Ask an Eye Doctor: Will My Children Inherit My Vision Problems?

Are vision problems genetic? It’s a common question, and one that eye doctors are now better able to answer. Here’s what parents need to know.

Son and father wearing glasses.

Lilia D., 13, has her mother’s blue eyes and athletic build. She also inherited her father’s thick black hair and big smile. 

But, so far, the teen has dodged one genetic trait that affects both her parents: vision problems. She has 20/20 vision, though her father has worn eyeglasses for decades and her mother, who has been nearsighted since age 5, relies on both eyeglasses and contact lenses. 

“Will my children inherit my vision problems?” is a question many parents wonder about and ask their eye doctors. 

The answer: Probably, maybe not, and it’s complicated, says Rebecca Taylor, M.D., clinical spokesperson for the American Academy of Ophthalmology and a comprehensive ophthalmologist in Nashville, Tenn.

“Many inherited vision problems are silent, meaning they can be symptom-free for years, even decades, before you notice them,” she says. “Other times, a genetic eye condition can be unique to one person, but it won’t be in the genes they pass down to their children.”

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Your Vision Problems' Family Ties

Researchers do know that 10 of the most common eye diseases and disorders—including myopia (nearsightedness), cataracts (clouding of the eye’s lens), glaucoma (damaged optical nerve), and retinitis pigmentosa (a group of disorders that break down cells in the retina)—are associated with specific gene variants.

And there is a movement to incorporate genetic screening into preventive eye care, according to researchers at the Eye and Vision Science Laboratory at the University of Louisville School of Medicine in Kentucky, who reviewed 25 years’ worth of data on the genetic makeup of eye conditions and published their findings in 2018 in the International Journal of Ophthalmology

But we’re not there yet. More clinical trials of some eye disorders are needed to prove a clear benefit to having the screening. Optometrists and ophthalmologists also would need training to be able to apply the results of individual screenings to the treatment recommendations for their patients. 

Plus, notes Dr. Taylor, visual clarity can’t be predicted based solely on genetics. For example, in healthy younger people, how well they see depends largely on the size and shape of their eyeball.

Here’s how that plays out in the real world: Let’s say you’re 10 and your mom or dad is nearsighted, with a long, cone-shaped eyeball. You’re more likely to become nearsighted than your BFF whose parents both see fine without glasses or contacts.

But if your mom or dad is farsighted (hyperopia), with a relatively flat corneal shape, you could end up with either condition. Or you may hit the jackpot and end up with perfect vision like Lilia.

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Genetics Become More Important for Age-Related Vision Problems

In older adults, glaucoma and age-related macular degeneration—two leading causes of blindness—both appear to be largely inherited. 

Researchers have mapped several genes for glaucoma and are starting to identify the genes involved in macular degeneration (the erosion of your central vision), notes Dr. Taylor. Scientists also are making progress in pinpointing the genes that cause retinitis pigmentosa, a cluster of degenerative diseases of the retina that cause night blindness and gradual vision loss. 

There are other factors that complicate how you inherit vision. Diabetes, for example, can increase your risk for certain eye diseases. And because diabetes is partially a hereditary disease, you may pass along this complication to your children indirectly. 

What Can You Do Now to Avoid Vision Problems Later?

So what should you do if you’re worried about inheriting familial eye conditions or passing yours along to your children? Make sure you tell your eye doctor about any diseases or conditions—especially those that affect the eye—that run in your family.

“Even if it’s a distant relative,” says Dr. Taylor. The earlier you can be screened and monitored for the problem, the better your prospects for a lifetime of clear vision.