High myopia, chances of complications, risks

[thebanana]

Hi,
(I apologize in advance for a lengthy post!)
I am 20 years old and have high myopia (OS -9.75 Sph. and -1.25 cyl.  and OD -8.75 sph. and 0.75 cyl.).  Until about a year and a half ago I didn't know i had high myopia, i thought it was pretty mild.  I have always had excellent corrected vision, occasionally noticing the odd floater but that was it.  No one ever bothered to tell me about the risk of RD etc.  I first got glasses at age 5 right after starting school, and made numerous visits to an eye hospital (not an optometrist) between the ages of 5-10 where they dilated my eyes, made me look at some awesome pictures that i recall seemed to look 3D etc.  I recently asked my mother why i had to go to an eye hospital and she told me it was just because my eyes changed quite rapidly, but my eyes where healthy, that's why i stopped going at about age 10 (might have been earlier).    I only wore my glasses part time for reading/watching tv/classroom until age 12 when i was not far off -5.00, then i got contact lenses.    As i said i was not informed about the risk of RD.  During high school i received numerous blows to the head, got jabbed in the eye countless times and never had any problems.  However a classmate of mine got RD and seemed to have somewhat less myopia than me, he also never got hit on the head or jabbed in the eye, it just seemed to happen one day.  I am trying to understand if all high myopes are at the same risk level or do things like family history, blood pressure, diet etc have any effect on risk levels?  
Also after i found out last year that i was highly myopic and read about floaters, i started seeing them more and more until now i cannot go outside without them really bothering me, if i squint in bright light i can even see what looks like showers of faint ones, and some older ones have gotten a lot darker.  Do you think these have recently appeared or this is just me tuning into them?  I had an optomap exam 7 months ago and the doctor said my retina was very healthy.  After asking about thinning she said there was some thinning in one part but she said that was normal for everyone, asked if everyone meant high myopes or general population, and she said the general population and said it was normal and nothing to worry about.  Is this true?  Do normal people get thinning?  
Unfortunately since finding out about all these risks my life has not been so great, i have pretty bad anxiety issues and all i have thought about for the last year has been my sight, am i going to lose it etc.  About 6 months ago i started seeing permanent afterimages appear and some lasted hours before going away, and then in may one appeared and stayed for weeks.  I got a regular eye exam, my doc said possibly a retinal hole, then she looked over my optomap record and completely changed her mind said its probably nothing, come back in 6 months if you really feel you need a dilation.  I came back after about a week and saw another doctor, she did a really thorough dilation exam, and said my retina looked very healthy still and there was nothing to worry about.  She said whatever was causing the afterimage was a mystery, she suggested possibly a migraine.  After a few more weeks my vision returned to normal.  Then last week i got the same thing in happen in the other eye, it has now mostly faded but i can still see it from time to time and when i blink.  Any idea what this could be, and should i be worried?
My eye pressure was normal, 13 and then 14 a week later.  I have a caffeine problem, i drink a lot of coffee and tea, have since i was about 10.  I asked my doc if i should stop and she said no it was fine.  Should i stop? or cut down?  Does caffeine increase the risk of complications?

I am a very health conscious person and have been for the past 8 years, Never smoked, balanced diet, ate oily fish rather than meat, drink infrequently (less than once a month), exercise regularly, supplement with a multi-vitamin, 9mg lutein and a spoon of fish oil a day.  I have no family history of blindness, glaucoma, or retinal problems, although my immediate relatives all experience floaters despite having far milder myopia than me.  My grandmother (in her mid 70s) is a quite nearsighted (not sure how much, pretty sure less than me though) and still sees fine. My question is, do i stand a good chance, based on the information i have provided, of maintaining good vision to an old age, by old i mean like 80+.  Are there lifelong high myopes out there who reach old age without any real problems?  Or does high myopia mean eventually something will definitely go wrong?  If there are people who don't have any real issues, is it a majority or a minority?  Do all high myopes eventually get glaucoma?  And can i continue to live an active lifestyle or should i be seriously restricting my activity (i have read in many places that i shouldn't even go running, although my doc didn't place any limitations on activities)

I apologise again for the long post and for asking so many questions, i just can't seem to get any answers anywhere and i would really like to stop worrying.  Any help greatly appreciated!

[Kristina55]

Hi! How are your eyes now? I'm having floaters too and worried of RD..

[jkmi55]

Dr. Hagan,
I've was just just quickly reading through some replies about high myopics, and I've just been struck by your one sentence about federal government intervention in healthcare.  I hope you don't mind if I borrow and endlessly repeat your wonderful and most eloquent phrase about poor quality medicine for everyone being better than high quality medicine for most everyone.  That is so well-put!  I also appreciate your well-delivered medical information.

