Since spectacles were invented in Italy in the 13th century, there have been few developments in eyesight correction. In fact, portraits of glasses-wearers painted in the 1400s show what look very much like NHS specs. Contact lenses have only been around since the 1950s, although Leonardo da Vinci showed foresight by sketching some early models in his notebooks.

Now, new scientific developments are providing the 12 million short- and long-sighted Brits with hope that they might be able to dispense with their glasses or lenses for ever. The need for a better solution is about more than vanity. While substandard sight is not life-threatening, myopia is linked to the development of cataracts and glaucoma, which can lead to blindness. In addition, some people are unable to wear glasses at work for safety reasons, and some medical conditions (such as blepharitis) and commonly prescribed medications (tricyclic antidepressants) preclude the use of contact lenses. For these unfortunates - and for those of us too vain to stick with the specs - here's a rundown of the three most important developments.

The overnight fix

If you are a short-sighted sportsman or woman, work in a dusty workplace or suffer from dry eyes, wearing glasses or contact lenses during the day may not be an option. The Ortho K system - contact lenses that correct short-sightedness while you sleep - could offer a solution. Wearing the tailor-made, gas-permeable lenses overnight reshapes the cornea (the dome-shaped window covering the front of the eye) to its correct position, giving the wearer 20/20 vision upon waking. The sight correction generally lasts for the entire day, and sometimes longer: some wearers find they may only need to wear the lenses every other night. Swimmers, rejoice: you can wear them in the pool, too. Although the lenses don't cure short sight, some studies have indicated that using them may slow down the progression of myopia. The technology has been around since the 1960s, but has only recently become affordable.

Optometrist Charles Babumba, of City Eyes in the City of London, is prescribing Ortho K lenses to 220 of his patients, including his 13-year-old daughter, and monitoring the results. "The lenses are not appropriate for everybody," he says. "They are not suitable for people with diabetes, high blood pressure or very high prescriptions (over -6), or astigmatism. They only work when the wearer is asleep and must be worn for at least six hours, so some people's lifestyles might rule them out."

Duncan Perry, a 33-year-old sales manager from Fulham, west London, has been an Ortho K guinea pig for four months. Though only minimally short-sighted, without correction he squints and is very tired by the end of the day. "I'd rather not wear anything, but I didn't fancy laser eye surgery," he says. "My optometrist recommended I try Ortho K, which cost about the same as my ordinary lenses. They are harder than normal lenses and at first were more uncomfortable to put in and take out. You have to use eye drops to lubricate your eyes. But I've got used to it and, of course, you're asleep while they're in, so there's no prolonged discomfort."

The lenses are now recommended by the Institute of Optometry, but Daniel O'Leary, professor of optometry at Anglia Polytechnic University, has concerns. "These lenses are safe and effective if used by good practitioners with the right equipment. But they have been banned in China, where there were no controls and they were available off the shelf, because they were found to cause corneal ulcers."

O'Leary also worries that the lenses redistribute the epithelium, the layer of cells that covers the surface of the cornea. "The epithelium is the barrier to infections, so if there are physical changes in the structure of the tissue, there may be safety consequences. There has not yet been a large study on the long-term safety of the lenses."

Surgery without a knife

For those who want a more permanent solution, laser eye surgery is still the only option. Widely available in the UK since the 1990s, it has become increasingly commercialised, and safety concerns have led to bad press. Boots closed its laser eye clinics after reports of faulty equipment and side effects in patients who had had the treatment.

Now ophthalmologists have developed a new, safer technique. A study presented to the Royal College of Ophthalmology last month showed that the technique, Intralasik, which uses computer software and a futuristic laser (rather than a knife) to cut the corneal flap, had been successfully used on 500 eyes. There were no apparent side effects, no complications, such as problems with night vision, and all patients' vision was corrected to better than driving standard. Most - 71% - were left with better than 20/20 vision (an arbitrary figure used to denote normal vision).

According to consultant ophthalmologist Sheraz Daya, of the Centre for Sight at the Queen Victoria Hospital, East Grinstead, who presented the paper, the best thing about Intralasik is its accuracy. "A blade is a mechanical device and therefore prone to error," he explains. "A laser is 100 times more accurate and cuts the corneal flap more uniformly, so visual outcomes are better. There is a smaller margin for error and ophthalmologists are able to see exactly what they're doing, so they can stop and restart at any point. With a blade, problems can only be seen at the end of the procedure."

Mike Farmer, 20, from Hull, was severely short-sighted from the age of three and his lifelong ambition - to join the police - was thwarted by his myopia. "I was devastated," he says. "I ended up becoming a mechanic, but it wasn't what I wanted to do."

After a period grappling with contact lenses, Farmer's only option was laser surgery. He initially had misgivings, but in 2004 a friend showed him a newspaper cutting about a musician who had tried a new type of laser surgery that didn't use a blade. The police said if he had it done, he could join, so he went ahead with the procedure a few weeks ago at the Centre for Sight.

"I was bricking it, but it was painless and over very quickly. The first thing I saw was the clock - I could actually read the face clearly. My eyes were a bit sore for a few days and I had to use steroid drops for a week, but they have now fully recovered. My eyesight is 20/20 in one eye and 20/15 in the other - better than perfect. I'll be joining the police at the next enrolment."

Although Intralasik is becoming the gold standard for laser correction in the USA, in the UK it is currently only available at the Centre for Sight. Daya says the technique can be used on patients who would previously not have been eligible for laser surgery. It can also be used for corneal transplants and misshapen corneas, and has been approved by the Queen Victoria Hospital Foundation Trust for this purpose. However, for vision correction - viewed as a cosmetic procedure - it is likely to remain an option only for private patients, at a cost of about £2,000 per eye.

Myopia-busting lenses

Most people would agree that prevention is better than cure. So perhaps the most exciting development in vision correction is contact lenses that halt the progression of myopia. Professor O'Leary has devoted his career to this end. It has taken his team 15 years to research and design a contact lens that appears to stop myopia in its tracks. He has now been given the go-ahead to carry out a clinical trial on patients.

"Unlike ordinary lenses or glasses, which just correct short-sightedness, the new lenses are specially shaped to correct all imperfections in the eye," explains O'Leary. "Because of these imperfections, short-sighted people do not focus accurately when doing close work, such as reading or using a computer, even when their vision is corrected by glasses or contacts. It is believed that this is what leads to progressive damage.

"However, the newly developed lenses, which will be tailor-made for each patient, will cure this problem and, theoretically, therefore prevent future damage."

If the trial is a success, O'Leary's team hopes to identify those whose sight could be at risk in the future, and treat them before they show any symptoms. "This could mean not only an end to myopia, but also a dramatic decrease in related diseases such as cataracts, glaucoma and retinal detachments," he says.

The lenses have already been tested on patients for safety, comfort and their ability to correct vision. O'Leary hopes that, if the current trial is successful, the lenses could be available on the NHS in just a few years. So, unlike their parents and grandparents, future generations of children may never have to hear the insult "four-eyes" shouted in the playground. Short-sightedness could become a problem of the past.

· Professor O'Leary is hoping to recruit 400 short-sighted patients, aged between 14 and 21. People willing to take part in the trial should call 01223 363271 x2962.
Centre for Sight: 07000 288 288/ www.centreforsight.com
Ortho K: 01424 850620/ www.orthoklenses.com