High Myopia: Concerns About Retinal Health and Eye Pressure

Q: High Myopia: Concerns About Retinal Health and Eye Pressure

Hello, anxious individual：<br>1. <br>Without a tear, you need to closely monitor for any changes, as it is impossible to predict when a tear may actually occur. <br>There is no way to prevent it from stretching; you can only reduce the risk by minimizing vigorous head movements.<

High myopia

Hello Doctor: I am severely myopic with a prescription of about -1000 diopters.
In the past six months, I have experienced floaters and suspected flashes of light.
I have a few questions to ask you:
1.
Yesterday, I underwent a dilated fundus examination, and the doctor said there are currently no retinal tears.
The flashes may be due to vitreous traction on the retina.
If the flashes persist, is there a significant risk that it could lead to a tear? How can I prevent further traction?
2.
The doctor mentioned that high myopia causes thinning of the peripheral retina and that my optic nerve appears somewhat pale, but he said this is typical for individuals with high myopia and that I am not particularly special (he did not mention preventive laser treatment).
I am still quite worried about this.
What is your opinion, Doctor? Should I consider preventive retinal laser reinforcement or any other examinations?
3.
My initial intraocular pressure readings were 22 and 23 mmHg, and after resting, they were 19 and 20 mmHg.
The doctor said my cornea is thicker than average, so these readings are not concerning and do not require treatment.
If I were to adjust these readings to account for an average corneal thickness, would my intraocular pressure be around 14 and 16 mmHg? Is this phenomenon common? I am also concerned about the possibility of developing glaucoma in the future.
I apologize for the lengthy questions, but even after the dilated examination, I still feel anxious.
Thank you, Dr.
Gao, for your clarification.

Jiao lü de ren, 20~29 year old female. Ask Date: 2016/12/20

Dr. Gao Pilin reply Ophthalmology

Hello, anxious individual:
1.
Without a tear, you need to closely monitor for any changes, as it is impossible to predict when a tear may actually occur.
There is no way to prevent it from stretching; you can only reduce the risk by minimizing vigorous head movements.
2.
If your physician has not mentioned laser reinforcement, it indicates that your peripheral retina is relatively stable, and there is currently no need for laser treatment.
3.
A thick cornea can result in elevated intraocular pressure readings.
Therefore, as long as you have regular measurements and they remain stable, with no changes in the optic nerve or visual field, there is no need to worry about glaucoma.
Please do not be anxious.
The Ophthalmology Department at Puzi Hospital in Taiwan is available: Monday to Friday from 8:00 AM to 12:00 PM, and Wednesday from 1:00 PM to 4:30 PM.
Online responses are for reference only; it is essential to seek care at a medical facility if necessary.
I hope to have the opportunity to serve you.
Dr.
Gao Pilin

Reply Date: 2016/12/20

More Info

High myopia, or severe nearsightedness, is a condition that can lead to various complications, particularly concerning retinal health and intraocular pressure (IOP). Your concerns about flashes of light, floaters, and the potential for retinal detachment are valid and warrant careful consideration. Let's address your questions one by one.

1. Flashes of Light and Retinal Detachment Risk: The presence of flashes of light can indeed be associated with vitreous traction on the retina, especially in individuals with high myopia. When the vitreous gel pulls on the retina, it can create the sensation of flashes. While the absence of retinal tears or holes during your examination is reassuring, persistent flashes can indicate ongoing vitreous traction. The risk of a retinal tear or detachment increases if the vitreous continues to exert force on the retina. To minimize this risk, it's essential to avoid activities that could exacerbate vitreous traction, such as heavy lifting or vigorous exercise. Regular follow-ups with your ophthalmologist are crucial to monitor any changes in your condition.

2. Retinal Health and Preventive Measures: High myopia is associated with thinning of the peripheral retina and changes in the optic nerve head, which can predispose individuals to retinal complications. Your doctor’s observation that your optic nerve appears "bloodshot" is not uncommon in high myopia, but it does require monitoring. Preventive laser treatment, such as laser photocoagulation, may be considered in certain cases where there are significant risk factors for retinal detachment. However, your doctor may have determined that your current condition does not warrant such intervention. It’s essential to have an open dialogue with your ophthalmologist about your concerns and to discuss whether further preventive measures are appropriate for your specific situation.

3. Intraocular Pressure (IOP) and Corneal Thickness: Your IOP readings of 22 and 23 mmHg are slightly elevated, but the interpretation of these values can be influenced by corneal thickness. Thicker corneas can lead to higher IOP readings, which may not necessarily indicate glaucoma. Your doctor’s reassurance that your corneal thickness mitigates the significance of your IOP readings is a positive sign. In general, IOP readings are assessed in conjunction with other factors, including optic nerve appearance and visual field tests, to determine the risk of glaucoma. Regular monitoring is essential, especially given your high myopia, as this condition can increase the risk of developing glaucoma over time.

In summary, while your concerns about retinal health and eye pressure are understandable, it’s important to maintain a balanced perspective. Regular eye examinations and open communication with your ophthalmologist are key to managing your condition effectively. If you experience any new symptoms, such as a sudden increase in floaters or flashes, or a change in vision, seek immediate medical attention. Managing anxiety related to your eye health is also crucial; consider discussing your feelings with your healthcare provider, as they can offer support and strategies to help you cope. Remember, staying informed and proactive about your eye health is the best approach to ensuring long-term well-being.

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