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Unraveling the Mysteries of Pathologic Myopia: Causes Symptoms and Treatments

Pathologic Myopia: Understanding the Basics and Key FactsMany of us have heard of nearsightedness, but have you ever wondered what happens when the severity of nearsightedness reaches extreme levels? The answer lies in pathologic myopia, a condition characterized by abnormal elongation of the eyeball and associated complications.

In this article, we will explore the definition, causes, and prevalence of pathologic myopia. We will also delve into the symptoms and diagnostic methods used to identify this condition.

Let’s unravel the mysteries surrounding pathologic myopia and gain a better understanding of its impact. Definition, Causes, and Prevalence of Pathologic Myopia

1.1 Definition of Pathologic Myopia

Pathologic myopia, also known as degenerative myopia, is a condition characterized by severe nearsightedness (myopia) that leads to irreversible structural changes in the eye.

Unlike regular nearsightedness, pathologic myopia causes the eyeball to elongate, resulting in thinning and stretching of the tissue layers at the back of the eye. This elongation can cause severe complications and vision loss if left untreated.

1.2 Causes of Pathologic Myopia

The causes of pathologic myopia can be attributed to a combination of genetic and environmental factors. Abnormal elongation of the eyeball is often seen in individuals with a family history of myopia, suggesting a hereditary component.

However, environmental factors such as excessive near work, lack of outdoor activities, and prolonged screen time can also contribute to the development and progression of pathologic myopia. The interplay between genetics and environmental factors remains an area of ongoing research.

1.3 Prevalence of Pathologic Myopia

Pathologic myopia is a leading cause of visual impairment worldwide. It is estimated that approximately 3% of the global population, or around 228 million people, are affected by this condition.

In fact, it ranks as the seventh leading cause of legal blindness. With the increasing prevalence of myopia, particularly in younger populations, the burden of pathologic myopia is expected to rise in the coming years.

Symptoms and Diagnosis of Pathologic Myopia

2.1 Common Symptoms of Pathologic Myopia

Pathologic myopia often presents with a range of symptoms that can significantly impact one’s visual abilities. Individuals with this condition may experience reduced visual acuity, making it difficult to see distant objects clearly.

Blind spots or scotomas may also occur, leading to areas of distorted or missing vision. Straight lines may appear wavy, and contrast sensitivity may be reduced, making it challenging to distinguish between light and dark areas.

Some individuals may also report a sensation of a dark curtain blocking their vision, floaters, or flashing lights, particularly during episodes of retinal detachment. 2.2 Diagnosis of Pathologic Myopia

Diagnosing pathologic myopia involves a comprehensive examination of the eyes and evaluation of the patient’s medical and family history.

Ophthalmologists will assess for structural changes in the back of the eye, such as the presence of a posterior staphyloma (an area of thinning in the eye’s structure). Additionally, imaging tests like spectral domain optical coherence tomography and fluorescein angiography may be used to visualize the internal structures of the eye, providing important diagnostic information.



Pathologic myopia is a severe form of nearsightedness that can cause significant complications and visual impairment. Its prevalence is increasing globally, making it a public health concern.

By understanding the causes, symptoms, and diagnostic methods associated with this condition, individuals can seek appropriate medical intervention and lessen the impact of pathologic myopia on their lives. Remember to prioritize regular eye check-ups and protect your eyes from excessive strain.

Your vision is a precious gift that deserves attention and care.

Effects and Risk Factors of Pathologic Myopia

3.1 Effects of Pathologic Myopia on the Eyes

Pathologic myopia can have profound effects on various structures within the eyes, often leading to visual impairment and potential complications. Understanding these effects is crucial for individuals diagnosed with this condition.

One of the hallmark effects of pathologic myopia is the development of a posterior staphyloma. This is an area of thinning and stretching of the eye’s structure, which can lead to the formation of myopic maculopathy.

Myopic maculopathy occurs when the macula, responsible for central vision, becomes damaged. This can result in reduced visual acuity and distortion of central vision.

In addition to myopic maculopathy, individuals with pathologic myopia may experience peripapillary atrophy, which is the thinning of the tissue surrounding the optic nerve. Chorioretinal atrophy, characterized by the degeneration of the retinal and choroidal tissue, can also occur.

