High Myopia: Challenges in Treatment and Care

High myopia

Hello: My mother is a severe myopic patient with a prescription exceeding 1000 degrees and has mild cataracts.
She has visited public hospitals multiple times, and each time she is told to come back next week for eye drops.
Eventually, a doctor finally mentioned scheduling a surgery.
However, after waiting outside the clinic, she only received a prescription and no appointment.
Consequently, I called to inquire, and the doctor's response was that they needed to inform my mother that she had left, as there were no suitable surgical options for her due to her high myopia (they had already notified the surgical team).
They asked her to return next week for further explanation.
Today, from the patient's perspective, I want to know if the instruments used for my mother are indeed very special, why there is continuous delay, or if there are ethical issues with the doctor (as I have my own practice).
Therefore, I am questioning whether I should continue consulting this doctor or seek another hospital.
Thank you!

Xiao Yun, 30~39 year old female. Ask Date: 2006/03/14

Dr. Zhang Yanrui reply Ophthalmology

When undergoing cataract surgery, it is essential to implant an artificial intraocular lens (IOL).
Typically, the operating room will have commonly used IOLs available, so there is no need for special ordering.
However, for patients with high myopia, specialized IOLs may need to be ordered, which could result in a delay.
Regarding ethical concerns, it is indeed challenging to address, as sometimes it may simply be a misunderstanding between the physician and the patient.
In reality, physicians genuinely want to help patients resolve their issues.

Reply Date: 2006/03/14

More Info

High myopia, often defined as a refractive error greater than -6.00 diopters or an axial length exceeding 26.5 mm, poses significant challenges for both patients and healthcare providers. Your concerns regarding your mother's situation are valid, especially considering her high degree of myopia and the presence of mild cataracts.
Firstly, high myopia is associated with various ocular complications, including retinal detachment, macular degeneration, and glaucoma. These risks necessitate careful monitoring and management. The fact that your mother has been experiencing delays in her treatment can be frustrating, and it raises questions about the adequacy of her care.
In terms of surgical options, cataract surgery is typically a straightforward procedure, but in cases of high myopia, the surgical approach may require special considerations. For instance, the choice of intraocular lens (IOL) is crucial. Surgeons often prefer specific types of IOLs that can accommodate the unique anatomical and optical characteristics of high myopic eyes. This could explain why the surgical team is taking extra time to ensure that the right equipment and lenses are available for your mother’s specific needs.

The repeated delays and lack of clear communication from the healthcare team can understandably lead to frustration and doubt about the quality of care. It is essential for healthcare providers to maintain open lines of communication with patients and their families, especially in complex cases like high myopia with cataracts. If your mother feels that her concerns are not being adequately addressed, it may be worthwhile to seek a second opinion from another ophthalmologist or a specialized eye clinic. This could provide her with a fresh perspective on her treatment options and possibly expedite her care.

In addition to surgical considerations, managing high myopia also involves regular eye examinations and monitoring for any potential complications. Patients with high myopia should be educated about the signs and symptoms of retinal detachment and other serious conditions, so they can seek immediate care if necessary.
Lifestyle modifications can also play a role in managing high myopia. Encouraging your mother to engage in outdoor activities, reduce prolonged near work, and maintain a balanced diet rich in antioxidants may help in overall eye health. Some studies suggest that increased time spent outdoors during childhood may reduce the risk of developing myopia, although this is less applicable to individuals who already have high myopia.

In conclusion, while high myopia presents unique challenges, particularly in surgical contexts, it is crucial for patients and their families to advocate for clear communication and timely care. If you feel that your mother is not receiving the attention and treatment she deserves, exploring other healthcare options may be beneficial. Remember, the goal is to ensure that she receives the best possible care tailored to her specific needs.

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