Understanding high myopia
High myopia is a severe form of myopia (nearsightedness) that makes distant objects appear very blurry and raises the risk of serious eye complications later in life.
Key takeaways
- High myopia simply means a more severe case of myopia (nearsightedness)
- Prescriptions higher than –5.0 Diopters are considered high myopia according to the World Health Organization
- Risk factors of high myopia include genetics and environmental factors like excessive “near work” and indoor time
- Symptoms of high myopia include very blurry distance vision, poor depth perception, and headaches
- Risks of high myopia include a higher chance of developing vision-threatening eye diseases like glaucoma, cataracts, retinal detachment, and myopic macular degeneration
- Treatment of high myopia depends on your age and myopia severity and may include correction like eyeglasses, contact lenses, surgery, or a myopia management plan for children whose eyes are still growing
What is high myopia?
As the name suggests, high myopia is myopia (nearsightedness) that has progressed to an extreme level that not only affects vision, but also puts a person at a higher risk for sight-threatening diseases. Since myopia is a chronic, progressive disease where the eye has grown too long from front to back (or the cornea or lens of the eye are more steeply curved), those with high myopia have a longer eye or more extremely curved cornea or lens.
How is high myopia measured?
An eye doctor measures the severity of myopia by determining your prescription (how much vision correction you need for clear sight) which is measured in “diopters” (D). When the eye is less elongated, the prescription sits closer to zero. Once it goes above -5D, you're considered to have high myopia according to the World Health Organization.
The more severe the myopia, the blurrier your distance vision and the higher the likelihood of complications down the road. While there's no upper limit to how high myopia can go, prescriptions higher than –10D are extremely high.
What are the risk factors for high myopia?
High myopia is associated with a combination of genetic and environmental factors. Generally, the earlier a child develops myopia, the more time it has to progress. Experts often can't predict whether a person will progress to high myopia, which is exactly why yearly comprehensive eye exams matter. Catching myopia early opens the door to myopia management that may help slow progression.
Genetics
- If one or both of your parents have high myopia, there's a greater chance you will too. But you can develop high myopia even if your parents don't have it.
Environment and habits
- Too much time spent indoors may increase a child's risk of developing myopia.
- Too much time on close-up activities, like reading or using screens, can also raise the risk.
What are the symptoms of high myopia?
The most common symptoms of high myopia are extremely blurry distance vision, poor depth perception, and frequent headaches or eye strain. Because myopia progresses over time, catching it early is key to managing it. Often, the first clue is blurry distance vision, like when a child struggles to see the board at school. Here's what to watch for:
Extremely blurry distance vision
Things more than a few feet away may look very blurry and hard to distinguish. With high myopia, simple things can become difficult and even dangerous—like avoiding tripping hazards on a trail or finding your way to the bathroom at night.
Poor depth perception
When faraway things are blurry, it's hard to judge exactly how far away they are. That creates challenges with driving, crossing the street, hiking, and more.
Headaches and frequent eye strain
People with uncorrected high myopia squint to see everyday things, like street signs and faces. That constant squinting and difficulty focusing can lead to headaches and eye strain.
There's no safe level of myopia
Consider this: every diopter increase in myopia (say, from -2D to -3D) raises the risk of myopic macular degeneration by 67%. High myopia carries the highest risks, but the risk exists at every level.
Eye health complications of high myopia
High myopia is more than just very blurry vision. As the eye becomes longer than normal, the tissues inside the eye can become stretched, which may increase the risk of certain eye diseases over time. Having high myopia does not mean these conditions will occur, but the likelihood may be higher than in people with lower levels of myopia.
Retinal detachment
The retina is the light-sensitive tissue at the back of the eye that sends visual information to the brain. In people with high myopia, stretching of the eye may make the retina more vulnerable to tears or detachment. A retinal detachment is a medical emergency that requires prompt treatment to help protect vision.
Myopic macular degeneration
The macula is the central part of the retina responsible for detailed vision used for reading, driving, and recognizing faces. High myopia may increase the risk of changes in the macula over time, sometimes called myopic macular degeneration or myopic maculopathy. These changes can affect central vision and may require ongoing monitoring by an eye-care professional.
