Is it Really Myopia? Recognizing Pseudomyopia (False Myopia)
Helen Otailku
Overview
Is it really Myopia? Recognizing Pseudomyopia (False Myopia). According to a PubMed research, between 18% to 24% of children and young adults are exposed to pseudomyopia due to constant use of electronic devices and other related factors, (1), and oftentimes it is mistaken for myopia which is a different more permanent condition and people are unaware live with this false diagnosis.
Pseudomyopia also known as false myopia is an eye condition that occurs when spasm of the ciliary muscle obstructs the eye focusing on distant objects, sometimes on a regular basis if the situation leading to the condition continues which differs from myopia which occurs due to permanent changes to the eye's shape. (2) The good news is that pseudomyopia can be treated through minimizing near work activities, enough sleep and or doctor-recommended eye drops.
Types of Pseudomyopia
There is an organic form of pseudomyopia that occurs as a result of exhaustion of an area of the brain known as the parasympathetic nervous system.
Another type of pseudomyopia is the functional form that occurs as a result of excessive pressure on the eyes (eyestrain).
Studies show that these identified types of pseudomyopia are common among people with working conditions that amount to long hours (eye accommodation) or generally prolonged near-work activities. (3) For example, students who are preparing for a rigorous exam or individuals in tech.
Signs of Pseudomyopia
One may not possess all these signs to be diagnosed with this eye condition. However, some signs that people with Pseudomyopia possess, include the following: (4)
● Blurring of vision after constant near work
● Short-sighted
● Headache
● Eye strain
● Cross eye
● Sensitivity to rays from light (photophobia)
● Seeing double
If all these signs occur following a situation or event, individuals are advised to visit the eye clinic for a clinical examination to rule out pseudomyopia.
Clinical Examination for Recognizing Pseudomyopia
When a person with pseudomyopia visits the eye clinic the most precise clinical examination to diagnose pseudomyopia is removing or lowering myopic refractive error then introducing cycloplegia.
The optometrist adds an agent such as cyclopentolate or atropine to the eyes which paralyzes the ciliary muscle (an area of the eye). If the person’s ability to see far objects gets better and the measured refractive error reduces under the influence of the cycloplegia introduced to the eyes, it is not myopia. (4)
This diagnosis involves recognizing the differences between the refractive error measured after relaxing the ciliary muscle responsible for accommodation and normal viewing.
Another precise way to recognize pseudomyopia is called ocular biometry. Whereby, the eye doctor measures the physical dimension of the eyes. In the case of pseudomyopia, the axial
length of the eyes is normal unlike myopia. It shows that the blur that prevents seeing a far object clearly is caused by the ciliary spasm (lens shape) not the eyeball being too long.
Other forms of recognizing pseudomyopia include
● changes in the sharpness of a person's vision (visual acuity) could be through the use of the Snellen chart
● inconsistent eye test results
● retinoscope examination to check the way light entering the eyes bounces off the retina
Note: A comprehensive eye examination should rule out other eye conditions (refractive error) in addition to pseudomyopia such as early development of myopia, improper accommodation, and several other sources of visual blur.
Pseudomyopia can be Cured
Unlike myopia, which has to be managed, pseudomyopia can be cured or reversed. The following intervention can be useful in treating pseudomyopia: (5)
1. Topical Cycloplegic.
The first medicine in treating pseudomyopia would be introducing topical cycloplegic agents to relax the ciliary muscle, which loosens accommodative spasm and restores good vision. Studies report complete reversal for Pseudomyopia patients after administering 1% of atropine eye drop 1-2 times every day for over 15 days.
2. Cycloplegic or Cyclopentolate.
2-3 drops (1%) of cyclopentolate every day or administering 1% drop of cycloplegics such as tropicamide 2 times every day for 30 days and then reduced to once a day afterwards have reported similar effectiveness under doctor's supervision, achieving complete reversal in 45 days of medical examination.
3. Optical Aid.
Optical aids support the treatment of pseudomyopia by reducing accommodative pressure during recovery.
