Aa
Myopic degeneration
Three months ago I noticed a waviness and grey patch in the central vision of my left eye. I went to the RS, and had a eye exam and OCT done, and it was found to be a bleeding from laquer crack. Both the waviness and grey patch has since been gone, and I believe there is a very slight effect (vision seems not as clear as before, tho it's quite slight) on my left eyesight. The RS explained that this was due to the thinning of the RPE and retina, and there is at present not much I or they can do to arrest the issue. I am 33, and have very severe myopia, L-18.00D R-20.00D. Been wearing specs since very young.
Dear doc, could you advise me based on your experiences, what will the future holds for le like me who has very high myopia? Am I right to say the potential of going blind or visually challenged in future is very high? What will the most important factor that will determine how bad my eye condition will get in future? It seems like my myopia has not stabilised, despite the fact that it should stabilised in your early twenties.
Is there any older people out there with severe myopia and still coping well with their sight?
I've been very worried ever since this episode. Before that, I never know and therefore, never worry, that high myopia will lead to so much complications later in life. And now the posibilities of all these happening seems so real. To make matter worse, my girlfriend, whom I have the intention to get married, is also very severely short-sighted (about 11D and 13D), and has lazy eye in one eye. I kept thinking what will the future holds for us if we shall get together. It certainly looks bleak, very bleak.. I really can't imagine about the future as the potential of both of us going blind one day seems so real!
Doc, what do you think we should do??? Any advices will be appreciated.
Dear doc, could you advise me based on your experiences, what will the future holds for le like me who has very high myopia? Am I right to say the potential of going blind or visually challenged in future is very high? What will the most important factor that will determine how bad my eye condition will get in future? It seems like my myopia has not stabilised, despite the fact that it should stabilised in your early twenties.
Is there any older people out there with severe myopia and still coping well with their sight?
I've been very worried ever since this episode. Before that, I never know and therefore, never worry, that high myopia will lead to so much complications later in life. And now the posibilities of all these happening seems so real. To make matter worse, my girlfriend, whom I have the intention to get married, is also very severely short-sighted (about 11D and 13D), and has lazy eye in one eye. I kept thinking what will the future holds for us if we shall get together. It certainly looks bleak, very bleak.. I really can't imagine about the future as the potential of both of us going blind one day seems so real!
Doc, what do you think we should do??? Any advices will be appreciated.
MEDICAL PROFESSIONAL
Hello Myopic 74 Things are not nearly as bleak as you seem to believe. FIrst of all none of the conditions you mention are likely to cause total blindness (no sight whatsoever). It is true that they could cause legal blindness (best corrected vision in better eye less than 20/200. People with legal blindness due to loss of central vision get around without aids and function well. True they cannot legally drive and have to use reading machines to read but they do pretty good. So erase entirely the mindset of being totally blind.
Your retina surgeon is correct. The percentage of high myopes that end up legally blind in both eyes is very, very small. The two most common mechanisms of legal blindness would be myopic macular degeneration and macular neovascularization (NV) either due to wet macular degeneration or NV from breaks in Bruch's membrane (lacquer cracks).
The genetics of myopic transmission are incompletely understood but just as your parents were not high myopes but your are you and your myopic fiancee could have non-myopic children.
What will happen to you as you get older is mostly a matter of "luck" either good or bad as myopic macular NV and degeration are not strongly driven by patient behavior.
You might adhere to the things that reduce or slow the progression of dry age related macular degeneration: diet of fruits, vegetables, fish, fiber, berries, nuts. Low in fatty food. Eat a lot of lutein containing food. Don't smoke, don't get obese, protect your eyes from UV light (hat and UV blocking glasses/sunglasses). Test you eyes weekly with an Amsler grid and consider taking a multivitamin and 2 Bausch & Lomb Preservision with lutein/day. See an ophthalmologist yearly.
To repeat you are likely to have good to fair vision all your life.
JCH III MD Ophthalmologist
Your retina surgeon is correct. The percentage of high myopes that end up legally blind in both eyes is very, very small. The two most common mechanisms of legal blindness would be myopic macular degeneration and macular neovascularization (NV) either due to wet macular degeneration or NV from breaks in Bruch's membrane (lacquer cracks).
The genetics of myopic transmission are incompletely understood but just as your parents were not high myopes but your are you and your myopic fiancee could have non-myopic children.
