Pathological Myopia: Eye Axis Growth and Complications - Ophthalmology

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Pathological myopia, also known as degenerative myopia, is a condition characterized by excessive elongation of the eyeball, leading to various ocular complications. As you noted, your axial length has increased, which is a common concern for individuals with high myopia, especially when the axial length exceeds 29 mm.
To address your questions, it is important to understand the relationship between axial length, age, and the progression of myopia. Generally, the growth of the eye, particularly the axial length, tends to stabilize after the age of 25 to 30. However, in individuals with pathological myopia, there can still be some degree of axial elongation even into their 30s and beyond. This is due to the structural changes in the eye that occur as a result of high myopia, including thinning of the sclera and changes in the vitreous body.
In your case, the increase in axial length of 0.20 mm in the left eye and 0.07 mm in the right eye over three years indicates that your myopia is still progressing, albeit at a potentially slower rate than during your younger years. It is essential to have regular eye examinations to monitor these changes, as continued elongation can lead to complications such as retinal detachment, macular degeneration, and glaucoma.

Regarding intraocular pressure (IOP), it is not directly correlated with axial length. However, in some cases, as the eye elongates, the risk of developing glaucoma may increase due to changes in the eye's anatomy and drainage system. It is crucial to monitor your IOP regularly, especially since high myopia can predispose individuals to glaucoma.

As for the complications associated with pathological myopia, posterior scleral staphylomas, retinal tears, and macular changes are common. In severe cases, particularly when there is significant retinal detachment or other serious complications, surgical intervention may be necessary. The decision to enucleate (remove) the eye is typically reserved for extreme cases where the eye is no longer functional, poses a risk of severe complications, or if there is significant pain that cannot be managed. This is a rare outcome and usually occurs in the context of advanced disease processes.

In summary, while axial length may continue to increase in some individuals with pathological myopia even after the age of 30, it often stabilizes over time. Regular monitoring of your eye health, including axial length measurements and intraocular pressure assessments, is essential to manage the risks associated with high myopia. If you experience any new symptoms, such as changes in vision, flashes of light, or an increase in floaters, it is crucial to seek immediate medical attention.