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Myopia and Pathological Myopia

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Myopia and Pathological Myopia Fundus Photo, Right Eye (OD) Eye Right Photo, Fundus Myopia and pathological myopia Contents 3 What is myopia and pathological myopia 9 What treatments are there for 3 How does the eye focus light? pathological myopia? 3 What is myopia? 10 How can I see better? 4 Development of myopia 11 Can I stop myopia from getting worse? 4 What causes myopia? 11 Is there anything I can do to prevent pathological myopia? 5 How is myopia graded? 11 Light sensitivity 5 High myopia 12 Driving 5 Posterior vitreous detachment (PVD) 6 Retinal detachment 12 Coping 6 Glaucoma 12 Further help and support 6 Cataract 12 Sources of Support 7 Looking after your eyes 13 Other useful contacts 7 Pathological myopia 14 We value your feedback 7 How does pathological myopia affect the retina? 7 Retinal atrophy 7 Lattice degeneration 8 Lacquer cracks 8 New blood vessels (neovascularisation) 8 Myopic macular degeneration 9 Foster Fuchs spot 9 Other changes 2 What is myopia and pathological myopia What is myopia? Myopia, also known as “being short sighted”, causes For vision to be clear, light entering your eye needs to be your vision to be blurry in the distance but clearer when focused accurately on your retina. Light entering your looking at things up close. It’s a very common focusing eye is first focused by the cornea and then finely focused problem, and for most people it can easily be corrected by the lens. This focusing system of your eye makes sure using glasses or contact lenses, making vision clear and that when light enters your eye, it is sharply in focus crisp. Most people with myopia have healthy eyes. as it hits the retina. This means that we see everything in focus without any blurriness. However, if someone Pathological myopia is different from simply being short has a focusing or “refractive error”, light is not focused sighted. Pathological myopia means that you are very correctly onto the back of the eye and vision is not clear. short sighted and that this has caused degenerative changes to the back of your eye. Pathological myopia There are three main types of refractive errors where the can cause a reduction in your sight that cannot eye is unable to correctly focus light onto the retina: be corrected with glasses or contact lenses. • Myopia (short-sightedness) which causes your vision to be blurry in the distance and clearer when looking at things How does the eye focus light? close up. Light rays enter the front of our eye through the clear cornea Hypermetropia (long-sightedness) which means that your and lens which bend the light, focusing it on the retina at • eye focuses better in the distance than when looking at the back of the eye. This gives us a clear, sharp image. things close up. The retina is a delicate tissue that lines the inside of • Astigmatism can cause blurry vision at all distances, and is your eye and is made up of light sensitive cells. Your caused by the focusing of the eye not being quite spherical retina converts the light into electrical signals that travel (rounded). Astigmatism is very common and many people along the optic nerve to our brain. The brain interprets who wear glasses have some degree of astigmatism. these signals so we can “see” the world around us. In people with myopia the light entering the eye The retina is supplied with blood by a delicate network of comes to a focus point before it reaches your retina. blood vessels on its surface and by a layer of blood vessels This makes vision blurry and is caused by the eyeball (the choroid) underneath the retina. The central part of being too long or the cornea (the clear window at the retina is called the macula and is very important for the front of the eye) being more steeply curved. seeing detail, colour and things we look at directly. 3 Short sighted Development of myopia Light is focused in front of the retina, You can develop myopia at any age, but it’s common for it to develop and worsen in childhood or teenage years. which makes the image appear blurred. Myopia usually becomes more stable in adulthood but there can be periods when myopia continues to increase. These episodes can happen at any age and are more common if Retina Lens you have higher levels of myopia. In general the younger you are when myopia begins to develop, the higher the level of myopia you will reach. For some people their myopia Macula reaches a certain level and stays the same for many years. Light What causes myopia? It’s not known what causes myopia and research suggests there could be a number of different Cornea reasons why you may become short sighted. Optic Myopia often runs in families so is thought to be Nerve Choroid partly genetic. Children who have one parent with myopia have a higher chance of developing it. This Diagram of cross section of the eye (labels: cornea, lens, chance increases if both parents have myopia. macula, retina, choroid, optic nerve). Diagram shows Some environmental causes of myopia in children have also light entering the eye through the cornea and the lens, been studied. Factors that are thought to increase the risk and coming to a focus point in front of the retina. of myopia are too little time spent outdoors and excessive close work. The general advice around these is that although People with myopia need a glasses prescription with a minus children should be encouraged to read, they should also lens to correct their vision. This lens reduces the bending spend some time each day doing outdoor activities. of the light by the eye, focusing light onto the retina, Myopia which develops in older adults can be because of rather than before it, to produce a sharp clear image. other conditions. If you have diabetes you may experience temporary myopia when your blood sugar level is not well controlled. Glasses alone may not be the best way to correct this change in your vision. Good control of your blood 4 sugar levels will help stabilise your vision and your diabetic High myopia nurse and GP will be able to help you to achieve this. If you have myopia higher than – 6.00D then you Some types of cataracts can also cause myopia to develop. may be at greater risk of developing certain other The myopic changes caused by early cataracts can be eye conditions. However, not everyone with myopia corrected by glasses. When cataracts continue to develop, above – 6.00D will develop other eye conditions, glasses may no longer be helpful and surgery to remove the and for most people their eyes will be healthy. cataracts would then be required to improve your vision. High myopia can increase the risk of developing the following eye conditions: How is myopia graded? Optometrists (also known as opticians) measure the Posterior vitreous detachment (PVD) focusing power of your eye in dioptres. This is a technical A PVD occurs because of natural changes to the gel term for how strong a lens would have to be to correct (the vitreous) in your eye as we get older, commonly the focusing of your eye and give you clear vision. when we are in our 50s. However, it can develop earlier if you have high myopia. A PVD doesn’t cause sight loss, Generally speaking this is written like; – 3.00 dioptres (D). but you may have symptoms such as seeing floaters On your glasses or contact lens prescription a minus sign is (small dark spots or shapes) and flashing lights. used to show that the lens you need corrects for myopia. The higher the number the more short sighted you are. It’s important if you notice an onset of floaters or flashing lights that you have your eyes checked straight away • Mild myopia includes powers up to – 3.00 dioptres (D) (within 24 hours) by an optometrist or at your local A&E • Moderate myopia, values of – 3.00D to – 6.00D so that an accurate diagnosis can be made. This is because • High myopia is usually myopia over – 6.00D symptoms of a PVD are similar to those of a different eye condition called retinal detachment, which needs prompt Most people with myopia of less than – 6.00D don’t treatment to prevent sight loss in the affected eye. develop any further problems. This is sometimes known as simple myopia, meaning that your eyes are healthy You can find more information about PVD and that the blurriness that your myopia causes is on our website rnib.org.uk/eyehealth easily corrected for with glasses or contact lenses. or by calling our Helpline on 0303 123 9999. 5 Retinal detachment Glaucoma If you have high myopia then there is a higher chance Being short sighted can mean that you are at a higher risk of you developing a retinal detachment. This is where a of developing glaucoma. Glaucoma is a where the optic hole or tear can develop in your retina. If a hole or tear nerve, which carries electrical signals from your retina to develops, fluid in your eye can leak through this gap and your brain, is damaged by the pressure of the fluid inside behind your retina, which can cause your retina to detach your eye. Treatment for glaucoma is given to lower your from the back of your eye. A retinal detachment can eye pressure and prevent damage to your optic nerve and lead to sight loss in that eye if it’s not treated quickly.
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