Prescribing glasses for myopia

Myopia is a one-symptom refraction problem: blurring of distance vision. Correction of the myopia should eliminate this symptom, but a prescription for glasses may, in fact, produce other symptoms equally--or more--disturbing. A few of the more common pitfalls in prescribing for the myopic patient are: (1) failure to recognize accommodative stress masquerading as low myopia; (2) confusion as to when, or whether, to prescribe for the unilateral myopic patient; (3) overcorrecting the myopic refractive error and failure to appreciate the symptoms that result from overcorrection; (4) difficulties in gaining acceptance of bifocals by the myopic presbyopic patient; (5) appropriate selection of bifocal segments; and (6) acquired myopic anisometropia caused by sclerosis of the crystalline lens. Although myopia would appear to be the least troublesome of all refractive problems, the maximizing of visual potential with comfort and safety needs refracting skills, experience, and clinical judgement.