What will happen to you as you get older is mostly a matter of "luck" either good or bad as myopic macular NV and degeration are not strongly driven by patient behavior.
You might adhere to the things that reduce or slow the progression of dry age related macular degeneration: diet of fruits, vegetables, fish, fiber, berries, nuts. Low in fatty food. Eat a lot of lutein containing food. Don't smoke, don't get obese, protect your eyes from UV light (hat and UV blocking glasses/sunglasses). Test you eyes weekly with an Amsler grid and consider taking a multivitamin and 2 Bausch & Lomb Preservision with lutein/day. See an ophthalmologist yearly.
To repeat you are likely to have good to fair vision all your life.
JCH III MD Ophthalmologist
Nice to hear from you! Sorry to hear that you share similar prescription as mine, which is rather sad.
I also don't know why I developed such high myopia, because both my parents, all my siblings, grandmothers and grandfathers, all my uncles, aunties, cousins etc are normal sighted (as in some do wear specs but none has such high myopia). But mine started off on a very high base (6D since seven years old when I first started school).
I was quite concerned that the myopia will keep on progressing, though I wasn't too sure the pace. It seems to be it has been quite stabilised with some increments all these years, until the latest episode, which has began to affect me quite badly psychologically.
Have your myopia stabilised already over all these years? Is your vision still normal ie; no CNV, retina bleeding, lacquer cracks etc? I think you should go for regular eye check-up, just to make sure things are fine. I have began to notice that the gel in both my eyes has started to degenerate (more floaters, in strings etc), but so far, I would say it is slightly more than say 10 years ago, but still not so bad as to cause any significant difficulty is reading or seeing, though I don't know how bad will it progress in time to come.
My RS has tried to assured me that risks of high myopic getting complications at a later stage, or ended up blind, is higher than normal sighted person, but is not a definite.
I asked her what are the critical factors that will largely determines the outcome, but she has not given me a specific answer. She just said your eyes are fine now, come back immediately if you notice any significant changes such as sudden onset of curtain of floaters, light flashes. She also said that the bleeding (of the lacquer crack) will recur in the same eye, or the other eye.
What is a lens exchange? Never heard of it before. So far my vision is still quite fine, except that the power seems to be not strong enough. At present, I am wearing L 14D R 16D for my specs.
12 years ago was about L 13D, R 15D.
I also don't know why I developed such high myopia, because both my parents, all my siblings, grandmothers and grandfathers, all my uncles, aunties, cousins etc are normal sighted (as in some do wear specs but none has such high myopia). But mine started off on a very high base (6D since seven years old when I first started school).
I was quite concerned that the myopia will keep on progressing, though I wasn't too sure the pace. It seems to be it has been quite stabilised with some increments all these years, until the latest episode, which has began to affect me quite badly psychologically.
Have your myopia stabilised already over all these years? Is your vision still normal ie; no CNV, retina bleeding, lacquer cracks etc? I think you should go for regular eye check-up, just to make sure things are fine. I have began to notice that the gel in both my eyes has started to degenerate (more floaters, in strings etc), but so far, I would say it is slightly more than say 10 years ago, but still not so bad as to cause any significant difficulty is reading or seeing, though I don't know how bad will it progress in time to come.
My RS has tried to assured me that risks of high myopic getting complications at a later stage, or ended up blind, is higher than normal sighted person, but is not a definite.
I asked her what are the critical factors that will largely determines the outcome, but she has not given me a specific answer. She just said your eyes are fine now, come back immediately if you notice any significant changes such as sudden onset of curtain of floaters, light flashes. She also said that the bleeding (of the lacquer crack) will recur in the same eye, or the other eye.
What is a lens exchange? Never heard of it before. So far my vision is still quite fine, except that the power seems to be not strong enough. At present, I am wearing L 14D R 16D for my specs.
12 years ago was about L 13D, R 15D.
A related discussion, Myopic Macular degeneration was started.
Hi,
Thank you for sharing!
I hope your husband's condition will remain stable for long time to come.
Does your husband has an active leaking or any new vessels growth?
I agreed with you that it is indeed a nerve-wrecking experience learning about the condition, and even now, even though there's no active bleeding and my vision has returned to normal, I still feel very frightful and uncertain where my future is heading, when is another bleeding going to come and when will new vessels start growing, and eventually having to cope with the potential prospects of visual disability, and yet not knowing when will all the bad things come.
