenerative changes in the retina and other ocular tissues.
Causes and Risk Factors
Myopia is influenced by genetic and environmental factors. Children of myopic parents are more likely to develop myopia. Excessive near work such as studying, computer use, digital screen exposure, and limited outdoor activities also contribute significantly.
- Genetic predisposition: Family history increases risk two- to eightfold.
- Environmental factors: Prolonged indoor activity, reading without breaks.
- Excessive screen time: Smartphones, tablets, gaming devices.
- Lack of daylight exposure: Reduced ultraviolet exposure affects eye growth.
Signs and Symptoms of Myopia
Patients with myopia often present with:
- Difficulty seeing distant objects
- Squinting or narrowing eyes to see clearly
- Frequent headaches or eye strain
- Sitting too close to screens, television, or reading material
- Reduced academic performance due to visual impairment
Management and Treatment Options
The primary goal of myopia treatment is to improve visual acuity and slow down progression. Treatment strategies include:
- Corrective lenses: Glasses or contact lenses with concave (negative power) lenses to shift image focus onto the retina.
- Refractive surgery: LASIK, PRK, SMILE procedures reshape cornea to correct refractive error.
- Low-dose atropine eye drops: Effective in slowing progression in children.
- Orthokeratology (Ortho-K): Overnight rigid contact lenses temporarily reshape cornea.
- Lifestyle modifications: Increasing outdoor time, reducing screen time, proper reading habits.
Nursing Role in Myopia Care
Nurses play a crucial role in assessing visual acuity, educating patients and families about myopia progression, promoting preventive behaviors, and assisting with treatment adherence. Nursing interventions can significantly improve patient outcomes and reduce the psychosocial impact of living with a sensory impairment.
Nursing Diagnosis for Myopia (NANDA-I Based)
The following are important nursing diagnoses related to myopia:
- Chronic Low Self-Esteem related to impaired sensory acceptance or changes in sensory organ function.
- Anxiety related to changes in health status, eye discomfort, blurred vision, or fear of disease progression.
- Knowledge Deficit related to lack of understanding about myopia, prognosis, treatment options, and preventive measures.
Nursing Care Plans and Interventions
1. Chronic Low Self-Esteem
Related to: Impaired sensory function, use of corrective lenses, changes in physical appearance, or perceived limitations in daily activities.
Expected Outcomes: Patient expresses improved confidence, accepts visual aids, and demonstrates positive adjustment to visual limitations.
- Encourage the patient to verbalize feelings about visual impairment.
- Assist in choosing comfortable and aesthetically pleasing corrective lenses.
- Educate on treatment benefits to enhance self-perception.
- Promote participation in social and academic activities.
2. Anxiety
Related to: Health changes, worry about worsening vision, frequent headaches, or difficulty adapting to corrective lenses.
Expected Outcomes: Patient demonstrates decreased anxiety and improved coping mechanisms.
- Provide clear information about prognosis, corrective options, and expected outcomes.
- Teach relaxation techniques, deep-breathing exercises, or guided imagery.
- Encourage family involvement and reassurance.
- Clarify misconceptions regarding blindness and long-term disability.
3. Knowledge Deficit
Related to: Insufficient information about myopia, preventive strategies, or treatment modalities.
Expected Outcomes: Patient explains the nature of myopia, demonstrates proper use of visual aids, and understands preventive measures.
- Educate about proper eye care, importance of regular check-ups, and screen break intervals.
- Introduce the 20-20-20 rule: every 20 minutes, look 20 feet away for 20 seconds.
- Promote outdoor activities for children—at least 2 hours daily.
- Explain medication use if prescribed (e.g., atropine drops).
Psychosocial Aspects of Myopia
Myopia can affect emotional well-being, particularly in children and adolescents who may feel different due to wearing glasses. Early intervention and supportive counseling help minimize the risk of negative self-image and social withdrawal.
Prevention Strategies
- Reduce prolonged near work activities
- Encourage regular outdoor exposure
- Maintain appropriate reading distances (30–40 cm)
- Proper lighting during reading and screen use
- Limit screen time to age-appropriate durations
Conclusion
Myopia is a common refractive disorder significantly affecting global populations, especially children and young adults. Although easily corrected, unmanaged myopia can lead to serious ocular complications and reduced quality of life. Nurses hold a vital position in providing holistic care, identifying patient needs, teaching preventive behaviors, and supporting treatment adherence. By implementing accurate nursing diagnoses, evidence-based interventions, and patient-centered education, nurses help prevent complications, promote visual health, and improve psychosocial outcomes for individuals living with myopia.
References
1. World Health Organization. The impact of myopia and high myopia. WHO; 2015.
2. NANDA International. Nursing Diagnoses: Definitions and Classification 2021–2023. Thieme; 2021.
3. Walline JJ. Myopia control: A review. Eye Contact Lens. 2016;42(1):3–8.
4. Morgan IG, French AN, Ashby RS, et al. The epidemics of myopia: aetiology and prevention. Prog Retin Eye Res. 2018;62:134–149.
5. Flitcroft DI. The complex interactions of genes and environment in myopia development. Prog Retin Eye Res. 2012;31(6):622-660.
6. Holden BA, Fricke TR, Wilson DA, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 to 2050. Ophthalmology. 2016;123(5):1036–1042.
