As someone living with high myopia, I used to think that my prescription was just a number – higher than most clearly, but still, just a bit annoying.
Over the past few years however, I have entered an age of personal enlightenment in the subject of myopia: spurred on by serendipitous conversations and personal experiences.
As I entered my 40s, I started noticing changes in my vision — in particular, more floaters drifting across my view. This memorably was particularly accute when it clouded my view of the Eifel Tower on a bright sunny day in Paris, where i had gone with my fmaily to celebrate the big 4-0. As it is, of course, hard to see the world through someone else’s eyes, it’s hard to realise at teh beginning that these aren’t just ‘normal’ signs of ages, and that other people don't suffer in quite teh same way. It made me think about: what 'normal' is and, what high myopes like me see and should expect as we get older?
So, I set about finding the answers. Of course, my first point of call was my Myopia Focus Co-founder, Jason Higginbotham, who as an optometrist and myopia expert, was happy to answer my questions and give me his take on the long-term effects of high myopia. What I learned was eye-opening—and to be honest, a little frustrating. If only the treatments and advice available now, were available to me in my childhood!
The Reality of High Myopia in Adulthood
1. More Floaters –
I started seeing floaters in my late 30s—those little wispy shapes that drift across your vision, but noticed them much more in my 40’s. Jason explained that whilst many people have floaters, it is much more common in high myopes because of changes in the vitreous, the jelly-like substance that helps gives the eye it’s shape.
As we get older, the vitreous liquefies and pulls away from the retina (a process called posterior vitreous detachment, or PVD). It happens to almost everyone eventually, but it happens earlier in high myopes because our eyes are longer and more stretched.
Most of the time, floaters are just annoying. But for high myopes, like myself, they are a constant annoyance. It really does take away my full enjoyment of a bright blue sky for instance. Yes, I understand that in the grand scheme of things, this a relatively small issue – but still, it is annoying!!)— There is a bigger warning here also —a sudden increase in floaters, flashes of light, or a dark shadow in your vision could mean a retinal tear or detachment. That’s a medical emergency, so if you notice these signs suddenly appearing, don’t wait—get it checked immediately. I have this in the back of my mind – and it’s not a nice thought!
2. Light Scatter and Night Driving Struggles
If you’re a high myope, you’ve probably noticed halos around lights at night or found yourself squinting against glare during the day. Driving at night can be a nightmare.
Jason explained that this happens because of light scatter—caused by everything from tiny imperfections in the cornea to early cataract formation. It’s why:
Headlights can seem painfully bright and can make night driving increasingly more stressful.
Streetlights have halos or starbursts that reduce contrast and make it harder to focus on other things.
Even daytime glare from reflections or bright sun can be more intense.
And of course —cataracts develop earlier in high myopes, and they make these symptoms even worse. Cataracts aren’t just about cloudy vision; they cause serious problems with contrast sensitivity and glare, making everything look hazy.
3. Retinal Detachment – A Real Risk
One of the biggest concerns for high myopes like me, is the potential for retinal detachment (I read one story recently of a woman who said that high myopes shouldn’t bungy jump! – Note to Self: I should investigate this!). The longer the eye, the more stretched and fragile the retina becomes, making it more prone to tears and detachment. Jason confirmed that high myopes have a much higher lifetime risk of this happening.
The scary part - Retinal detachments can happen without warning. The best thing we can do is know the signs (flashes, sudden floaters, shadows in vision) and act quickly.
4. Glaucoma – The Silent Threat
Something else to look forward to/be mindful of—high myopia increases the risk of glaucoma. The structure of a myopic eye makes it more vulnerable to optic nerve damage, which can cause permanent vision loss without obvious early symptoms.
This is why regular eye exams are non-negotiable for us high myopes. Catching glaucoma early is key to protecting our sight. High myopes should have at least an annual eye examination.
Why This Matters for the Next Generation
Here’s the thing—none of this was surprising to Jason. He’s been telling people for years that high myopia isn’t just about wearing thick glasses. But for me, and probably for a lot of you reading this, it’s only by understanding these issues now—when we’re living them or facing them in the future—that we can truly see why myopia management for children is so important.
If we had known what we do now, we’d have wanted the myopia management treatments that exist today—day and night contact lenses, specialist glasses, atropine eye drops—anything to slow down myopia progression.
We can’t change the past, but we can change the future for our children. We need to make sure parents know that myopia isn’t just about needing glasses—it’s about protecting long-term eye health.
So, if you have high myopia and you’re experiencing some of these issues, share your story. Talk to parents of myopic children. Let them know that the treatments we wish we’d had are available now—and they work.
It’s too late for me, and other high myopes, but it’s not too late for our children. Let’s make sure they get the chance we didn’t.
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