High Myopia: Symptoms, Concerns, and Common Myths - Ophthalmology

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High myopia, often defined as a refractive error greater than -6.00 diopters, can lead to various ocular symptoms and concerns, particularly as the degree of myopia increases. Your questions touch on several important aspects of high myopia, including its symptoms, potential complications, and common misconceptions.

1. Symptoms and Retinal Concerns: The symptoms you describe, such as seeing flickering lights or flashes, particularly in low-light conditions, can indeed be associated with high myopia. In high myopia, the eyeball is elongated, which can lead to stretching of the retina. This stretching may cause the retina to become more susceptible to various issues, including retinal tears or detachments. The "old television flicker" you experience could be related to changes in the vitreous gel that fills the eye, which can pull on the retina, especially in myopic eyes. This phenomenon is known as posterior vitreous detachment (PVD), which is common in individuals with high myopia. It is crucial to monitor these symptoms closely, as they can indicate potential retinal complications. If you experience persistent flashes of light or a sudden increase in floaters, it is essential to seek an eye examination promptly.

2. Stability of Myopia in Adolescence: The belief that myopia stabilizes during high school is a common misconception. While many individuals may experience a slowdown in the progression of myopia during late adolescence or early adulthood, this is not universally true. Factors such as genetics, environmental influences (like prolonged near work), and overall eye health can affect the progression of myopia. Some studies suggest that myopia can continue to progress into the early twenties, particularly in those with high myopia. Regular eye examinations are essential to monitor any changes in your prescription and to manage your eye health effectively.

3. Visual Phenomena at Night: The experience of seeing moving lights or "clumps of light" when your eyes are closed could be related to several factors. One possibility is the phenomenon known as "phosphene," which occurs when pressure is applied to the eyes or when the retina is stimulated in ways that do not involve light. In high myopia, the retina may be more sensitive due to its elongation, leading to unusual visual sensations. Additionally, the brain's processing of visual information can sometimes create perceptions of light or movement even in the absence of external stimuli. If these experiences are frequent or bothersome, discussing them with an eye care professional can help clarify their significance and determine if further investigation is needed.

In summary, high myopia is associated with various symptoms and potential complications, particularly concerning the retina. It is essential to maintain regular eye examinations to monitor your eye health, especially given your symptoms. While some individuals may experience stabilization of myopia during adolescence, this is not guaranteed, and ongoing management is crucial. Lastly, unusual visual phenomena should be evaluated to rule out any underlying issues. Always consult with an eye care professional for personalized advice and treatment options tailored to your specific situation.