Pathologic Myopia – Causes, Symptoms and Treatments

Pathologic Myopia – Causes, Symptoms and Treatments

Pathologic myopia, also known as high myopia or degenerative myopia, is a severe form of nearsightedness that can lead to significant visual impairment. Unlike common myopia, which is typically corrected with glasses or contact lenses, pathologic myopia is characterized by a refractive error of -6.00 or greater and is associated with structural changes in the eye. 

In this comprehensive guide, we will explore the underlying causes of pathological myopia, discuss the common symptoms to watch out for, and explore the available pathologic myopia treatment options. 

Understanding Pathologic Myopia

Pathologic myopia is characterized by an elongated eyeball, which causes light rays to focus in front of the retina instead of directly on it. This results in blurred vision when looking at distant objects. The elongation of the eyeball can also lead to other structural changes, such as thinning of the retina and the development of posterior staphyloma (an abnormal bulging of the back of the eye). These changes can increase the risk of complications such as retinal detachment, macular degeneration, and glaucoma. The exact cause of pathologic myopia is not yet fully understood, but both genetic and environmental factors are believed to play a role. 

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Causes of Pathological Myopia

Pathologic myopia is believed to have a strong genetic component. Several genes have been identified that are associated with the development and progression of myopia. Environmental factors also play a role in the development of pathologic myopia. Excessive near work, such as reading or using digital devices for long periods, has been associated with an increased risk of myopia. Lack of outdoor activities and spending less time in natural light may also contribute to the development and progression of myopia.

Recognizing Symptoms of Pathologic Myopia

The pathological myopia symptoms can vary depending on the severity of the condition. Common symptoms include:

  • Blurred vision, especially when looking at distant objects
  • Difficulty seeing in low-light conditions
  • Squinting or straining to see
  • Frequent headaches or eye strain
  • Increased sensitivity to glare
  • Floaters or flashes of light in the field of vision

It’s important to note that these pathological myopia symptoms can also be indicative of other eye conditions, so it’s crucial to consult with an eye care professional for an accurate diagnosis.

Risks Associated With Pathologic Myopia

Pathologic myopia is associated with several risks and complications that can significantly impact vision. Some of the risks include:

Retinal detachment: The thinning of the retina in individuals with pathologic myopia increases the risk of retinal detachment, which can cause vision loss if not promptly treated.

Macular degeneration: Pathologic myopia is a known risk factor for the development of macular degeneration, a condition that affects the central portion of the retina and can lead to permanent vision loss.

Glaucoma: The elongated shape of the eyeball in pathologic myopia can increase the risk of developing glaucoma, a condition characterized by increased pressure within the eye that can damage the optic nerve and lead to vision loss.

These risks highlight the importance of regular eye examinations and early intervention to prevent or manage complications associated with it.

Lifestyle Changes and Prevention Strategies

While pathologic myopia has a strong genetic component, there are certain lifestyle changes and prevention strategies that may reduce the risk of developing or slowing down the progression. These include:

Spending time outdoors: Studies have shown that spending more time outdoors, particularly during childhood and adolescence, may help reduce the risk of myopia development and progression.

Taking regular breaks from near work: Engaging in activities that require focusing at a distance, such as looking out of a window or taking short breaks from reading or using digital devices, can help reduce eye strain and potentially slow down the progression of myopia.

Practicing good eye hygiene: Ensuring proper lighting when reading or using digital devices, maintaining a proper distance from the screen, and blinking regularly, can help reduce eye strain.

Annual Retina Examination: Being at an increased risk of retinal detachment and retinal degeneration, a detailed retina scan is recommended at least once a year.

It’s important to note that lifestyle changes and prevention strategies may not completely eliminate the risk of developing pathologic myopia, especially in individuals with a strong genetic predisposition. 

Treatment Options for Pathologic Myopia

The pathologic myopia treatment options aim to manage the condition, improve vision, and prevent or manage complications. They are:

Corrective lenses: Glasses or contact lenses can help individuals with pathologic myopia see more clearly by compensating for the refractive error. However, they do not slow down the progression of myopia.

Medications: In some cases, medications such as atropine eye drops may be prescribed to slow down the progression of myopia in children.

Orthokeratology: This pathologic myopia treatment involves the use of special rigid contact lenses that reshape the cornea overnight, temporarily reducing myopia during the day. It is primarily used in children and adolescents.

Surgical interventions: In severe cases of pathologic myopia, surgical interventions may be considered. These include procedures such as refractive lens exchange, implantable collamer lens implantation, and corneal cross-linking. These procedures aim to correct the refractive error and reduce the risk of complications.

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The choice of pathologic myopia treatment depends on various factors, including the severity of myopia, the age of the individual, and the presence of any pathological myopia complications.

Can LASIK Correct Pathologic Myopia?

LASIK surgery is a popular refractive surgery procedure that can correct common myopia. However, it is not typically recommended for individuals with pathologic myopia as the structural changes in the eyes make them poor candidates for LASIK surgery. Other surgeries, such as refractive lens exchange or implantable collamer lens implantation, may be considered in severe cases of pathologic myopia.

Conclusion

Pathologic myopia is a severe form of nearsightedness that can have a significant impact on an individual’s vision and quality of life. Understanding the causes of pathological myopia, recognizing its symptoms, and exploring the available pathologic myopia treatment options are crucial for managing this condition effectively.

FAQs

What is a pathological myopia?

Pathological myopia, also known as high myopia or degenerative myopia, is a severe form of nearsightedness that is associated with structural changes in the eye. It is characterized by a refractive error of -6.00 or greater.

What is the difference between pathologic myopia and progressive myopia?

Pathologic myopia refers to a severe form of nearsightedness that is associated with structural changes in the eye and can lead to visual impairment. Progressive myopia, on the other hand, refers to the gradual worsening of myopia over time.

What is simple vs pathologic myopia?

Simple myopia refers to common nearsightedness that can be corrected with glasses or contact lenses. Pathologic myopia is a severe form of myopia that is associated with structural changes in the eye and can lead to visual impairment.

What is pathological myopia in one eye?

Pathological myopia in one eye refers to the condition where one eye has severe nearsightedness and associated structural changes, while the other eye may have a less severe refractive error.

Is pathological myopia serious?

Yes, pathological myopia is a serious condition that can lead to significant visual impairment and increase the risk of complications such as retinal detachment, macular degeneration, and glaucoma.

Does pathological myopia stop?

Pathological myopia is a progressive condition, which means that it tends to worsen over time. However, the rate of progression can vary among individuals.