Managing High Myopia: Concerns About Vision Loss and Treatment Options

High myopia

Dear Doctor,
I am 30 years old and have a girlfriend with whom I am considering marriage.
However, I have been troubled by my eye issues for a long time, even contemplating whether I should get married, as I worry about the possibility of becoming blind in the future.
I have high myopia, with both eyes at -1400 diopters.
I regularly visit Mackay Memorial Hospital for retinal examinations every six months.
The doctor mentioned that my retina appears to be in good condition but shows signs of thinning, which concerns me.
I have a few questions I would like to ask:
1.
If I notice a "rain" phenomenon in my vision, does that indicate retinal detachment? Should I go to an outpatient clinic or the emergency room? Can laser surgery be performed in the outpatient setting?
2.
As someone with high myopia, am I destined to experience retinal detachment? If so, is there a risk of blindness, and at what age might this occur? Additionally, if detachment happens, what are the chances of recovery after surgery (to what degree can vision be restored)?
3.
Recently, a colleague with high myopia underwent refractive surgery to eliminate the need for glasses.
Given my situation, am I a candidate for such surgery? Are there any potential side effects?
4.
I used to wear contact lenses, but since around March of this year, I have experienced discomfort whenever I wear them.
My ophthalmologist indicated that this is due to conjunctivitis and advised me to take a break from wearing them.
I have now switched to regular glasses.
Should I consider wearing contact lenses again in the future?
5.
Due to my work, I frequently use a computer, which causes eye strain.
What eye care practices can I adopt, and what should I be mindful of in my daily routine?
Thank you for your assistance regarding my eye concerns.
Best regards,
Jason

jason, 30~39 year old female. Ask Date: 2004/06/21

Dr. Zhang Zhengzhong reply Ophthalmology

Hello Jason,
1.
The symptoms of retinal detachment include the presence of fixed shadows.
If you experience this, please seek medical attention promptly.
Additionally, if you notice symptoms resembling rain in your vision, it may indicate warning signs from the retina, and you should also seek medical care as soon as possible.
2.
Individuals with high myopia are not guaranteed to experience retinal detachment, but the likelihood is higher compared to those without myopia.
This is because people with high myopia have larger eyeballs, which can lead to thinning of the peripheral retina, thereby increasing the risk of retinal detachment.
Post-surgery, the retina cannot be restored to its pre-detachment state, so it is best to avoid retinal detachment altogether.
3.
Regarding refractive surgery for myopia, a thorough examination is required to determine if your eyes are suitable for the procedure.
However, it is important to note that whether or not you undergo myopia surgery, your retina will not become healthier, so regular retinal check-ups are still necessary.
4.
Whether you can continue wearing contact lenses should be discussed with the doctor who examined you, as I cannot provide guidance without having conducted an examination.
5.
Regularly check the condition of your retinal health.
If you notice an increase in the number of floaters or the presence of fixed shadows, please seek medical attention promptly.
Sincerely,
Director Zhang Zhengzhong

Reply Date: 2004/06/21

More Info

Hello Jason,
Thank you for reaching out with your concerns regarding your high myopia and the potential implications for your vision and future. It's understandable to feel anxious about these issues, especially when considering significant life decisions like marriage. Let's address your questions one by one.

1. Symptoms of Retinal Detachment: The "rain" phenomenon you mentioned, often described as seeing floaters or flashes of light, can indeed be a sign of retinal detachment or other serious eye conditions. If you experience this, it is crucial to seek immediate medical attention. While you may be able to visit an outpatient clinic, if the symptoms are acute or worsening, going to the emergency department is advisable. Laser surgery for retinal tears can often be performed in an outpatient setting, but the urgency of your symptoms will dictate the appropriate course of action.

2. Risk of Retinal Detachment in High Myopia: Individuals with high myopia are at a higher risk for retinal detachment due to the elongation of the eyeball, which can lead to thinning of the retina. While not everyone with high myopia will experience retinal detachment, the risk increases with the degree of myopia. If detachment occurs, the chances of vision recovery depend on how quickly treatment is initiated and the extent of the detachment. Many patients can regain functional vision, but it may not return to their pre-detachment levels. Regular monitoring and early intervention are key.

3. Refractive Surgery Options: Regarding laser eye surgery (like LASIK or PRK), candidates with high myopia can sometimes undergo these procedures, but it depends on the overall health of your eyes and the thickness of your cornea. Given your history of retinal thinning, a thorough evaluation by a qualified ophthalmologist is essential to determine if you are a suitable candidate. Potential risks include complications that could affect your vision, so it’s important to weigh the benefits against the risks.

4. Contact Lens Use: If you have been experiencing discomfort with contact lenses, especially if diagnosed with conjunctivitis, it is wise to follow your eye doctor's advice and take a break from wearing them. Depending on the severity of your condition, you may be able to return to contact lenses after your eyes have healed. However, if you continue to have issues, it might be worth discussing alternative options, such as different types of lenses or solutions that are more compatible with your eye condition.

5. Eye Care for Computer Use: Given your work requires frequent computer use, it’s important to practice good eye hygiene. The 20-20-20 rule is a helpful guideline: every 20 minutes, look at something 20 feet away for at least 20 seconds. This can help reduce eye strain. Additionally, ensure your workspace is well-lit to minimize glare on your screen, and consider using artificial tears to keep your eyes moist. Regular breaks and proper ergonomics can also help alleviate discomfort.

In summary, while high myopia does present certain risks, proactive management through regular check-ups and prompt attention to any new symptoms can significantly mitigate these risks. It’s great that you are already having regular eye examinations. I encourage you to maintain open communication with your eye care provider about your concerns and treatment options.

Wishing you the best of health and clarity in your vision.

Best regards,
Doctor Q&A Teams

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