I really hope you husband will be alright and respond well to treatment if any.
Cheers!
Thank you for sharing!
I hope your husband's condition will remain stable for long time to come.
Does your husband has an active leaking or any new vessels growth?
I agreed with you that it is indeed a nerve-wrecking experience learning about the condition, and even now, even though there's no active bleeding and my vision has returned to normal, I still feel very frightful and uncertain where my future is heading, when is another bleeding going to come and when will new vessels start growing, and eventually having to cope with the potential prospects of visual disability, and yet not knowing when will all the bad things come.
I really hope you husband will be alright and respond well to treatment if any.
Cheers!
My PVD's came on suddenly, but I'm told that with many people it occurs gradually until they the floaters become bothersome. The symptoms of sudden-onset PVD resemble the symptoms of retinal detachment, so anybody who hallucinates curtains of lights and flashing showers like rainbows, it's not an acid flashback from the 60's. Go to your ophthalmologist ASAP.
BTW, after many years, the floaters settled on the bottom - below my field of vision. They don't trouble me anymore.
BTW, after many years, the floaters settled on the bottom - below my field of vision. They don't trouble me anymore.
MEDICAL PROFESSIONAL
Hello Myopic 74 Symptoms of PVD sudden increase in floaters, sometimes in showers, flashes of light like lightening in eye. Loss of peripheral vision is NOT a sign of PVD. A PVD occurs when the central vitreous is so water like it doesn't support the outter layers of the vitreous and it peels or detaches off the eye. All retinal detachments (RD) do not start from PVD, example would be penetrating or blunt eye injury. PVDs are a normal part of aging, but occurs earlier in those of us that are myopic. Huge disparity between incidence of PVD (1 in 2 people by age 50) and RD (1 in 3-5,000 people that have NOT had cataract surgery).
Also good to point out that legal blindness due to loss of central vision is NOT the same at total blindness where there is no sight at all.
JCH III MD
Also good to point out that legal blindness due to loss of central vision is NOT the same at total blindness where there is no sight at all.
JCH III MD
This thread is SO WONDERFUL!! My husband (age 54) was diagnosed with myopic degeneration in July, and so we have been on a journey of finding out all we can about the treatment, prognosis, causation, etc. I completely understand myopic74's concerns and questions about the future. Even for my husband and myself, the fears of him facing blindness were not easy to deal with. We're actually very stable, well-grounded people, but it's hard not to imagine the worst! But, because of an excellent specialist, great treatment options (injection of avistin), and all the knowledge and research that being done, we are both far less fearful than we were a month ago. Three weeks ago there was already significant improvement...he'll find out more after today's visit. Thanks to all who've posted!
sorry.. messages were sent errorneously while typing halfway..
To continue from the above post.. how do you tell when you got PVD? My RS did mentioned to me that my virteous is beginning to show signs of degenerating. I can see quite a few floaters, in strings and more prominent if in well-lit places like under the sun, in both eyes. Sometimes, it looks like tiny cell structures in a magnifying glass if I take out my specs and look the bright lights. I read that is the virteous is beginning to liquify.
Until what stage the degenration process will it be considered a PVD? Will all PVD lead to Retina detachment? What is the percentage like and what contributing factors will lead a PVD to a RD?
To continue from the above post.. how do you tell when you got PVD? My RS did mentioned to me that my virteous is beginning to show signs of degenerating. I can see quite a few floaters, in strings and more prominent if in well-lit places like under the sun, in both eyes. Sometimes, it looks like tiny cell structures in a magnifying glass if I take out my specs and look the bright lights. I read that is the virteous is beginning to liquify.
Until what stage the degenration process will it be considered a PVD? Will all PVD lead to Retina detachment? What is the percentage like and what contributing factors will lead a PVD to a RD?
What is a PVD like? I don't think I have personally experience
What is a PVD like? I don't think I have personally experience
Hi,
Regarding sclera buckle, my RS did not specifically mentioned what are the risks, as no one was doing it in where I live, in Singapore. Moreover, as far as I read, the results has not been particualrly proven.
I guess as in any surgery, there is a considerable amount of risks involved, not to mention risk of RD for high myopes.
