Glaucoma Risks in High Myopia Patients

Glaucoma issues?

Hello Doctor: I have high myopia, with my prescription around -8.50 and -9.50 in each eye.
A few weeks ago, I had a health check-up where my intraocular pressure was measured at 22 mmHg in the left eye and 14 mmHg in the right eye.
I was informed that a pressure above 20 mmHg raises concerns for glaucoma.
I later visited an ophthalmologist, and my intraocular pressure was found to be below 20 mmHg.
During the examination with dilating drops, the doctor mentioned that there was a cupping of the optic nerve.
Is it possible that I have glaucoma? Thank you.

Shibin, 20~29 year old female. Ask Date: 2015/08/14

Dr. He Jianxian reply Ophthalmology

It is recommended that you undergo a visual field test, which can help determine if you have glaucoma.
However, considering your age, the likelihood of having glaucoma is probably not very high!

Reply Date: 2015/08/14

More Info

Understanding the risks of glaucoma in patients with high myopia is crucial, especially given your recent eye pressure readings and the findings from your ophthalmological examination. High myopia, defined as a refractive error greater than -6.00 diopters, is associated with various ocular complications, including an increased risk of glaucoma.
Glaucoma is a group of eye diseases that damage the optic nerve, often due to elevated intraocular pressure (IOP). In your case, the initial measurement of 22 mmHg in your left eye raised concerns, as normal IOP typically ranges from 10 to 21 mmHg. However, subsequent tests showed your IOP was below 20 mmHg, which is reassuring. The presence of optic nerve cupping, as noted by your ophthalmologist, is a significant factor in assessing the risk of glaucoma.
Patients with high myopia are at a higher risk for developing glaucoma for several reasons. Firstly, the structural changes in the eye associated with high myopia, such as elongation of the eyeball, can lead to alterations in the optic nerve head and increase susceptibility to damage. Secondly, high myopia can be associated with other conditions, such as lattice degeneration and retinal detachment, which may complicate the clinical picture and increase the risk of secondary glaucoma.

Given your situation, it is essential to monitor your eye health closely. Regular eye examinations, including IOP measurements and assessments of the optic nerve, are vital. Your ophthalmologist may recommend additional tests, such as visual field testing or optical coherence tomography (OCT), to evaluate the health of your optic nerve and the presence of any functional loss.

In terms of management, if glaucoma is diagnosed, treatment options may include medications (such as prostaglandin analogs or beta-blockers) to lower IOP, laser treatments, or surgical interventions, depending on the severity and type of glaucoma. It is also important to maintain a healthy lifestyle, including a balanced diet rich in antioxidants, regular exercise, and avoiding smoking, as these factors can contribute to overall eye health.

In conclusion, while your current IOP readings are reassuring, the presence of optic nerve cupping and your history of high myopia necessitates ongoing monitoring and possibly further evaluation for glaucoma. It is crucial to maintain open communication with your ophthalmologist regarding any changes in your vision or eye health. Regular follow-ups will help ensure that any potential issues are addressed promptly, allowing for the best possible outcomes in managing your eye health.

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