Inner Visual Blind Spots: Causes and Concerns for High Myopia - Ophthalmology

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Understanding inner visual blind spots, especially in the context of high myopia, can be a source of concern for many patients. Given your situation, where both eyes are affected by high myopia (1000-1050 degrees), and you have a history of regular eye examinations, it’s important to address your concerns regarding the newly noticed blind spots.


1. Normal vs. Abnormal Visual Blind Spots
In general, visual blind spots (scotomas) can occur for various reasons. The most common blind spot is the physiological blind spot, which is located in the peripheral vision due to the absence of photoreceptors where the optic nerve exits the eye. However, the presence of new blind spots, especially in the central or inner visual field, can be concerning.

In your case, the fact that these blind spots are located in the inner visual field (one in the horizontal line of sight and another in the lower quadrant) is noteworthy. While it is not typical for blind spots to appear in these areas, it is not entirely uncommon for individuals with high myopia to experience visual anomalies due to structural changes in the eye.


2. Potential Causes of Inner Visual Blind Spots
Several factors could contribute to the development of these blind spots:
- Vitreous Changes: High myopia is often associated with changes in the vitreous body, including liquefaction and posterior vitreous detachment. These changes can lead to visual disturbances, including the perception of blind spots.

- Retinal Issues: Although your recent OCT and fundus examinations did not reveal significant issues, high myopia increases the risk of retinal complications, such as retinal tears or detachments, which could manifest as scotomas.

- Optic Nerve Health: Conditions affecting the optic nerve, such as glaucoma or optic neuritis, can also lead to visual field defects. Regular monitoring of optic nerve health is crucial, especially in high myopia patients.

- Neurological Factors: Sometimes, visual disturbances can be linked to neurological conditions. However, given your recent normal MRI results, this is less likely.


3. What to Do Next?
Given your situation, here are some recommendations:
- Follow-Up Examination: It is advisable to schedule a follow-up appointment with your ophthalmologist to discuss these new symptoms. A visual field test can help determine the extent and nature of the blind spots.

- Regular Monitoring: Continue with your routine eye examinations, as regular monitoring is essential for high myopia patients to catch any potential complications early.

- Document Changes: Keep a record of any changes in your vision, including the size, location, and frequency of the blind spots, as well as any associated symptoms like flashes of light or floaters.

- Stay Informed: Educate yourself about the potential risks associated with high myopia, including retinal detachment and other complications. Understanding these risks can help you manage your anxiety regarding your vision.


Conclusion
While the discovery of new blind spots can be alarming, it is essential to approach the situation with a clear understanding of the potential causes and the importance of regular monitoring. High myopia can lead to various visual phenomena, and while some changes may be benign, others may require intervention. Therefore, maintaining open communication with your eye care provider and promptly addressing any new symptoms is crucial for your ocular health.