Glaucoma
People with high myopia may have a greater risk of developing glaucoma, a group of eye diseases that can damage the optic nerve. Because glaucoma often develops gradually and without noticeable symptoms early on, regular comprehensive eye exams are important for early detection.
Cataracts
High myopia is also associated with an increased likelihood of developing cataracts. Cataracts occur when the eye's natural lens becomes cloudy, causing blurred vision, glare, and difficulty seeing clearly.
Vision loss risk
Most people with high myopia maintain good vision with proper correction and routine eye care. However, serious complications related to the retina, macula, glaucoma, or other eye conditions can lead to permanent vision impairment if left undetected or untreated. Regular monitoring helps support early diagnosis and treatment when needed.
Warning signs that need urgent attention
- Seek prompt eye-care evaluation if you experience:
- Sudden flashes of light
- A sudden increase in floaters
- A dark curtain, veil, or shadow across your vision
- Sudden unexplained vision loss
- Rapid distortion of central vision
These symptoms can be signs of retinal complications that require urgent medical attention.
How is high myopia corrected?
High myopia is most commonly corrected with:
- Eyeglasses
- Contact lenses
- Laser eye surgery
These options address the blurry distance vision, but they don't manage the progression or reduce the risk of other eye complications. Anyone with high myopia should plan on seeing their eye doctor every year because of the increased risk of other eye complications.
Can you slow or prevent high myopia?
There's no "cure" for myopia once it develops, but as a parent you can take steps that may reduce the likelihood of your child developing high myopia or help manage its progression.
Time outside
Research shows spending at least two hours a day outdoors can help reduce myopia onset or slow its progression.
Less "near work"
Cutting back on close-up tasks (like reading or tablet use) outside of school can help reduce myopia onset.
The 20-20-20 rule
Every 20 minutes, look 20 feet away for 20 seconds during near-work activities like reading or homework.
Orthokeratology
Ortho-k can help manage myopia and typically provides glasses-free vision during the day by temporarily flattening the cornea with a hard contact lens worn overnight.
Eye drops
Low-dose atropine has been shown to slow the progression of myopia in children and teens.†
Myopia management contact lenses
Worn during the day, these special contacts have optics that both correct vision and help manage myopia.
Get your or your child’s eyes checked for high myopia
Frequently asked questions
Myopia is measured in diopters, a measurement your eye doctor takes to determine the lens power needed to correct your vision. Technically, there's no limit to how high or low diopters can go, but anything above -10D is extremely high.
The World Health Organization recognizes –5.0 diopters and higher as high myopia.
The extreme blurry vision associated with uncorrected high myopia can make life extremely challenging and possibly dangerous because it can be difficult to judge depth perception and/or identify dangers.
High myopia also increases the risk of developing vision-threatening eye disease later in life.
High myopia itself doesn't cause blindness, but it does increase the risk that you will develop sight-threatening eye disease later in life like retinal detachment, myopic macular degeneration, and more.
Typically, high myopia continues to progress until your 20s, when eye growth begins to level off. That's why starting a myopia management plan early is so important—myopia at any level can lead to other serious eye conditions, like cataracts and retinal detachment.
There's no cure for high myopia. Treatments like glasses, contact lenses, and laser surgery correct blurry distance vision, but they don't reverse the underlying elongation of the eye or eliminate the risk of related complications. That's why ongoing eye care is so important.
People with high myopia should have yearly comprehensive eye exams at least once a year, and also see their eye doctor immediately if they experience any sudden or concerning changes in their vision.
Related content
Managing your child’s myopia (nearsightedness): what to know
How to read the numbers on your contact lens prescription
Footnotes
† Low-dose atropine is currently not approved by any regulatory body for myopia control. Atropine's use is considered off-label and is subject to local regulatory, legal, and professional requirements that the ECP must understand and comply with to cover all aspects of off-label prescribing in their country.
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