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Progressive Myopia and Its Impact on Eye Health

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Progressive Myopia and Its Impact on Eye Health

Progressive myopia, often referred to as pathological myopia, denotes a visual condition where an individual’s prescription continuously worsens due to structural alterations within the eye. It stands as a primary contributor to visual impairment and blindness. This comprehensive article offers an extensive examination of progressive myopia, encompassing its origins, signs, diagnostic methods, available treatments, and strategies to mitigate its advancement. Key highlights include the importance of early intervention, potential treatments like orthokeratology and atropine eye drops, and lifestyle changes to protect your eyesight.

Introduction:

Myopia, also known as nearsightedness, is a vision condition that is becoming more prevalent. It manifests as clear vision of nearby objects but blurriness when observing objects at a distance. Myopia develops when the eyeball elongates from its front to back, leading to the convergence of light rays in front of the retina rather than on it. While myopia often stabilizes in adulthood, some people experience “progressive myopia” where their prescription worsens year after year. If not addressed, this pathological advancement has the potential to result in retinal harm, compromised vision, and even blindness. This underscores the importance of comprehending the origins, risk elements, and available remedies for progressive myopia.

Causes and Mechanisms:

The exact mechanisms behind progressive myopia are not fully understood. However, research points to both environmental and genetic factors. Spending a lot of time indoors doing sustained close work can contribute to eye growth and progressive myopia development. Additionally, genetics play a role, as pathological myopia tends to run in families. The visual environment influences the release of chemicals in the retina that lead to progressive elongation of the eye and increasing nearsightedness. The sclera also thins and the retina stretches, increasing risk for retinal holes, tears, and detachments.

Symptoms:

The primary symptom of progressive myopia is worsening vision and a need for stronger prescriptions every 1-2 years. Other symptoms include:

  • Blurry distance vision
  • Squinting or eye strain
  • Headaches after visual tasks
  • Difficulty seeing at night
  • Frequent changes in prescriptions
  • Objects appearing distorted or smaller than normal

If left untreated, severe progressive myopia can cause:

  • Impaired peripheral vision
  • Blind spots
  • Retinal atrophy
  • Retinal holes, tears or detachments
  • Myopic macular degeneration
  • Glaucoma
  • Cataracts

Diagnosis: If frequent prescription changes occur, see an optometrist or ophthalmologist. They will conduct a comprehensive eye exam to check for signs of pathological myopia, including:

  • Refraction to test visual acuity and prescription strength
  • Slit-lamp exam to inspect the eyes
  • Retinal imaging to check for retinal abnormalities
  • Axial length measurement using ocular ultrasound or optical devices to measure eye size
  • Corneal topography to map the curvature of the cornea
  • Visual field testing to map peripheral vision

Early diagnosis and monitoring for structural changes can help prevent vision loss from progressive myopia.

Treatment and Management: While there is no cure for progressive myopia, the progression can be slowed with treatment and lifestyle changes. Options may include:

  • Glasses or contact lenses – Corrective lenses help focus light properly on the retina to reduce eye strain.
  • Orthokeratology – These rigid contact lenses are worn overnight to reshape the cornea and temporarily improve vision.
  • Atropine eye drops – Low-dose atropine has been shown to reduce myopia progression by over 50% in children.
  • Other eyedrops like low-dose pirenzepine may also control myopia progression.
  • Refractive surgery like PRK or LASIK – This reshapes the cornea to correct nearsightedness but does not always slow progression.
  • Lifestyle changes like more outdoor time and reduced near work can help.
  • Regular eye exams to monitor for retinal changes. Early treatment of abnormalities can prevent detachments or vision loss.
  • Myopia control specialty contact lenses slow progression by manipulating focus.

The key is early intervention. The younger the age at diagnosis, the better the chances of slowing progression and protecting long-term vision.

Common Questions:

Q: Is there anything I can do to prevent progressive myopia? A: Getting enough outdoor time and avoiding excessive near work can help. Focus on distance vision as much as possible. Also, myopia control techniques and eye drops in childhood can significantly slow progression.

Q: How fast does progressive myopia advance? A: It varies, but on average myopia progresses -0.50 to -1.00 diopters per year during school ages. In adulthood, it may progress -0.5 to -0.75 diopters every 1-2 years.

Q: Does progressive myopia go away? A: No, progressive myopia is lifelong and irreversible. But progression can often be slowed with treatment.

Q: Can progressive myopia be stopped completely? A: It’s difficult to halt completely. But implementing myopia control methods and eye drops as early as possible in childhood offers the best chance of significantly slowing progression.

Q: Is laser surgery effective for progressive myopia? A: Laser refractive surgery like LASIK can improve vision and reduce dependence on glasses or contacts. But it does not always change the underlying progressive myopia, which could still continue post-surgery.

Conclusion: Progressive myopia is a serious condition that can put you at risk for vision impairment or blindness. The key is early detection and intervention to slow progression. See an eye doctor right away if your prescription is worsening yearly. Implementing treatment options like orthokeratology, atropine drops, or specialty contacts can help protect your vision for years to come. With proper management, most cases of progressive myopia can achieve good vision outcomes.

Sources:

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