Myopia: Causes, Tests, Laser Intervention and Cost


What is Myopia and Why does it occur?

Myopia is the most frequent vision defect, its symptom is difficulty seeing distant objects. In nearsighted people, light rays coming from a distant object are not focused on the retina but in front of it. The consequence is that observed objects tend to appear blurry. While vision improves at a short distance. Myopia is measured in diopters: the more myopic an eye, the higher the diopters. The diopter is the power of the lens that allows us to obtain the best vision when we have a visual defect. Myopia can be:

  • Mild (up to 4 diopters)
  • Medium (up to 8 diopters)
  • Severe (greater than 8 diopters)

In all cases it is possible to perform an operation to eliminate myopia. Thanks to innovative techniques, even high myopia can be corrected differently from what happened in the past.

The causes

Myopia is generally due to an excessive length of the eyeball or to an altered curvature of the cornea or lens. Reading, using tablets or cell phones for a prolonged time, especially at a young age, can often be associated with the development and increase of myopia. In contrast, time spent in outdoor activities appears to have a protective effect against developing myopia. In women, pregnancy and especially prolonged breastfeeding can be associated with an increase in myopia. Myopia can also occur in the initial and intermediate stages of cataracts or following metabolic alterations (diabetes for example). The alteration of the shape of the cornea observed in keratoconus also leads to the presence of myopia and astigmatism.

The Myopia test

You can find out if you are nearsighted with a simple nearsightedness test, like the one below.

At 3 meters away do you see the letter better in red or green? The short-sighted person sees the letters in RED better. Hyperopic people see letters better in GREEN. The evaluation is more precise the greater the distance. For scientific confirmation, it is a good idea to perform an eye examination.

Correcting myopia: Glasses, Contact Lenses or Surgery

In addition to glasses and contact lenses which have always been useful for correcting myopia, today there are many new possibilities for intervention. Myopia can be eliminated using the following laser techniques:

  • Excimer laser (PRK and LASIK)
  • Femtosecond Laser (SMILE)
  • Intraocular lenses
  • Intraocular contact lenses (phakic lenses).

We then hear about techniques to heal myopia naturally without interventions or glasses. One of these techniques is orthokeratology. It consists of wearing special contact lenses during the night, in the morning when you wake up you remove these contact lenses and you can see well. What happens is that these contact lenses deform the cornea, flattening it during the night so that you can see better during the day. They work a bit like a corset that worn overnight makes you look slimmer when you wake up. In fact, there is no fix. The risk is to ruin the cornea with these deformations induced repeatedly.

Myopia: When to Operate

The minimum conditions for laser eye surgery is 18-20 years. However, myopia must be stable for at least 2 years, otherwise it can return after surgery, making retreatment necessary. Over the age of 45 , other interventions can also be considered to correct myopia: Phacorefractive surgery which consists in replacing the crystalline lens with an intraocular lens that allows you to see well from far away and up close without glasses. After the age of 60 it is usually no longer recommended to perform laser surgery for myopia because there are often already opacities in the lens – or they could appear within a short time – and this could cause myopia to return. In this case, it is advisable to perform the Phacorefractive surgery, suitable for correcting astigmatism and myopia . Depending on the type of intraocular lens used, you may or may not need to use glasses for near reading. Laser surgery can be performed on both eyes. In the case of correction of myopia by implanting phakic intraocular lenses or phacorefractive, it is usually possible to operate on both eyes a couple of days apart. In cases of severe myopia, intraocular contact lenses – also called phakic lenses – can be implanted inside the eye with the advantage of having very fast vision recovery. The latest innovation for treating myopia is the High Tech intraocular lens customizable with light resulting from the studies of Nobel Prize winner Grubbs. During the phacoemulsification surgery, a High Tech lens is introduced in place of the natural crystalline lens. The lens can be customized using a light beam on an outpatient basis. This method has the advantage of being able to correct high degrees of myopia but also of astigmatism, hyperopia and presbyopia.

Is laser surgery covered?

Laser surgery for myopia can no longer be performed through the National Health Service (NHS) or ASL (Local Health Authority) in most Italian regions. However, myopia laser surgery can be performed in agreement with the main insurance companies, supplementary funds and health funds. Some insurances provide direct payment of the medical service without any cost to the patient, others provide indirect assistance. In this case the patient will receive a refund after presentation of the invoices for the services received. Each insurance has its own price and reimbursement schedule. Read the list of affiliated insurance companies here.

How much does Laser Myopia Surgery cost

The cost of the operation to eliminate myopia varies from 1,200 to 4,800 euros per eye depending on the type of technique used. The factors that determine the choice of technique are different: degree of myopia, the coexistence of astigmatism or presbyopia, the age of the patient and the characteristics of the eye. LASER, PRK, FemtoLASIK and SMILE techniques are less invasive and less expensive than intraocular lens implantation. The cost of the surgery varies from 1,200 euros to 2,500 euros per eye. The implantation of phakic intraocular lenses and phacorefractive surgery are indicated for more severe myopia and their cost varies from 3,000 to 4,800 euros per eye depending on the characteristics of the lens that is implanted.

Causes and return of Myopia

The return of myopia is an extremely rare occurrence if the correction was carried out with latest generation laser techniques and if the operation was performed when the visual defect had been stable for at least a year, a necessary condition to be able to carry out the operation in safety. However, in patients operated with first generation lasers, myopia can return. In these cases there are some therapeutic options:

  • A New Laser Intervention
  • Phacorefractive and the use of a premium intraocular lens such as High Tech.