Progressive Myopia-Distance Blurred Vision [Complications, Types And Treatments]

• Myopia affects up to 85% -90% of adults in Asia and 33% in the United States.
• The higher degree of myopia is directly proportional to the higher risks of complications that may lead to irreversible vision loss.
• It is worldwide accepted that myopia is a combined result of genetic predisposition and environmental influence.
• It has been divined that, till 2050, progressive myopia will affect 9.8% of the global population (a total of 938 million people).
• Progressive  Myopia increases the danger of open-angle glaucoma, retinal detachment, and myopic macular degeneration.

Myopia is a medical dictionary word that means nearsightedness. It is an ophthalmic condition in which an individual can see close objects clearly, but distant objects appear blurred. If myopia progresses untreatable it can result in high myopia or even blindness. The refractive error of the eye unit is “Diopter” (D).

Myopia befalls when the eyeball is excessively large or the cornea is too arched that results in the light entering the eye aren’t focused correctly, and distant objects look blurred. Myopia affects up to 30% of the U.S. whole population while the specific cause of myopia is still unknown, but there is a meaningful explanation that may be people with inherited myopia or people with the tendency to develop myopia but actual development may be affected by how a person uses his/ her eyes. People who consume much time reading, working at a computer, or doing intense close visual work may be more likely to develop myopia.

Types of Myopia

Myopia may generally occur in childhood and typically progresses until 20 age, but it also befalls adults due to visual stress and health-related issues. 

1. Night myopia

The distant blurred vision that experiences only at night called night myopia. Low intense light makes it difficult for the eyes to focus properly at night and increased pupil size puts more pressure on the eye.

2. False / Pseudo Myopia

An excessive amount of near-vision jobs on screens may encounter a false or “pseudo” myopia. When people do long periods of near work, their eyes are unable to refocus to perceive distant things.  Vision got normal usually after resting the eyes. Despite this, continuous visual stress may lead to a permanent loss in distance vision over time.

3. Health/ Disease Induced Myopia

Sometimes health issues (malnutrition) and disease (like diabetes or cancer suffering patients) may enhance an indication for myopia and other eye problems.

Possible Complications of Progressive Myopia

Individuals with untreated and progressive myopia are at a greater risk of developing several eye conditions associated with the elongation of the eye and stretching of the retina. The retina is the thin layer of tissue at the back of the eye that “receives” light.

If eye abnormality such as progressive myopia develops and is left untreated, it can threaten part or all of your vision. People with progressive myopia have a higher chance of developing certain conditions:

1. Retinal detachment

A retinal detachment is the disconnection (detachment) of the light-sensitive retina from the back of the eyeball it occurs because elongation of the eye causes expanding and thinning of the retina that results in rips in the peripheral retina and detachment of retinal tissue from the inner layers of the eye.

 A detached retina is a serious eye condition that needs a medical emergency.  According to research in the Community Eye Health Journal, progressive myopia patients are about 5-6 times more likely to experience a retinal detachment. 

2. Macular degeneration

Macular degeneration is also called age-related macular degeneration that affects the macula. The macula is the small middle area of the retina that controls our sharpest vision. The healthy macula defines our ability to read, recognize faces, drive, watch, and other detailed visual tasks. Blindness is rare in macular degeneration.

Progressive myopia can raise the chances of developing myopic age-related macular degeneration. Just the same as retinal detachment, myopic macular degeneration is also the result of retinal stretching, tightening, and thinning.

3. Glaucoma

A glaucoma is a group of conditions that describe damage to the optic nerve the pathways between the eyes and the brain that’s usually caused by elevated pressure inside the eye; untreated it can lead to blindness. Some observable symptoms are;

• Blurred vision, 
• Headaches, 
• Nimbuses around lights, 
• Difficulty seeing in the dark,
• Loss of peripheral vision (doesn’t occur until the condition is worse). 

To prevent blindness from glaucoma it is extremely important to have a routine eye examination.

