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Cataracs and High Myopia
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Cataracs and High Myopia

First off, thank you so much for taking the time and effort in addressing the questions in this forum.   It's been a valuable resource.

My son is 7 yrs old and has degenerative myopia.  His prescription is -17.75 in the left eye and -19 in the right.  Recently he mentioned that he noticed his right eye being more "blurry" than usual.  We took him to his ped Opthomologist and he found a catarac on his lense.  The retinal doc then examined my son and found no signs of retinal detachment.

The Opthomologist recommends us doing nothing about catarac's unless it gets to point where his vision is useless in this eye.  His concern is that catarac surgery may result in retinal detachment.  My questions are as follows:

1. Why does catarac surgery increase the risk of RD?  

2. Do cataracs tend to get worse over time or do they stabilize?

3. If RD does occur and laser treatment is used, is there an increased risk of more detachments?

4. Is there something we should do to Luke's diet to decrease the chance of RD or cataracs forming?  Didn't know if there was a particular supplement he should be taking (besides multivitamin).  Are there any studies out there?  

5. Also, I've read that UV rays may cause cataracs - should he always to wearing sunglasses?    

And again, thanks for taking the time to answer questions.      

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Dear Luke2798,

In a highly myopic individual, the retina is thinner due to the length of the eye. With removal of the natural lens barrier, traction on the retina may result in retinal detachments.  There are many types of cataracts and their behavior is not uniform. Often, cataracts progress slowly but the progression may be related to the type of cataract and its location.  For example, central cataracts often cause a reduction of vision sooner because they are located in the path of the pupil.  I would recommend that Luke stay away from sports in which trauma to the eye may occur.  We advise the use of sunglasses as well. These are excellent questions and I would definitely recommend that you discuss these with your eyeMD that knows your son’s eyes.

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California

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There have been numerous indepth discussions on degenerative myopia on this forum.  Use the search feature and type in degenerative or pathological myopia to pull up info.  One possible promising drug is 5-methylxanthine that is being developed by Denmark researchers.  

It is unfortunate, but degenerative myopia is a truly neglected area of research in the U.S.  I suggest contacting advocacy groups for low vision and blindness (e.g, Lighthouse,  Prevent Blindness in America, etc.) and urge them to fund research in myopia.  We need to advocate for funding to get a better understanding of the underlying biological mechanisms of myopia so that treatments can be developed that are specific to the cause.

Good luck.
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