These changes can further compromise vision and contribute to blind spots or scotomas. Another significant complication of pathologic myopia is the development of choroidal neovascularization.

This occurs when abnormal blood vessels grow beneath the retina, potentially leading to vision loss if left untreated. Lacquer cracks, small breaks in a layer of the eye called Bruch’s membrane, are often seen in association with choroidal neovascularization.

Other effects of pathologic myopia include the formation of Fuchs spots, which are yellow-white patches on the retina, and an increased risk of retinal tears and retinal detachment. Furthermore, individuals with pathologic myopia may be at higher risk for developing glaucoma and cataracts due to the structural changes in the eye.

It’s important to note that pathologic myopia can also increase the likelihood of posterior vitreous detachment, a condition where the gel-like substance in the eye separates from the retina. This detachment can lead to symptoms such as floaters, flashes of light, or the sensation of a curtain obstructing vision.

Lastly, pathologic myopia can even cause optic neuropathy, which is damage or dysfunction of the optic nerve. 3.2 Risk Factors for Pathologic Myopia

While anyone with myopia may be at risk for developing pathologic myopia, certain factors increase the likelihood of its occurrence.

High myopia, often defined as a refractive error of -6.00 diopters or greater, is a significant risk factor for developing pathologic myopia. The higher the myopic prescription, the greater the risk of developing complications associated with pathologic myopia.

Likewise, the length of the eyeball, known as axial length, is an important metric. Eyes with longer axial lengths are more prone to the abnormal elongation seen in pathologic myopia.

Age is also a contributing factor. Older individuals are more likely to develop pathologic myopia as the elongation of the eyeball progresses over time.

Additionally, genetics play a role, with individuals having a family history of myopia or pathologic myopia being at an increased risk. It is important for those with family members affected by pathologic myopia to be vigilant about regular eye exams and early intervention.

Importantly, pathologic myopia is often associated with other ocular conditions, further intensifying its impact. For example, there is an increased risk of retinal detachment, where the retina detaches from its supporting tissue, leading to vision loss.

Glaucoma, a condition characterized by increased pressure within the eye, can also occur more frequently in individuals with pathologic myopia. Finally, optic neuropathy, which involves damage to the optic nerve, is another condition that can manifest alongside pathologic myopia.

Prevention and Treatment of Pathologic Myopia

4.1 Decreasing the Risk of Pathologic Myopia

Preventing the progression of myopia into pathologic myopia is a complex challenge, and while there is no definitive answer, various strategies have shown promise. Slowing down the progression of myopia is a key goal.

One approach involves the use of atropine eye drops, which have been shown to reduce the rate of myopia progression. Myopia control eyeglasses and contact lenses, designed specifically for myopia management, can also help slow down the elongation of the eyeball.

Another technique gaining popularity is overnight orthokeratology. This involves wearing specially designed contact lenses overnight, which temporarily reshape the cornea to correct for myopia during waking hours.

Environmental adjustments, such as increasing outdoor time and reducing excessive near work or screen time, may contribute to mitigating the progression of myopia. 4.2 Available Treatments for Pathologic Myopia

Once pathologic myopia has developed, treatments can help manage its effects and improve visual acuity.

However, it’s important to note that there is no method to alter the length of the eye once it has elongated, and the thinning of the retina, choroid, and sclera is irreversible. Medical treatments, such as anti-vascular endothelial growth factor (anti-VEGF) therapy, can be used to manage choroidal neovascularization associated with pathologic myopia.

This approach involves injections of medication into the eye to inhibit the formation of abnormal blood vessels. Vitreoretinal surgery may also be necessary in cases of retinal detachments or severe myopic maculopathy.

Photodynamic therapy, which involves the use of light-activated medication to target and destroy abnormal blood vessels, can be effective in certain cases. In cases where the structural integrity of the eye is compromised, posterior scleral reinforcement techniques may be used to strengthen the weakened tissue.

Optical correction options, such as high-index lenses or contact lenses, can provide improved visual acuity for individuals with pathologic myopia. Additionally, low vision aids, such as magnification devices and reading aids, can assist those with significant vision loss in performing daily tasks.


