Living with refractive errors

The prevalence of refractive errors is very high, and millions of people live with one or more types of refractive error. Worldwide, around 26% of adults have myopia, 30% have hyperopia, and 40% have astigmatism (Source: Journal of Current Ophthalmology).

Refractive errors happen when light going into the eye doesn't focus correctly on the retina. Most people can wear prescription glasses or contact lenses to correct this. Some people feel their quality of life would be better if they didn't have to wear lenses and choose to pay for corrective surgery.

Children and adults with any kind of refractive error should have regular eye examinations to check for vision changes that may need a new prescription.

Managing refractive errors

Managing daily life with a refractive error is straightforward for most people. Glasses or contact lenses can correct your vision, meaning you don't have to struggle with blurred vision or other symptoms.

It's still important to have regular eye examinations after diagnosis. Children and some eligible adults get free eye tests. There are many benefits to regular eye tests:

• Eye tests check your general eye health for a range of eye conditions, some of which can begin without causing symptoms.
• Your optician will measure your visual acuity and detect any changes in your vision. For example, people with farsightedness or nearsightedness can develop trouble with their near vision (presbyopia) in their 40s. Regular eye exams will ensure you have the right prescription and the clearest possible vision.
• Your optician can advise options, including glasses, contact lenses, and refractive surgery. They can also tell you about innovations such as new types of contact lenses or lens treatments for glasses.
• Children may not recognise or be able to describe problems with their sight. Regular eye tests should pick up any issues early. This is important as uncorrected refractive errors can lead to other eye problems such as amblyopia (lazy eye) or squint (strabismus) in children, which can be avoided.
• Children already diagnosed with a refractive error can experience changes. Nearsight may increase and long-sight may get less as children grow older.
• Some people can develop severe nearsightedness called high myopia, or in rare cases, degenerative myopia. This can increase the chance of having other eye conditions such as retinal detachment, glaucoma, macular degeneration, and cataracts. Regular eye tests can help monitor your eye health if you're very myopic.

As well as having regular eye tests, there are other ways to take care of your eye health:

• Give your eyes regular breaks when using screens to reduce eye strain.
• Wear sunglasses on bright sunny days to protect your eyes from UV damage.
• If you have a condition like diabetes or high blood pressure that can affect eye health, keep up with your appointments and follow the advice about managing your condition.
• Always see your optician if you notice your vision has changed or you have any concerns.

Refractive errors and driving

The DVLA has a minimum standard for both visual acuity and visual field that you must meet to drive. Although refractive errors cause blurred vision, most people can wear glasses or contact lenses to give them clear enough vision for driving. You should have regular eye tests to ensure your prescription is up-to-date.

Astigmatism can make night driving more difficult, causing problems with glare, especially from bright lights such as headlights. Prescription lenses should improve this, but you can also ask your optician about lens treatments to reduce glare.

If you have refractive surgery, ask your eye care team for advice about when it is safe to drive after treatment.

Some people with high myopia can develop pathological myopia, which can't always be corrected with glasses or contact lenses. Ask your ophthalmologist for advice.

Refractive errors and work

Refractive errors aren't a barrier to work, although if undiagnosed or your prescription isn't up-to-date, eye strain and headaches can be a problem, especially if your job involves lots of screen time. If you use display screen equipment like a computer, laptop, or smartphone for work, your employer should provide or pay for you to have an eye test.

You can take steps to look after your eye health at work. If you use computers and screens, give your eyes regular breaks. If you work with machinery or chemicals, use protective eyewear to help prevent eye injuries.

What should I do if my vision gets worse?

Your vision can change over time; for example, presbyopia typically first develops in adults over 40. You can also experience new symptoms such as blurred vision, headaches and eye strain if your prescription isn't up-to-date. Regular eye tests can help keep on top of this. However, if you notice any vision changes or new symptoms before your next eye test is due, see your optician as soon as possible rather than waiting for your next appointment.

There can be other reasons for changes to your vision, and some eye diseases don't cause noticeable symptoms. Regular eye tests can detect a range of eye diseases and ensure you get treatment sooner rather than later.

Support for refractive errors

The NHS helps towards the cost of glasses or contact lenses for people under 16, under 19 and in full-time education, and if you're on certain benefits including Income Support and Jobseeker's Allowance.

If your prescription is -10/+10 dioptres or more, for example, if you have high myopia or need prism-controlled bifocal lenses, you may be able to get complex lens vouchers from the NHS to help with the cost of your lenses.

Frequently asked questions

The Royal College of Ophthalmologists champions excellence in the practice of ophthalmology and is the only professional membership body for medically qualified ophthalmologists. The RCOphth is unable to offer direct advice to patients. If you’re concerned about the health of your eyes, you should seek medical advice from your GP, optometrist or ophthalmologist.

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