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Eye Care  (Expert Forum)
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Severly myopic patients predisposed for Retinal detatchment, catract, glaucoma
Answered by
John C Hagan III, MD, FACS - Ophthalmology
Discover Vision Centers Kansas City - MO
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MedHelp Member's Question

Severly myopic patients predisposed for Retinal detatchment, catract, glaucoma

by myopic, Jul 10, 2007 12:00AM
Hello,

-I’m a 30 years old male with severe myopia (- 9.5 right eye, -11.5 left eye).
-Recently I was fully examined by an ophthalmologist. She said that I’m beginning to develop cataract! And that I shouldn’t worry since it’s at its earliest stages. She said that this due to shortsightedness.

My questions:
-I know I’m severely myopic but aren’t I still too young to have cataract?
-I was shocked to learn I’m developing cataract because my eyesight is very clear and I have noticed absolutely no change… how much time do you think I have before I begin noticing the problem of cataract?
-Developing cataract at age 30, when do you think I might need a surgery to replace the lens?
-Is there anything at all I can do to impede cataract’s progress? I always wear my sunglasses, what else can I do?  

...continued in next post
Doctor's Answer

by John C Hagan III, MD, FACS, Jul 10, 2007 12:00AM
Cataracts can occur at any age, you can even be born with cataracts (congenital cataracts). Age is the biggest factor so we associate cataracts with aging. The development of cataracts at a younger age can be due to: heritary, diabetes, use of steroids/cortisone, trauma, heavy use of alcohol and/or tobacco, bad diets and BAD LUCK.

Slow cataracts down: good diet, no tobacco, moderate alcohol (if you must drink), multivitamin, sunlight ultraviolet protection.

Don't do surgery until your vision is a major problem. You are at an increased risk of retinal detachment with your high myopia and this will increase 10X with cataract surgery. This has been discussed at length in this forum use the search feature and archives to review relationship of high myopia, cataracts and retinal detachment.

JCH Eye physician & Surgeon (ophthalmologist)
Member Comments (5)

by myopic, Jul 10, 2007 12:00AM
... continued from previous post:

-11 years ago, at age 20 (1996) I had a retina detachment in my left eye that required surgery which included the use of a buckle and laser too. Extensive preventive laser treatment was applied to my right eye (it was the most physically painful experience ever!). Since the laser treatment, I started seeing flashes of light I understand that this is the vitreous pulling away from the retina but it’s been 11 years already! How much longer till the vitreous is completely detached from the retina?
-Let’s say that my cataract developed to the point of requiring lens replacement surgery, isn’t this too dangerous for my retina, especially that it was detached before? What am I supposed to do in this case??!
-My IOP readings used to be consistently normal (around 13) but in 2004 the readings were (17 left eye, 13 right eye) and in 2005 the readings were (17 left eye, 25 right eye!). The same exact readings were in place for 2006.I read somewhere that cardio exercise along with healthy weight and quitting smoking can lower the IOP readings significantly. So, 1 year ago I quit smoking (after being a smoker for 6 years), reduced my BMI from 31 to 25 and started performing vigorous cardio on a regular basis. So, this year of 2007, when I was examined by my doctor two days ago, my IOP measurements were: (17 left eye, 19 right eye). So my right eye’s IOP dropped 6 units! Although my optic nerves, according to my doctor, look awesome I’m still extremely concerned about my eye pressure because I read somewhere that severely myopic patients are predisposed to develop glaucoma, cataract and retinal detachment! It’s as if severely myopic people are predisposed to become blind! And by the way, I have an aunt, an uncle and a cousin (all from my father’s side of the family) who are blind (I don’t know the causes) but my father himself never had any eye problems except for being farsighted. Anyway, my question is: do you think that diet and exercise did have something to do with my recent IOP drop?

Thank you so much!

by John C Hagan, Jul 10, 2007 12:00AM
Diet is not felt to have an effect on intraocular pressure. Vigerous exercise will lower the intraocular pressure but usually for only a few hours after the exercise then it goes back up to baseline levels.

Glaucoma is somewhat more common in high myopia and for a variety of reasons more difficult to diagnosis.

Tests that would need to be done periodically to determine the presence of glaucoma and monitor your: Visual fields, corneal thickness (pachymetry), optic nerve photographs, OCT of the optic nerve.

Try and find out why your relatives went blind. It is very useful to your ophthalmologist (Eye MD).

While high myopia does predispose you to several eye problems more than others it does not condemn you to going blind, especially if you remain under the care of a competent ophthalmologist.

JCH MD Eye Physician & Surgeon

by myopic, Jul 10, 2007 12:00AM
Thank you very much for your prompt response!

I still need to ask these 2 questions:

- Based on statistics/studies/experience, usually how much time do people (who first develop cataract) have before they begin actually noticing that they have a vision problem?

- 3 days have lapsed between the last time I performed a vigorous cardio exercise and my visit to the ophthalmologist where my IOP reading was taken. Could the drop in the IOP pressure be attributed to an exercise performed 3 days earlier? Also, I read somewhere that weight lifting tends to "transiently" cause the IOP to rise, is that true? Also, although I have already quit smoking 1 year ago I still need to ask  the following: is it true that nicotine also causes a transient rise in the IOP pressure?

thanks a lot.

by John C Hagan, Jul 10, 2007 12:00AM
1. The amount of time a cataract takes to progress to cause symptoms and then to require surgery varies so much there are no exact statistics. Today I saw 4-6 people with cataracts over 15 years that still didn't need surgery.

2. The effect of exercise on lowering IOP last hours not days.

3. Lifting heavy weights or standing on one's head or bearing down (valsalva maneuver) does briefly raise the IOP. Glaucoma patients that do yoga are advised not to stand on their heads.

4. Any effect of nicotine on IOP is brief and transient. Nicotine is bad for the eye