AMETROPIA

Ametropia = any refractive error where the eye can’t focus light directly on the retina without help.

Main types

  1. Myopia (nearsightedness)
    • Eye is too long or cornea too curved → light focuses in front of retina.
    • Close objects are clear, distant ones are blurry.
  2. Hyperopia (farsightedness)
    • Eye is too short or cornea too flat → light focuses behind retina.
    • Near vision is harder; distance vision can be okay (but may be strained).
  3. Astigmatism
    • Cornea (or lens) is irregularly shaped (more curved in one direction) → light focuses on multiple points.
    • Vision is blurry at all distances, often with a “stretched” look.
  4. Presbyopia
    • Age-related loss of lens flexibility (usually after 40).
    • Near focus gets tough, even if distance vision is fine.

How it’s measured

  • Spherical equivalent (SE): Combines sphere (myopia/hyperopia) + half of cylinder (astigmatism) to give one number.
  • Diopter (D): Unit of lens power. Negative D = myopia, positive D = hyperopia.

Causes & risk factors

  • Genetics: Family history strongly influences myopia/hyperopia risk.
  • Environment: Too much near work (reading, screens) + little outdoor time → higher myopia risk.
  • Age: Lens stiffens → presbyopia.
  • Eye injuries or surgeries can induce irregular astigmatism.

Correction options

  • Glasses: Simple, non-invasive.
  • Contact lenses: Directly on eye; options like toric for astigmatism, multifocal for presbyopia.
  • Refractive surgery: LASIK, PRK, SMILE (laser reshapes cornea). Lenses or implants for high prescriptions.
  • Orthokeratology (ortho-k): Wear special rigid lenses overnight to temporarily reshape cornea (often for myopia control).

Management (especially for myopia control)

  • Outdoor time: 2+ hours daily linked to slower myopia progression in kids.
  • Low-dose atropine drops: Can slow myopia worsening.
  • Multifocal/Defocus lenses: Some contact lenses or glasses designed to reduce progression.