4. Cataracts

A cataract is emerging from a cloud in the eye lens. It is the common cause of vision loss in the world, but it is treatable. It occurs because the proteins that help form up the lens start to clump together and cause clouding. Individuals with progressive myopia have a high risk of developing cataracts. Cataracts usually occur earlier in life among those with progressive high myopia and symptoms include blurred and hazy vision, halos around lights, increased dazzle, and reduced vibrancy of colors.

Treatment

People with progressive myopia have several options available to regain clear distance vision or to slow/ stop the progression of myopia. Options include: 

1. Eyeglasses

It is the most common option especially for children who do not undergo laser or surgical options. As eyeglasses are the primary selection for correction. Depending on the severity of myopia, people only demand to wear glasses for some activities, like while seeing a screen. Usually, a single-vision lens is recommended to provide clear vision at all distances. But the patients’ age above 40, or children and adults whose myopia is progressing due to the stress of near vision work, may need a bifocal and progressive addition lens. The multifocal lenses give different powers throughout the lens to provide a clear vision for the distant object.

2. Contact lenses

It is a common option in adults who have detected early myopia. It offers clearer vision plus a wider field of view than eyeglasses. Still, the contact lenses are worn straight on the eyes, so they require proper evaluation and care plus safeguard eye health.

3. Ortho-k or CRT

Orthokeratology is also known as corneal refractive therapy (CRT). It is a non-surgical procedure, in which a person wears a series of specially designed rigid contact lenses to slowly reshape the curvature of the cornea. The lenses place pressure on the cornea to flatten it and focus light entering the eye. A person wears the contact lenses for short periods (such as overnight) and then removes them. Individuals with moderate myopia may be able to momentarily obtain clear vision in their daily activities.

3. Laser procedures

Laser procedures such as LASIK (laser in situ keratomileuses) or PRK (photorefractive keratectomy) are common possible treatment choices for myopia in adults. In a laser procedure, the laser beam of light reshapes the cornea by excluding a short amount of corneal tissue. The amount of myopia corrected by laser procedure is limited by the amount of corneal tissue that can be safely removed.

In Photorefractive Keratectomy, a laser eliminates a thin layer of tissue from the outside of the cornea to change its shape and refocuses the light into the eye. While in  LAser SItu Keratomileusis, a laser excludes tissue from the inner layers of the cornea by lifting and folding the section of the outer corneal surface to expose the inner tissue.

4. Refractive surgery

People whose corneas are too light or thin for laser procedures may have the option for myopia surgically corrected. In this procedure, ophthalmologists may implant small lenses with the desired optical change in the eyes. The implant can be fixed just in front of the natural lens, or implant by replacing the natural lens. This lens extraction surgical procedure is similar to cataract surgery but transpires before a cataract is present.

5. Vision therapy for stress-related myopia.

Vision therapy is for those people who have blurred distance vision. It is caused by a contraction of the eye muscles that control eye-focusing. Multiple eye exercises are included in this therapy that can improve poor eye focusing ability and regain clear distance vision.

6. Atropine eye drop

According to recent studies, using topical 0.01% atropine eye drops have been shown to successfully slow myopic progression. The atropine eye drop working mechanism to slow the progression of myopia is yet not clear but it has fewer side effects compared to higher doses of atropine (e.g., light sensitivity or blurred near vision). Additionally, a recurring effect was not noted after stopping this low-dose atropine treatment.

People with myopia have a variety of options to correct vision problems. A doctor of optometry will give you a variety of options and help to select the treatment that best meets the visual and.

What is the difference between high myopia and progressive/ mild myopia?

High myopia usually is defined as a nearsightedness measurement of -5.00 D or more. While progressive/ mild myopia usually falls between -0.25 D – -3.00 D.

Takeaway

Progressive myopia is the medical condition in which far objects appear blurred due to many genetic, health, and environmental contributing factors. There are several ways to lower the progression of myopia, but this requires active management of myopia and a person or parents to change the lifestyle and habits of their children as progressive myopia management wants a long-term and continuous effort.