Regarding sclera buckle, my RS did not specifically mentioned what are the risks, as no one was doing it in where I live, in Singapore. Moreover, as far as I read, the results has not been particualrly proven.
I guess as in any surgery, there is a considerable amount of risks involved, not to mention risk of RD for high myopes.
MEDICAL PROFESSIONAL
Hello Brown 33 While stem cell researach both adult and embroyonic offer great promise in many fields of medicine including ophthalmology, the ability to "grow" a new retina or a new eye is likely many years of hard research down the road.
In the meantime: have you eye examined frequently, never longer than a year, wear protective eye glasses, avoid activities with high eye injury rate (contact and racquet sports, firearms, firecrackers, etc), don't go on amusement rides that throw the head about, don't smoke, eat a good diet, keep your blood pressure, body weight and cholesterol under good control, take a multi vitamin and consider taking a ARED eye supplement like EyeCap, Ocuvite or Preservision with lutein (all over the counter).
JCH III MD
In the meantime: have you eye examined frequently, never longer than a year, wear protective eye glasses, avoid activities with high eye injury rate (contact and racquet sports, firearms, firecrackers, etc), don't go on amusement rides that throw the head about, don't smoke, eat a good diet, keep your blood pressure, body weight and cholesterol under good control, take a multi vitamin and consider taking a ARED eye supplement like EyeCap, Ocuvite or Preservision with lutein (all over the counter).
JCH III MD
Hi, I am currently undergoing treatment for a PVD in my right eye. I was able to catch the symptoms of the Retinal Detachment through the large retina detachment in my left eye. I am 30 years old and scared of becoming totally blind since my right eye is the only useful eye I have.
My question is will retina stem cell research be available soon, and if so will it be able to help me and others like me beat this cruel condition?
My question is will retina stem cell research be available soon, and if so will it be able to help me and others like me beat this cruel condition?
Dr. Ward is the only person performing this sclera buckle procedure in United States. I am curious that what are the risks your RS mentioned regarding this procedure?
MEDICAL PROFESSIONAL
It's hard to over-correct a person in their 50's. The problem is with young people. If you give them too much minus lens than can focus or accommodate and clear their vision. A 50 year old won't do this. It's also why ophthalmologists usually do the glasses test (refraction) on young people after their eyes are dilated.
You are missing a great deal of the world's beautify by wearing such a weak correction. I don't think there's evidence that going to your full myopic correction would make your myopia worse and certainly will not cause neovascular membranes in your lacquer cracks.
JCH III MD
You are missing a great deal of the world's beautify by wearing such a weak correction. I don't think there's evidence that going to your full myopic correction would make your myopia worse and certainly will not cause neovascular membranes in your lacquer cracks.
JCH III MD
Thank you, doctor. This discussion thread was very helpful for me. As a severe myopic, I've felt that I live in a lonely world with many of the aforementioned fears. Thanks for all the information.
Hi Doctor,
Thank you for your attentiveness and professionalism! I really can't thank you enough for all the good work which you have done for me and everybody here.
Nowadays I take fish oil capsule and Scots cod liver oil emulsion as supplements everyday. Besides that, I also take steamed green leafy veges (kailan veges) once every two day.I read that green leafy veges is supposed to be rich in lutein.
One question though. I heard from somebody on the web that the fact that bleeding has been observed in the lacquer cracks (my left eye) means that CNV may have already developed to some extent. However, my RS said there is no active leakage nor new blood vessels growth after having done a dilated exam on my eyes. She said there is no clinical suspicions, and hence didnt even asked for a FFA or ICG, and just asked me to come back 4 months later, or whenever I find something wrong with my vision. Right now, four months after the bleed in th left, there don't seem anymore bleed and the waviness and blood patch has also since been gone. So I'm really confused and wonder which is true?
Right now I am wearing my old specs (L -13.75D R-16) which I am seeing something like 6/9-6/12. My new prescription is L-18 R-20, which will give me a VA of 6/7.5. Though I am not seeing too well with my old prescriptions, especially at dimly lit condition, but is still manageable, and I have been wearing them for the past 5-6 years. I heard that it is not good to overcorrect for high myopia. So do you think by changing to the new prescription, will it be better off or worse off?