[thebanana]

I read some of your posts, i see you're 67 and very nearsighted, that gives me some hope that i will hopefully still have good vision at that age.  Were you always nearsighted or did yours start when you were an adult?  At what age did it stabilize?  I have been thinking that perhaps stress may have some effect as the more stressed i am the worse it seems to get, trouble is if that's the case then i'm stuck in a vicious circle as the worse my sight gets the more worried i get and the more stressed i get!  Mine does seem to be stabilizing but now i'm afraid of retinal problems.  I recently started wearing sun glasses every time i go outside after reading about the risks from sun exposure, although i didn't for my first 20 years as no one bought me sunglasses as a kid and i didn't know just how risky it was.  

[ruby2zdy]

I read once that people tend to get more nearsighted in spurts:  when they enter high school, when they enter college, and when they go out into the work world.  So:  Due to stress?  The curve of becoming more myopic levels off some as you age (and I mean age).  Also, sun exposure increases your risk for cataracts.

[thebanana]

By the way, i read there was some research done in Australia with regards to sunlight exposure and myopia.  One thing i have noticed is that my eyes stopped changing as much once i finished school (age 16) and  was doing a lot of work outdoors (-0.75 change both eyes in 3 years) and seemed to worsen more rapidly in the last year (-0.75) since i have been working inside and searching the net everyday (i have a problem) for info on high myopia.  I wonder if there is a link and i wonder if maybe trying to spend more hours outside a day and less time sitting in front of my laptop might help to stop it getting much worse.  

[thebanana]

I read through some of your posts, really hope something like that does not happen to me.  I only read your first few posts, i see you were pretty lucky to still see 20/15, is this still the case?  It does come as some comfort to learn that there are people out there with high myopia who don't lose vision.  When i first found out that i had high myopia and started searching the net for all the info i could find, all everything seemed to say was that i would lose vision and the future was not good.  People always say to me don't worry about the future, but i cant help it, being an active and very independent person i am terrified of losing the one thing i completely rely on.  I think what bothers me the most is that there seems to be little i can do to reduce the chances of problems, especially as i am willing to do anything to make myself healthier.  I have accepted wearing thick glasses (i have been wearing soft contacts for 8+ years and still do fantastic with them, but wear glasses more often recently due to laziness ie the hassle of cleaning contact lenses and my vision gets better if i dont wear my contacts every day).  Sometimes i get stares from people but i really don`t care, i would have a a year ago, but now all i care about is that i can see, i guess the fear of losing what i have makes me appreciate it more!  

[dukey]

What a familiar story.

You should be a little concerned as you are certainly at risk for some potentially nasty complications. You can read many of my posts on this topic. Most doctors will assure you that it is normal etc etc but let me assure you that thinning of the retina is NOT normal and is a classic finding in high myopes (i.e. tigroid fundus). You are still in the developmental stages of high myopia and I wouldn't expect to see more serious complications for 10 years or more, if they come at all. Many high myopes do live a full life without deteriorating vision but many myopes gradually lose visual acuity as they age. I was in EXACTLY the same situation as you when I was 20 (same Rx) and, well, you can read my story now.

You are too young to worry about it but you should be on the look out for trouble.    

[John C Hagan III, MD, FACS, FAAO]

You're welcome.

Good luck in the future. Keep taking care of yourself. There is much research being done on high myopia. In your lifetime many of the problems about progression, RD and myopic macular degeneration will be cured (unless the Federal Government takes over healthcare in the US and puts the pharmacological/instrumentation and research centers out of business). Their model is poor quality Medicine for everyone is better than high quality for most everyone. Like the dumbing down process that's going on in US public education now.

JCH MD

[thebanana]

Thank you very much for the re-assurances and the very fast response too!  

[John C Hagan III, MD, FACS, FAAO]

Yes that's not a big change amortized over 4 years.

JCH MD

[thebanana]

Just want to add, my eyes seems to have worsened by about 1.50 diopters in both eyes between the ages of 16 and 20, i can still see pretty good out of my 4 year old pair of glasses, does it sound like my eyes are stabilizing?  

[John C Hagan III, MD, FACS, FAAO]

There are extensive discussions on high myopia and floaters and risks of same that you can access with the archives or search feature.

Caffeine has no effect on your eyes.

Provided you see an ophthalmologist yearly and right away with sudden increase in floaters, flashes or loss of visual field you have an excellent chance of good vision til you die many decades from now.

I think it likely your awareness of the floaters is due to anxiety. Especially if you have anxiety about other health issues and it is a moderate problem you may consideer seeing a psychiatrist to help you deal with these. Pharmacological treatment of anxiety and depression is a great story in the history of psychiatry.

Avoid trauma to your eye, stay off amusement park rides and continue the health lifestyle.  Running does  NOT increase the risk of RD.

JCH MD