One of my patients has come for an eye examination today. She is 60 years old with a prescription of -12.00 DS in each eye. She started wearing glasses when she was 9 years old and her prescription has increased regularly from -0.50 DS. She complains of blurred and distorted print when she reads a book which she has noticed for around one week. Amsler grid testing reveals broken and wavy lines when viewed with the left eye. She has gone from 6/9 to 6/24 in that eye. What is going on?

  • People with high myopia (more than -6.00 DS) are at risk of a range of eye diseases. These are the main ones:
  • Retinal atrophy – these are areas where the retina has become thin and is no longer functioning.
  • Lattice degeneration – a type of retinal thinning at the periphery of the retina.
  • Lacquer cracks – breaks that occur in the membrane (Bruch’s membrane) between the retina and its underlying blood supply (the choroid layer).
  • New blood vessels (myopic choroidal neovascularisation) – new leaky blood vessels from the blood supply underneath the retina (the choroid layer), through lacquer cracks or areas of atrophy onto the retina.
  • Myopic macular degeneration – these degenerative changes can develop at the macula.
  • Myopic macular degeneration is also known as myopic maculopathy, affecting your central detailed vision.
  • Foster Fuchs spot – myopic choroidal neovascularisation can lead to scarring at the macula, known as a Foster Fuchs spot causing a blank or missing patch in your central vision.

It sounds as if this patient has a macular problem associated with her myopia; myopic choroidal neovascularisation and/or myopic macular degeneration. It also sounds like she has only had this for a few days, which means this condition can be treated using anti-VEGF injections. She deserves to be referred on an urgent basis to an eye specialist with experience in treating macular disorders.

0 Comments

Submit a Comment

Your email address will not be published.

This site uses Akismet to reduce spam. Learn how your comment data is processed.

If you like EyeTools Questions of the Day…

Children’s Eye Examinations
How to Run a Successful Low Vision Clinic
How to Run a Successful Optometry Practice

EyeTools.Education

 

NEW WEBINARS ADDED REGULARLY – this is for:
– Optometry students
– Pre-registration and novice optometrists
– Optometrists returning to work
– Junior eye doctors
– Dispensing opticians and orthoptists preparing for refraction exams
– Contact lens opticians, clinical assistants and eyecare educators

Improve your optometry skills with introductory & specialist instruction videos, topical live & recorded expert webinars, presentations and book reviews.

Start with the first section, ‘Pre-refraction procedures’ free, then choose a monthly or yearly subscription. To see English captions, click the CC button on any video.