Blurry Vision: Insights on Retinal Health and Nerve Myelin

Q: Blurry Vision: Insights on Retinal Health and Nerve Myelin

Hello： Myopia patients exhibit posterior elongation of the eyeball due to an increase in axial length, leading to degeneration of the choroid and retina surrounding the optic nerve. <br>This is a common occurrence and should not be a cause for concern. <br><br>Optic Nerve Myelina

Blurred vision (Sequence 208652)

Hello Dr.
Gao,
Today I had an ophthalmology appointment where I underwent OCT and dilated fundus examination.
Everything is normal except for the peripheral retina in my right eye, which is thinner (the doctor mentioned it resembles that of someone with -6.00 to -7.00 diopters).
Additionally, there is a white spot beneath the right cornea, but since it is located at the bottom, it does not affect my vision.
The OCT of the macula and optic nerve also appeared normal.
However, the doctor suddenly mentioned the optic nerve myelin sheath, stating that while it does not affect vision, previous doctors during dilated examinations did not mention it, which makes me a bit uneasy.
I would like to ask if this could have developed suddenly or if it is congenital.
Could it have future implications?
Furthermore, if the optic nerve myelin sheath does not affect vision, are there other possible causes for my blurry and unstable vision? Today, my prescription measured at -4.75, which is the same as my current glasses, but my distance vision is blurry and not as clear as before.
My prescription had decreased previously, but in the last few days, it has increased again.
Is it possible that this fluctuation is due to increased screen time on my phone over the past couple of days? Are there any other potential causes? What exactly is the optic nerve myelin sheath? Additionally, is it possible for the retina to be naturally thinner? My peripheral retina is thin at -4.75, resembling that of -6.00 to -7.00 diopters.
I am concerned about whether it will continue to deteriorate, or if the retinal condition can stabilize and not change further.

Thank you, Dr.
Gao.
🙏

Hua Hua, 30~39 year old female. Ask Date: 2024/05/24

Dr. Gao Pilin reply Ophthalmology

Hello: Myopia patients exhibit posterior elongation of the eyeball due to an increase in axial length, leading to degeneration of the choroid and retina surrounding the optic nerve.
This is a common occurrence and should not be a cause for concern.

Optic Nerve Myelination refers to the presence of a myelin sheath surrounding the optic nerve fibers.
Myelin is typically found within the central nervous system, but in some individuals, it can also be present on the optic nerve fibers in the eye.
This is a congenital structural anomaly and not a pathological condition.
In most cases, optic nerve myelination does not affect vision and is usually discovered incidentally.
Since this was not mentioned in previous dilated fundus examinations, it may be because this structure typically does not change or cause symptoms, leading the previous physician to believe it was not necessary to emphasize.
The presence of optic nerve myelination does not change or worsen over time, so there is no need for excessive concern.
Causes of Blurred Vision and Changes in Prescription: There are many potential reasons for blurred vision, including changes in prescription, dry eye syndrome, visual fatigue, or other refractive issues.
Here are several possible causes:
1.
Eye Strain: Prolonged near-vision activities such as looking at a smartphone or computer can lead to visual fatigue, resulting in temporary blurriness.
It is advisable to rest the eyes and take breaks to look at distant objects.

2.
Dry Eye Syndrome: If the eyes are dry, vision may be unstable or blurry.
Using artificial tears in moderation may help alleviate symptoms.
3.
Refractive Errors: Changes in vision may be related to refractive errors, especially if there have been recent fluctuations in prescription.
Ensure that eyeglass prescriptions are appropriate and have regular vision checks.
4.
Environmental Lighting: Bright or reflective environments may affect vision; adjusting the lighting conditions is recommended.
Peripheral Retinal Thinning: Peripheral retinal thinning is particularly common in myopic patients, especially those with high myopia.
This does not necessarily mean that it will worsen or lead to retinal detachment, but it is important to protect the eyes and avoid activities that could cause retinal damage, such as vigorous exercise or head trauma.
Regular visits to an ophthalmologist, especially when there are changes in vision or new symptoms arise, can help detect problems early.
Comprehensive Recommendations:
1.
Maintain Good Eye Habits: Avoid prolonged near-vision tasks and take breaks as needed.
2.
Regular Check-ups: Even without symptoms, annual eye examinations are recommended, especially for those with high myopia or thinner retinas.
3.
Appropriate Eyeglass Prescription: Ensure that eyeglass prescriptions are suitable and check regularly if adjustments are needed.
4.
Avoid Eye Injuries: Steer clear of activities that may cause eye trauma, such as intense sports or heavy lifting.
Optic nerve myelination does not have a direct impact on vision, and peripheral retinal thinning does not necessarily lead to retinal detachment.
As long as regular check-ups are maintained and eye habits are observed, eye health can be effectively preserved.
If vision problems persist or new symptoms arise, it is advisable to consult an ophthalmologist for a more detailed evaluation.

Reply Date: 2024/05/24

More Info

Hello! Thank you for your detailed inquiry regarding your recent eye examination and concerns about your vision and retinal health. It’s understandable to feel anxious when faced with new medical information, especially concerning something as vital as your eyesight.

From what you’ve described, your eye doctor performed several tests, including an OCT (Optical Coherence Tomography) scan and a dilated fundus examination, which revealed that your right eye's peripheral retina is thinner than normal. This thinning can indeed be associated with high myopia (nearsightedness), which you mentioned is around -600 to -700 degrees. High myopia can lead to various retinal issues, including retinal detachment, so it’s essential to monitor this condition closely.

Regarding the mention of the optic nerve myelin, the myelin sheath is a protective covering that surrounds nerve fibers, including those in the optic nerve. It plays a crucial role in the efficient transmission of electrical signals along the nerve. If your doctor indicated that the myelin is present but not affecting your vision, it suggests that while there may be some changes, they are not currently impacting your visual acuity. Myelin can be affected by various factors, including genetic predispositions, autoimmune conditions, or even environmental influences, but it’s not something that typically changes suddenly without a significant underlying cause.

You also expressed concerns about fluctuating vision and the possibility of other factors contributing to your blurry vision. Fluctuations in vision can occur for several reasons, including changes in lighting, fatigue, prolonged screen time, or even dry eyes. If you’ve been using your phone more than usual, this could certainly contribute to temporary visual disturbances. It’s essential to take regular breaks from screens and practice the 20-20-20 rule: every 20 minutes, look at something 20 feet away for at least 20 seconds.

As for the thinness of your retina, it is indeed possible for some individuals to have a naturally thinner retina, which can be a hereditary trait. However, it’s crucial to maintain regular check-ups with your eye care provider to monitor any changes over time. Your doctor will likely recommend follow-up appointments to keep an eye on your retinal health, especially given your myopia.

In terms of your vision fluctuating between 475 and your current prescription, it’s not uncommon for individuals, especially those with high myopia, to experience variations in their vision. This can be due to several factors, including the state of your eye's focusing ability, changes in the shape of the eye, or even the health of the cornea and lens. If you find that your vision is consistently unstable, it would be wise to discuss this with your eye doctor, who may suggest further testing or adjustments to your prescription.

In conclusion, while the findings from your examination may seem concerning, it’s essential to remember that many factors can influence eye health and vision stability. Regular monitoring and open communication with your eye care provider are key to managing your eye health effectively. If you have any further questions or if your symptoms change, don’t hesitate to reach out to your doctor for guidance. Take care of your eyes, and I wish you the best in maintaining your vision health!

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