Pathologic myopia is a complex condition that can have significant effects on vision and eye health. Understanding the effects and risk factors of pathologic myopia is crucial for individuals and healthcare professionals alike, as it facilitates early detection and appropriate management.

While prevention strategies are still being refined, it is important to prioritize regular eye exams and take steps to protect eye health. By staying informed and seeking appropriate treatment, individuals can minimize the impact of pathologic myopia on their quality of life.

Regional Variances and Demographics of Pathologic Myopia

5.1 Pathologic Myopia in Different Parts of the World

Pathologic myopia affects individuals worldwide and has varying prevalence in different regions. The condition is often associated with high myopia, but the risk and prevalence can differ among populations.

In certain ethnic groups, such as Jewish, Japanese, Chinese, and Middle Eastern populations, there is a higher prevalence of both myopia and pathologic myopia. These populations have a genetic predisposition to myopia, which likely contributes to the higher rates of pathologic myopia as well.

In fact, pathologic myopia is considered a significant public health concern and a leading cause of blindness in East Asia. In East Asian countries like China, Japan, and Singapore, where myopia is prevalent, studies have shown a high incidence of pathologic myopia.

For example, in a study conducted in China, it was found that nearly 80% of individuals with high myopia had associated chorioretinal atrophy, a common feature of pathologic myopia. These findings highlight the importance of early detection and intervention in these populations to prevent the development of severe complications.

5.2 Prevalence of Pathologic Myopia in the United States and Europe

While East Asia often receives attention regarding the prevalence of myopia and its associated complications, pathologic myopia is not limited to this region. It is important to examine the prevalence of pathologic myopia in the United States and Europe as well.

In the United States, myopia affects a significant portion of the population, with nearly one in three Americans being myopic. Regarding pathologic myopia specifically, estimates suggest that approximately 1% of Caucasians have this condition.

However, this figure may underestimate the true prevalence, as milder cases of pathologic myopia might go undiagnosed or be classified as non-pathologic myopia. Nonetheless, pathologic myopia remains a concern in the United States, and its impact on visual impairment and blindness cannot be ignored.

In Western populations, pathologic myopia contributes to visual impairment and is a significant cause of blindness. Studies have reported a prevalence of visual impairment caused by pathologic myopia in Western populations as high as 7%.

This underscores the importance of early detection and appropriate management of myopia to prevent the progression to pathologic myopia and subsequent visual impairment. Although the prevalence of pathologic myopia may vary across regions, it is clear that the condition has a global impact, affecting individuals from various backgrounds and ethnicities.

As the prevalence of myopia continues to rise worldwide, it is essential to address the risk factors and develop strategies for prevention and management to reduce the burden of pathologic myopia on individuals and healthcare systems.


Pathologic myopia manifests differently in various regions and populations, with varying prevalence rates. East Asian countries such as China and Japan have higher incidences of pathologic myopia, largely due to a combination of genetic factors and a high prevalence of myopia overall.

However, pathologic myopia is not limited to these regions, as it also affects individuals in the United States and Europe. Understanding the regional variances and demographics of pathologic myopia offers insights into the genetic and environmental factors that contribute to its development.

By acknowledging the varying prevalence rates, healthcare professionals can tailor screening and intervention strategies to specific populations, aiming to prevent or minimize the impact of this condition on individuals’ vision and quality of life. Continued research and collaboration are necessary to address the global burden of pathologic myopia and develop effective prevention and treatment strategies.

Pathologic myopia is a significant global concern, affecting individuals across different regions and demographics. This condition, characterized by severe nearsightedness and structural changes in the eye, can lead to vision loss and complications.

Prevalence rates vary, with higher incidences observed in East Asian populations. However, pathologic myopia also impacts individuals in the United States and Europe.

Understanding the effects, risk factors, and regional differences is essential in promoting early detection and appropriate management. By prioritizing regular eye exams, implementing preventive measures, and exploring innovative treatments, we can mitigate the impact of pathologic myopia on individuals’ vision and improve their quality of life.

Let us remember to protect our eyes and seek professional care to preserve this precious gift of sight.

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