Short answer
High myopia (−6 D to −10 D) is treated with LASIK, SMILE Pro, or ICL — the choice depends on corneal thickness, not prescription alone. Above roughly −8 to −10 D, or with thin corneas, ICL is often the safer primary option, correcting up to −20 D without removing corneal tissue. Glasses and contacts remain valid daily management if surgery is not suitable.
What counts as high myopia?
High myopia is typically −6 to −10 dioptres (D). Above −10 D is classified as severe myopia. Both need careful retinal assessment — longer eyeballs carry a modestly higher risk of retinal thinning.
On your prescription, look at the Sph column: −7.50 means 7.5 dioptres of short-sightedness. High myopes often need full-time correction and benefit from annual retinal monitoring independent of whether they choose surgery.
High myopia treatment options compared
| Option | Best for | Prescription range | Key constraint |
|---|---|---|---|
| Glasses / contacts | Daily management; all prescriptions | Any | Does not correct — manages blur daily |
| LASIK | Stable high myopia with thick corneas | Up to ~−10 D | Corneal thickness after ablation |
| SMILE Pro | Same range as LASIK; dry eye / sports | Up to ~−10 D | Same thickness rules — not higher limits |
| ICL | Borderline corneas; −8 D and above | Up to ~−20 D | Anterior chamber depth |
| PRK | Thin corneas unsuitable for flap | Up to ~−8 to −10 D | Longer recovery than LASIK |
How surgeons choose for high myopia
- 1Pentacam tomography — maps corneal thickness and shape; calculates safe tissue removal at your prescription.
- 2Prescription stability — 12+ months without meaningful change required before any surgery.
- 3Retinal exam — dilated fundoscopy for −6 D+ to rule out lattice degeneration or holes.
- 4Anterior chamber depth — measured if ICL is considered; must be adequate for implant safety.
- 5Age and lifestyle — contact sports may favour SMILE; thin corneas favour ICL.
Read: Can LASIK fix severe myopia? · How much myopia can LASIK correct? · LASIK vs ICL.
LASIK or ICL for −8 D?
At −8 D, both may be possible — the decision is corneal, not arithmetic. Adequate residual stromal bed after LASIK ablation → laser. Borderline thickness → ICL avoids corneal structural risk entirely.
ICL often delivers slightly sharper night vision at extreme prescriptions because the cornea's optical zone stays untouched. LASIK offers faster recovery and lower cost when corneas permit. Neither is universally "better" — appropriate selection is what makes either safe.
High myopia plus astigmatism
Both corrected in one session. Example: −7.50 / −2.00 × 180 = high myopia + astigmatism — LASIK, SMILE Pro, or toric ICL treat sphere and cylinder together.
Combined prescriptions use more corneal tissue in laser planning, which can push borderline cases toward ICL. See myopia vs astigmatism and the astigmatism guide.
When is surgery not recommended?
- Prescription still changing
- Under 21
- Keratoconus or suspicious topography
- Uncontrolled glaucoma or diabetes
- Pregnancy or breastfeeding
- Insufficient corneal thickness for laser at your Rx
- ICL — no corneal tissue removed
- Continued glasses or contacts
- Annual retinal monitoring regardless
High myopia?
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Return to the high myopia section on the myopia pillar · Full myopia guide