What can an optometrist do about irreversible pathologic myopia?

Pathological myopia occurs when light rays from nearby objects enter the eye and are not properly focused onto the retina, but instead focus on a point in front of the retina, resulting in blurry vision. This is primarily due to an excessively long axial length of the eyeball, which prevents the lens from focusing light on the retina, or an excessively curved cornea. As a result, an increase in refractive error of about -6.00D or an uncontrollable progression of axial length of 26.5mm or more is a determinant factor that contributes to pathologic myopia.

According to Windsor L, & Windsor K (2021), thirty percent of all cases of pathologic myopia are diagnosed at birth, sixty percent of patients are diagnosed between the ages of 6 and 13, and it progresses throughout life. Early examinations of at-risk children are critical, because failure to detect high myopia in young children may result in vision loss from amblyopia.

Children of myopic parents are statistically more likely to develop myopia than children of non-myopic parents. Given this, researchers believe there may be a genetic component to the development of this condition.

• taking case history - focus highly in family history
• preliminary examinations
• ocular health examinations - specially the retina, optic disc, maculs and fovea.

As a result of this investigation, the pathologic myopia features and its plausible cause for the degeneration associated with this condition are ruled out.

Alternatively, the recommended optometric management for pathologic myopia is vision loss prevention.

By performing regular follow-up checks for visual acuity, refraction, general ophthalmic health, and dilated retinal monitoring.

By changing how light rays bend in the eye, spectacles and contact lenses can be prescribed to stabilize high refractive error.

Beside that, low vision considerations such as specific low vision care and low vision aids such as magnifiers and CCTVs are provided.

Optometric care allows the patient's maximum vision to be prolonged.