Comprehensive Eye Exam: Concerns for High Myopia and Surgery Options

Eye Examination

Hello, I am currently about 17.5 years old.
I have been wearing soft contact lenses for nearly two and a half years, and during this time, I have not experienced any eye-related diseases.
My prescription (for both eyes) is approximately -8.9 diopters (measured in August of last year), and I also have astigmatism, but I forgot the exact measurement.
Because my myopia is quite high, I am concerned about whether any eye conditions might arise due to the high prescription.
I plan to have a comprehensive eye examination at a hospital next summer.
Could you recommend a good hospital for this? Also, what specific aspects of the examination results should I pay particular attention to?
If I want to undergo surgery to correct my vision, what age do you think would be appropriate? After the surgery, is there a possibility of developing myopia again? Could you also provide information about the relevant surgical procedures and their costs? Lastly, thank you for your help.

Kandi, 10~19 year old female. Ask Date: 2003/08/23

Dr. Huang Bozhen reply Ophthalmology

Retinal detachment is most commonly seen in patients with myopia ranging from -500 to -800 diopters.
You can go to any ophthalmology clinic for a dilated fundus examination.
As long as your myopia has not increased for a year and you are at least 20 years old, you can undergo laser surgery for myopia.
Major medical centers offer this procedure, with costs ranging from NT$20,000 to NT$30,000 for both eyes.
It is possible to become myopic again after the surgery unless you engage in regular outdoor activities.

Reply Date: 2003/08/23

More Info

Hello! It's great to hear that you're taking proactive steps regarding your eye health, especially given your high myopia (around -8.9 diopters). High myopia can indeed increase the risk of various eye conditions, including retinal detachment, macular degeneration, and glaucoma. Therefore, regular comprehensive eye exams are crucial for monitoring your eye health.

Recommended Eye Examination
When you go for your comprehensive eye exam, it's essential to have a thorough evaluation that includes:
1. Visual Acuity Test: This assesses how well you can see at various distances.

2. Refraction Assessment: This determines your exact prescription for glasses or contact lenses.

3. Dilated Fundus Examination: This allows the doctor to examine the retina and optic nerve for any signs of damage or disease.

4. Ocular Pressure Measurement: This is important for assessing the risk of glaucoma.

5. Retinal Imaging: Technologies like Optical Coherence Tomography (OCT) can provide detailed images of the retina and help detect any early signs of retinal issues.

Choosing a Hospital
For your eye examination, I recommend visiting a reputable eye care center or a university-affiliated hospital with a strong ophthalmology department. These institutions typically have the latest technology and experienced specialists. You might consider places like the Wilmer Eye Institute at Johns Hopkins or the Massachusetts Eye and Ear Infirmary, depending on your location.

Surgical Options
Regarding surgery to correct your vision, options like LASIK or SMILE (Small Incision Lenticule Extraction) are commonly performed. However, the suitability of these procedures often depends on several factors, including:
- Age: Most surgeons recommend waiting until your vision has stabilized, typically around 18-21 years old. Since you are currently 17.5, it might be wise to wait until next summer when you are closer to 18.

- Corneal Thickness: Adequate corneal thickness is necessary for these procedures.

- Stability of Prescription: If your prescription has been stable for at least a year, you may be a good candidate.

Risks and Considerations
While these surgeries are generally safe, there are potential risks, including:
- Undercorrection or Overcorrection: This may result in needing glasses or contacts post-surgery.

- Dry Eyes: A common side effect that usually resolves over time.

- Visual Disturbances: Such as halos or glare, especially at night.

Post-Surgery Expectations
After surgery, while many patients achieve 20/25 vision or better, there is still a possibility of regression, especially with high myopia. Some patients may experience a gradual return of myopia over time, necessitating enhancements or additional procedures.

Costs
The cost of laser eye surgery can vary widely depending on the type of procedure, the surgeon's experience, and the facility. In the U.S., LASIK typically ranges from $2,000 to $3,000 per eye. It's essential to check if your insurance covers any part of the procedure, as many do not.

Conclusion
In summary, it's excellent that you're planning to have a comprehensive eye exam. Make sure to discuss your concerns about high myopia and potential surgical options with your eye care provider. They can provide personalized recommendations based on your specific situation. Remember, maintaining regular check-ups is key to preserving your vision and overall eye health. Good luck, and take care!

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