Degenerative Myopia: Causes and Treatments

Written by Medicover Team and Medically Reviewed by Dr Manaswini Priya Varanasi , Ophthalmologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Degenerative myopia, also called pathological myopia, is a severe form of nearsightedness in which the eyeball becomes excessively elongated, leading to progressive vision problems. Over time, it can cause damage to the retina and other eye structures, increasing the risk of serious complications and vision loss.

What are the Causes of Degenerative Myopia?

Degenerative myopia is primarily caused by excessive elongation of the eyeball, leading to progressive thinning of the retina and other eye structures. Genetic factors, environmental influences such as prolonged near work, and early-onset high myopia can all contribute to its development.

Genetic Factors

Genetics plays a pivotal role in the development of degenerative myopia. If one or both parents have this condition, the likelihood of their children developing it increases significantly. Specific genes have been identified that are associated with the risk of developing high myopia and its degenerative form.

Environmental Influences

While genetics is a primary factor, environmental influences cannot be ignored. Factors such as excessive near work, lack of outdoor activities, and prolonged screen time have been linked to the progression of myopia, potentially exacerbating the condition into its degenerative form.

Structural Abnormalities

Degenerative myopia often involves structural abnormalities in the eye, such as a thinner sclera or weaker connective tissues. These abnormalities contribute to the progressive elongation of the eyeball and the accompanying retinal changes.

When Should You See a Doctor for Degenerative Myopia?

Consulting an ophthalmologist or retina specialist is important if vision changes worsen or signs of complications develop.

Rapid decline in vision clarity
Sudden increase in floaters or flashes of light
Signs of retinal detachment, such as shadow or curtain-like vision
Difficulty performing daily activities due to vision problems

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What are the Symptoms of Degenerative Myopia?

Degenerative myopia may cause progressively worsening blurred distance vision, along with difficulty seeing clearly even with glasses. Other symptoms can include floaters, flashes of light, reduced visual acuity, and in severe cases, complications such as retinal detachment or macular degeneration leading to vision loss.

Progressive Vision Loss

One of the most notable symptoms of degenerative myopia is the gradual worsening of distance vision. This progression can be swift and severe, leading to significant visual impairment.

Floaters and Flashes

Patients with degenerative myopia often report seeing floaters (small, shadowy shapes that drift across the visual field) and flashes of light. These symptoms are indicative of changes in the vitreous humor and potential retinal complications.

Retinal Detachment

As the retina stretches and thins, the risk of retinal detachment increases. Symptoms include sudden flashes of light, a shadow or curtain over part of the visual field, and a sudden increase in floaters. Retinal detachment is a medical emergency requiring immediate attention.

What are the Types of Degenerative Myopia?

Degenerative myopia can be classified based on the extent of eye changes and associated complications. Common types include simple high myopia, pathologic (progressive) myopia with structural damage to the retina, and myopic macular degeneration, which affects central vision due to changes in the macula.

Primary Degenerative Myopia

Primary degenerative myopia is typically inherited and manifests early in life. It progresses rapidly and is often associated with significant retinal changes and complications.

Secondary Degenerative Myopia

Secondary degenerative myopia results from other ocular or systemic conditions. These may include conditions such as Marfan syndrome, Ehlers-Danlos syndrome, or other connective tissue disorders. Management of the underlying condition is crucial in addressing secondary degenerative myopia.

How is the diagnosis of Degenerative Myopia?

Degenerative myopia is diagnosed through a comprehensive eye examination, including visual acuity testing and refraction assessment. Additional tests such as fundus examination, optical coherence tomography (OCT), and imaging studies help evaluate retinal changes and detect complications associated with the condition.

Comprehensive Eye Examination

A thorough eye examination is essential for diagnosing degenerative myopia. This includes a refraction test to measure the degree of myopia, as well as a dilated eye exam to examine the retina and other structures within the eye.

Optical Coherence Tomography (OCT)

OCT is an advanced imaging technique that provides detailed cross-sectional images of the retina. This helps in assessing the extent of retinal thinning, choroidal atrophy, and other structural changes associated with degenerative myopia.

Fundus Photography

Fundus photography involves taking detailed photographs of the retina. These images are crucial for documenting the progression of degenerative changes and identifying complications such as retinal detachment or macular degeneration.

What are the Treatment Options for Degenerative Myopia?

Treatment for degenerative myopia focuses on slowing progression and managing complications. Options include corrective lenses, medications such as anti-VEGF injections for myopic macular degeneration, and procedures like laser therapy or surgery in advanced cases. Regular eye check-ups and lifestyle modifications are essential to preserve vision and detect complications early.

Pharmacological Interventions

Pharmacological treatments aim to slow the progression of myopia and manage associated complications. These may include:

Atropine Eye Drops: Low-dose atropine drops have been shown to slow the progression of myopia in children, potentially reducing the risk of developing degenerative myopia.
Anti-VEGF Injections: For patients with myopic macular degeneration, anti-VEGF injections can help manage neovascularization and prevent further vision loss.

Optical Treatments

Optical treatments focus on correcting refractive errors and improving visual acuity. These include:

Contact Lenses: Specialized contact lenses, such as orthokeratology (Ortho-K) lenses, are designed to reshape the cornea and reduce the degree of myopia.
Spectacles: High-index lenses can effectively correct severe myopia, though they may be thicker and heavier than standard lenses.

Surgical Interventions

In advanced cases of degenerative myopia, surgical interventions may be necessary to address complications and improve vision:

Laser-Assisted in Situ Keratomileusis (LASIK): LASIK surgery reshapes the cornea to correct refractive errors. However, it may not be suitable for individuals with significant retinal changes or very high myopia.
Phakic Intraocular Lenses (IOLs): Phakic IOLs are implanted in the eye to correct severe myopia. This option is considered for patients who are not candidates for LASIK.
Vitrectomy: In cases of retinal detachment or significant vitreous changes, a vitrectomy may be performed to remove the vitreous gel and repair the retina.

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How Can Degenerative Myopia Be Prevented?

Degenerative myopia cannot always be fully prevented, but its progression can be slowed with early intervention. Measures such as regular eye check-ups, limiting prolonged near work, increasing outdoor activities, and using prescribed corrective lenses or treatments can help protect vision and reduce complications.

Regular Eye Check-Ups

Early detection and monitoring are critical for managing degenerative myopia. Regular eye check-ups can help identify changes in vision and address complications promptly.

Lifestyle Modifications

Adopting healthy lifestyle habits can help slow the progression of myopia:

Limit Screen Time: Reducing the amount of time spent on digital devices can alleviate eye strain and prevent the worsening of myopia.
Encourage Outdoor Activities: Spending time outdoors has been shown to reduce the risk of myopia progression in children and adolescents.