Retinal Detachment Risks for High Myopia Patients

Q: Retinal Detachment Risks for High Myopia Patients

Hello HANK： 1. If the retina is healthy, it will not occur. 2. Prolonged near vision followed by sudden distance vision can sometimes lead to blurred vision due to the ciliary muscle's inability to adjust. 3. The incidence of retinal detachment in the general

Retinal issues

I would like to ask the doctor: 1.
For someone who works long hours on a computer and has a refractive error of over 1000 diopters in both eyes without dilation, does the risk of retinal detachment increase with age? 2.
Sometimes I feel that my vision is not as clear, could this be related to the need for my pupils to adjust when shifting focus from near to far due to prolonged near work? 3.
How much higher is the risk of retinal detachment in individuals with high myopia compared to the general population? 4.
What precautions should individuals with high myopia take in their daily lives? I've heard that heavy lifting can increase the risk of retinal detachment due to the strain involved.
5.
Excluding trauma, are there any behaviors that could lead to a higher risk of retinal detachment? Thank you, doctor, for your patient answers.

HANK, 30~39 year old female. Ask Date: 2020/01/18

Dr. Gao Pilin reply Ophthalmology

Hello HANK: 1.
If the retina is healthy, it will not occur.
2.
Prolonged near vision followed by sudden distance vision can sometimes lead to blurred vision due to the ciliary muscle's inability to adjust.
3.
The incidence of retinal detachment in the general population is only 0.1%, but for those with myopia greater than 600 diopters, the incidence rises to 1%.
4.
If there is no thinning or holes in the peripheral retina, retinal detachment is less likely.
However, if there is thinning or holes, one should be cautious about exertion or physical activity.
High myopia over 1000 diopters is more likely to cause atrophy of the choroid and pigment layer near the macula, initially leading to decreased vision that gradually worsens; if bleeding occurs, it can result in a central scotoma.
If the atrophy of the macula reaches a certain extent, it may also lead to holes, and if accompanied by vitreous traction from above, it could trigger retinal detachment, which, if left untreated, poses a risk of blindness.
Taiwan E-Hospital Puzi Hospital Ophthalmology: Monday, Tuesday, Thursday, and Friday mornings from 8:00 AM to 12:00 PM, Wednesday afternoons from 2:00 PM to 4:30 PM.
Online responses are for reference only; it is necessary to seek medical attention at a healthcare facility.
I hope to have the opportunity to serve you.
Gao Pi-Lin

Reply Date: 2020/01/18

More Info

Understanding the risks of retinal detachment, especially for individuals with high myopia, is crucial for maintaining eye health. High myopia, defined as a refractive error greater than -6.00 diopters, is associated with various ocular complications, including an increased risk of retinal detachment. Let's address your questions one by one.

1. Age and Retinal Detachment Risk: As you age, the risk of retinal detachment does indeed increase, particularly for individuals with high myopia. This is due to the structural changes that occur in the eye over time. The vitreous gel, which fills the eye, can become more liquid and may pull away from the retina, leading to tears or detachment. Additionally, the elongation of the eyeball associated with high myopia can predispose the retina to more significant stress and potential detachment.

2. Visual Clarity and Accommodation: If you experience difficulty focusing on distant objects after prolonged near work, this could be related to a phenomenon known as "accommodative fatigue." When you focus on close objects for extended periods, your eye muscles can become fatigued, making it harder to adjust to viewing distant objects. This is common among individuals who spend long hours on computers or engaging in close-up tasks. Regular breaks and the 20-20-20 rule (looking at something 20 feet away for 20 seconds every 20 minutes) can help alleviate this issue.

3. Retinal Detachment Probability in High Myopia: The risk of retinal detachment in individuals with high myopia is significantly higher compared to the general population. Studies suggest that the risk can be up to 10 times greater for high myopes. This increased risk is attributed to the structural changes in the retina and the eye's elongated shape, which can lead to thinning and increased susceptibility to tears and detachment.

4. Precautions for High Myopia: Individuals with high myopia should be vigilant about their eye health. Regular eye examinations are essential to monitor for any changes in the retina. It's advisable to avoid activities that could increase intraocular pressure or strain the eyes, such as heavy lifting or straining. If you experience sudden flashes of light, floaters, or a curtain-like shadow over your vision, seek immediate medical attention, as these can be signs of retinal detachment.

5. Behaviors Increasing Retinal Detachment Risk: Besides trauma, certain behaviors can increase the risk of retinal detachment. These include engaging in high-impact sports without proper eye protection, sudden changes in body position (like rapid head movements), and activities that involve significant straining. Maintaining a healthy lifestyle, including proper nutrition and managing systemic health conditions (like diabetes and hypertension), can also contribute to overall eye health.

In conclusion, while the risk of retinal detachment is higher for individuals with high myopia, regular monitoring and proactive eye care can significantly mitigate this risk. It’s essential to maintain open communication with your eye care provider about any changes in your vision and to adhere to recommended follow-up appointments. Taking preventive measures and being aware of the signs of retinal issues can help preserve your vision and overall eye health.

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