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Refractive error

Globally, millions of people are blind or have low vision due to lack of access to spectacles, resulting in reduced quality of life.

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Types of refractive error

Refractive errors result in an unfocussed image falling on the retina, causing blurred vision of different types. Here are the common forms of refractive error. Select the right and left arrows to learn more.

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Myopia

  • Myopia (commonly known as short-sightedness or near-sightedness) is caused by the eye being too long, which results in light focussing in front of the retina, causing blurred distance vision.
  • Eye growth is regulated by genetics and the environment, including near work and outdoor time, and the prevalence of myopia is rising around the world.
  • Myopia commonly onsets in childhood and is corrected using spectacles or contact lenses. However, the condition commonly progresses and the eye continues to grow longer.
  • High myopia is a major risk factor for conditions which can cause severe vision loss such as macular degeneration, retinal detachment, glaucoma and cataract.

Hyperopia

  • Light from near objects is focussed ‘behind’ the retina.
  • This can make it difficult or uncomfortable for people with hyperopia to see near objects whilst for adults both near and distance vision may be blurred.

Astigmatism

  • Mostly caused by an irregular-shaped cornea and/or lens which give rise to multiple images that are not focussed on the retina.
  • Both distance and near objects appear blurred and distorted.

Presbyopia

  • As part of the ageing process the lens becomes harder and less elastic, making focussing on near objects more difficult.
  • Most people over the age of 40 will have a degree of presbyopia and cannot see near objects clearly.

Learn more about myopia

Myopia is a distance refractive error that is increasing quickly in prevalence around the world.

As a result of lifestyle changes, including reduced time spent outdoors and increased near-work activities, the number of people with myopia has been estimated to rise from 1.4 billion in 2000 to 2.6 billion in 2020 and 3.4 billion in 2030.

In some Asian countries, 70% of those 17 or above are myopic, as are 97% of 19-year-old male army conscripts in South Korea.

Additionally, there is a more sinister side to myopia. High levels of myopia (-5.00 D or worse) increase the risk of sight-threatening conditions including retinal detachment, cataract and glaucoma. In addition, highly myopic eyes are at risk of myopic macular degeneration, a condition fast emerging as a leading cause of blindness in Asia and other parts of the world. There were an estimated 10 million people with vision impairment from MMD in 2015 of whom over 3 million were blind.

Source and references

Approximately half of the world’s population, including children, live in towns and cities; by 2050, nearly 70% will live in urban areas (United Nations).

In 2010, just over 28% of the world’s population were affected by myopia (short-sightedness). This was predicted to rise to 34% by 2020 and nearly 50% by 2050 (Holden el al. 2016). This means the half the world’s population is predicted to have myopia by 2050.

There are significant health and economic implications from the rising prevalence of myopia. Managing the myopia burden requires a co-ordinated effort in prescribing and developing solutions to control onset and progression, and services to manage associated healthcare implications.