Myopic Degeneration

What is myopic degeneration?

Myopic degeneration, also known as pathologic or degenerative myopia, is a progressive eye condition that occurs in people with high myopia (severe nearsightedness). Over time, the eyeball becomes elongated, causing thinning and stretching of the retina and other structures at the back of the eye. This can lead to vision-threatening complications such as retinal atrophy, abnormal blood vessel growth, and retinal detachment.

Causes and risk factors

High myopia: The primary risk factor is severe nearsightedness, usually defined as 6.00 diopters or greater.
Genetics: Family history of high myopia increases risk.
Age: The risk of complications increases with age.
Posterior staphyloma: Outward bulging of the back of the eye, common in high myopia.
Other eye conditions: Previous retinal detachment or eye surgery can increase risk.

Symptoms

Gradual or sudden decrease in central vision
Distorted or wavy vision (metamorphopsia)
New floaters or flashes of light
Dark or empty spots in the central vision
Difficulty reading or recognizing faces

If you experience sudden changes in vision, seek prompt evaluation.

Diagnosis

Diagnosis is made during a comprehensive eye exam and may include:

Dilated retinal exam: To check for thinning, tears, or detachment.
Optical coherence tomography (OCT): Imaging to assess the retina and detect swelling, atrophy, or abnormal blood vessels.
OCT angiography or fluorescein angiography: To identify abnormal blood vessel growth (choroidal neovascularization).
Ultrasound: If the view to the back of the eye is blocked.

Treatment options

Observation: Early or mild cases may only require regular monitoring.
Anti-VEGF injections: Medications injected into the eye to treat abnormal blood vessel growth and bleeding.
Laser therapy: Occasionally used to seal leaking blood vessels.
Vitrectomy surgery: Removal of the vitreous gel for complications like retinal detachment, macular holes, or persistent bleeding.
Macular buckle surgery: A specialized procedure to support the back of the eye in severe cases.

Prognosis and ongoing care

The outlook depends on the severity and type of complications.
Early detection and treatment of complications can help preserve vision.
Regular follow-up is essential to monitor for new changes or progression.
Some patients may experience permanent vision loss, especially if complications are not treated promptly.

Our approach

We provide comprehensive care for patients with myopic degeneration, including advanced imaging, personalized monitoring, and the latest treatments for complications. Our goal is to preserve your vision and support your eye health at every stage.

Patient Resources

If you have additional questions or need support, please contact our office. We are here to help you every step of the way.

Frequently Asked Questions

Is myopic degeneration the same as regular nearsightedness?

No. Myopic degeneration is a complication of severe nearsightedness that causes structural changes and damage to the retina and other eye tissues.

Can myopic degeneration be prevented?

While high myopia cannot be prevented, regular eye exams and early detection of complications can help protect your vision. Research into preventive measures is ongoing, and in children some treatments have been shown to slow the progression of myopia.

What are the warning signs of serious complications?

Distortion or waviness in the central vision, sudden loss of peripheral or side vision, or new floaters, flashes of light, or a dark curtain in your vision should be evaluated immediately.

Will I lose my vision?

Many patients maintain useful vision with regular monitoring and timely treatment, but some may experience permanent vision loss if complications are severe or untreated.

How often should I have my eyes checked?

Patients with high myopia or myopic degeneration should have a comprehensive dilated eye exam at least once a year, or more often if recommended.