4. Vision Therapy.
For long cases of pseudomyopia, in addition to other treatment options, participating in physical eye exercises (orthoptic exercises) will help ease accommodation and maintain single focus. It should be performed for over 2 months at home or under physician supervision. The result of this is that it reduces signs of pseudomyopia, and sharpens vision (vision acuity).
The techniques involved in vision therapy include the following:
● Brock String: The patient looks at a string with coloured beads to train the brain to use both sides of the brain together at once and identify when the eyes are crossing correctly. ● Pencil Push-ups: The patient looks at a small letter on a pencil at arm's length and gradually moves it towards their nose with an effort to keep a single focus for a long while.
5. Environmental Control and Lifestyle Changes.
To avoid the recurrence of pseudomyopia controlling environmental and lifestyle factors that lead to pseudomyopia cannot be over emphasized. The 20-20-20 rule is essential, which involves for every 20 minutes of near work activities like electronic device use or reading, take a 20 seconds break to look at something 20 feet away. Sufficient rest, good time spent outdoors with eye exposure to natural light will contribute to treatment in addition to the other treatment options aforementioned.
Tabular Differences Between Pseudomyopia and Myopia
Pseudomyopia | Myopia |
Originates from the accommodation spasm from the ciliary muscle being contracted. | The origin is that the eyeball being too long |
During the cycloplegic test, far objects are clear | During the cycloplegic test, far objects remain blurred |
Treated by relaxing the muscle by using optical aids, the 20-20-20 rule, and orthoptic exercises | Managed with concave lenses, contact lenses, refractive surgery |
It is a muscle cramp which is temporary and can be reversed | It is permanent and cannot be reversed |
The blur fluctuates | The blur remains the same |
Frequently Asked Questions
1. Does Pseudomyopia resolve on its own without treatment?
If the common triggers of pseudomyopia are discontinued that strains the eyes in the first place, pseudomyopia will be resolved. (6)
2. If pseudomyopia is detected late, can treatment be commenced?
The simple answer is yes. While early diagnosis is the best, late detection of pseudomyopia can still be reversed after some weeks or in some cases, years.
3. Are there natural remedies for treating Pseudomyopia?
The natural remedy available for treating pseudomyopia is lifestyle changes which include frequent rest to relax the eye muscle, etc.
4. How long can pseudomyopia stay if left untreated?
The time frame of pseudomyopia is not specific. It can be situational in nature, that is if the underlying cause of the condition persists which is prolonged near work activity it reoccurs with treatment until the causes are addressed.
Conclusion
Many people mistake pseudomyopia for myopia but it's not. Pseudomyopia is an eye condition that is curable while myopia is a permanent eye defect without a known cure but can only be managed. This topic needs to be addressed in order for clinicians to rule out pseudomyopia and other visual blur when conducting an eye examination. Also, to expose what people with eye conditions need to test for, and not just myopia alone. An accurate diagnosis leads to favorable treatment outcomes because every patient deserves nothing but the truth pertaining to their health.
References
1. Chaloulis SK, Mousteris GE, Tsaousis KT. Short-term refractive outcomes of pseudomyopia induced by ocular blunt trauma. Cureus. 14(11):e31751.
doi:10.7759/cureus.31751
2. Khalid K, Padda J, Pokhriyal S, et al. Pseudomyopia and its association with anxiety. Cureus. 13(8):e17411. doi:10.7759/cureus.17411
3. García-Montero M, Felipe-Márquez G, Arriola-Villalobos P, Garzón N. Pseudomyopia: a review. Vision (Basel). 2022;6(1):17. doi:10.3390/vision6010017
4. Pseudomyopia. In: Wikipedia. 2025. Accessed May 6, 2026.
https://en.wikipedia.org/w/index.php?title=Pseudomyopia&oldid=1327571400 5. Koirala B, Chandan A, Kaiti R, Mahat M, Sitaula S. A combined intervention of single vision plus lens and tropicamide in the treatment of pseudomyopia: a perspective case report from nepal. Beyoglu Eye J. 2022;7(3):247-251. doi:10.14744/bej.2022.44127 6. If a child has pseudomyopia, will it recover on its own?-zhihu. Accessed May 6, 2026. https://www.zhihu.com/en/answer/3334587854
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