Eye Health: My Journey from Hyperopia to Possible Myopia

Q: Eye Health: My Journey from Hyperopia to Possible Myopia

Hello： <br>[Question 1] Based on your description, you have noticed a decrease in your hyperopia during a recent ophthalmic examination, and your corrected vision has improved. <br>This may indicate that your visual condition is changing, as the refractive power of the eyes can v

About the Eyes

Hello, Doctor.
After a 7-year gap, I went for an eye examination and discovered something surprising! When I was younger (at least before my first year of college), I clearly remember being diagnosed with high hyperopia, approximately +500 diopters in each eye, and astigmatism around +300 and +500 diopters (congenital).
Even after correction, my vision was still 0.5 in both eyes.
However, this time the results showed hyperopia of +400 and +300, with astigmatism unchanged, and after correction, my vision improved to 0.8!!!
Question 1: Does this mean I am gradually developing myopia? Additionally, the doctor mentioned that I have thinning of the nerve fibers, so I underwent the following tests: intraocular pressure: 23 and 25, OCT: the lower half was red, visual field test: both eyes normal.

Question 2: Is the thinning of the optic nerve caused by my previous high hyperopia? Will I definitely develop glaucoma in the future?
Question 3: Can I use methylsulfate neostigmine eye drops regularly? I read online that using it could lead to retinal detachment...
Is this used to lower intraocular pressure? (The doctor didn’t mention anything, and I only found out about this medication when I checked the prescription.) Thank you for your response, Doctor!

Xiao Xiao, 20~29 year old female. Ask Date: 2024/03/29

Dr. Gao Pilin reply Ophthalmology

Hello:
[Question 1] Based on your description, you have noticed a decrease in your hyperopia during a recent ophthalmic examination, and your corrected vision has improved.
This may indicate that your visual condition is changing, as the refractive power of the eyes can vary at different stages, sometimes related to the growth and development of the eyeball.
It is recommended that you continue to have regular eye examinations to stay informed about your visual status.
[Question 2] Optic nerve thinning is typically a chronic condition and is not solely caused by pre-existing high hyperopia.
While hyperopia may increase the risk of elevated intraocular pressure, it does not necessarily lead to optic nerve thinning.
Optic nerve thinning may be associated with various factors, including intraocular pressure, family history, and age.
Whether it will definitely progress to glaucoma depends on the control of intraocular pressure and other potential risk factors.
It is advisable to closely monitor changes in intraocular pressure and undergo regular ophthalmic examinations to ensure optic nerve health.
[Question 3] Methacholine sulfate eye drops do not cause retinal detachment, nor are they used to lower intraocular pressure.
They are intended to improve the symptoms of ocular muscle fatigue and relieve strain.

Reply Date: 2024/03/29

More Info

Hello! Thank you for sharing your journey regarding your eye health. It sounds like you have been through quite a bit, and I appreciate your detailed questions. Let’s address each of your concerns one by one.

Question 1: Am I gradually developing myopia?
It appears that your refractive error has changed from hyperopia (farsightedness) to a lesser degree of hyperopia, which may suggest that your eyes are adapting or changing over time. The fact that your corrected vision has improved to 0.8 indicates that your visual acuity has enhanced, but it does not necessarily mean that you are developing myopia (nearsightedness). Changes in refractive error can occur due to various factors, including age, eye strain, and changes in the shape of the eye. It’s essential to monitor these changes with regular eye exams, as they can provide valuable insights into your overall eye health.

Question 2: Is the thinning of the nerve fibers due to my previous high hyperopia? Will I definitely develop glaucoma?
Thinning of the nerve fibers can be associated with various conditions, including glaucoma, but it is not solely caused by previous high hyperopia. High hyperopia can lead to changes in the eye structure over time, which may contribute to nerve fiber thinning. However, it does not guarantee that you will develop glaucoma. Regular monitoring of your intraocular pressure (IOP) and visual field tests are crucial in assessing your risk for glaucoma. If your eye pressure is elevated (as indicated by your readings of 23 and 25), it may warrant closer observation and possibly treatment to prevent potential damage to the optic nerve.

Question 3: Can I use the medication Methazolamide (Sulfuric Acid Methylsulfonylmethane) frequently? Is it for lowering eye pressure?
Methazolamide is a carbonic anhydrase inhibitor that is used to lower intraocular pressure, particularly in conditions like glaucoma. While it can be effective, it is essential to use it under the guidance of your eye care professional. Concerns about potential side effects, including retinal detachment, are valid, but these risks are generally associated with improper use or underlying conditions. Your doctor should provide you with clear instructions on how to use this medication safely. If you have any concerns about its use, it’s best to discuss them directly with your eye care provider.

Additional Considerations:
Given your history of high hyperopia and the recent findings of nerve fiber thinning, it is crucial to maintain regular follow-ups with your eye care professional. They can monitor your eye health, assess any changes in your refractive error, and evaluate your risk for glaucoma. Lifestyle factors, such as reducing screen time, taking regular breaks during prolonged visual tasks, and ensuring proper lighting while reading, can also help alleviate eye strain and maintain overall eye health.

In conclusion, while your situation may seem concerning, many factors can influence eye health, and regular monitoring and communication with your eye care provider are key. If you have any further questions or concerns, don’t hesitate to reach out to your healthcare team. They are there to help you navigate your eye health journey. Wishing you all the best in your continued care!

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