To Sym11: I've asked my RS about Sclera buckle, but she said it was not available here in where I stay and so far results for such procedures done elsewhere has not been very promising nor proven to be effective. Furthermore, there is also considerable risks involved. So I don't think will be considering it at this stage, maybe until it is more proven or my situation gets worse. But, thanks for your suggestion!
Thank you for your attentiveness and professionalism! I really can't thank you enough for all the good work which you have done for me and everybody here.
Nowadays I take fish oil capsule and Scots cod liver oil emulsion as supplements everyday. Besides that, I also take steamed green leafy veges (kailan veges) once every two day.I read that green leafy veges is supposed to be rich in lutein.
One question though. I heard from somebody on the web that the fact that bleeding has been observed in the lacquer cracks (my left eye) means that CNV may have already developed to some extent. However, my RS said there is no active leakage nor new blood vessels growth after having done a dilated exam on my eyes. She said there is no clinical suspicions, and hence didnt even asked for a FFA or ICG, and just asked me to come back 4 months later, or whenever I find something wrong with my vision. Right now, four months after the bleed in th left, there don't seem anymore bleed and the waviness and blood patch has also since been gone. So I'm really confused and wonder which is true?
Right now I am wearing my old specs (L -13.75D R-16) which I am seeing something like 6/9-6/12. My new prescription is L-18 R-20, which will give me a VA of 6/7.5. Though I am not seeing too well with my old prescriptions, especially at dimly lit condition, but is still manageable, and I have been wearing them for the past 5-6 years. I heard that it is not good to overcorrect for high myopia. So do you think by changing to the new prescription, will it be better off or worse off?
To Sym11: I've asked my RS about Sclera buckle, but she said it was not available here in where I stay and so far results for such procedures done elsewhere has not been very promising nor proven to be effective. Furthermore, there is also considerable risks involved. So I don't think will be considering it at this stage, maybe until it is more proven or my situation gets worse. But, thanks for your suggestion!
Check out the article about degenerative myopia. web: http://www.mdsupport.org/library/degenmyopic.html. There is a solution
You may consider to have sclera buckle to stop the stretching.
Thanks so much for the supplement advice. I'll look into it ASAP. And yes, it's mind-boggling that a doctor would smoke in front of a patient. But I gather that they're getting a bit more anti-cigarette in Europe and Israel since I was there last in the late 90s. Sure hope so. I live in California where smokers are pariahs, which is fine with me.
MEDICAL PROFESSIONAL
In re-reading the conversation thread I don't think I commented on fish oil supplements. There is some evidence that it might help the blood vessels on the back of the eye stay healthy, help dry eyes, obviously help the heart a lot and possibly reduce the risk of neovascularization.
Be sure the fish oil is high grade and free of impurities. As your personal physician or ophthalmologist for the recommended dosage. If you have problems with a fishy taste and burping when you take them try enteric coated fish oil.
There are many good brands out there. The one I use is from cardiotaps (omega 3's) www.cardiotabs.com All profits from these sales are used for heart researach.
Also AREDS supplements (age related eye disease studies) may help, I would pick one that has lutein in it (vitimen's like Centrum have virtually no lutein). Popular brands are: EyeCap, Ocuvite and Preservision with Lutein. Be sure and take the proper dose which will be listed on the bottle. NONE OF THESE ARE ONE PER DAY. They are either two or four per day.
As an aside: any doctor that smokes in front of a patient ought to be put on administrative leave and sent to a smoking cessation camp and doctor behavior school. Sad, sad, sad.
JCH III MD EYe MD
Be sure the fish oil is high grade and free of impurities. As your personal physician or ophthalmologist for the recommended dosage. If you have problems with a fishy taste and burping when you take them try enteric coated fish oil.
There are many good brands out there. The one I use is from cardiotaps (omega 3's) www.cardiotabs.com All profits from these sales are used for heart researach.
Also AREDS supplements (age related eye disease studies) may help, I would pick one that has lutein in it (vitimen's like Centrum have virtually no lutein). Popular brands are: EyeCap, Ocuvite and Preservision with Lutein. Be sure and take the proper dose which will be listed on the bottle. NONE OF THESE ARE ONE PER DAY. They are either two or four per day.
As an aside: any doctor that smokes in front of a patient ought to be put on administrative leave and sent to a smoking cessation camp and doctor behavior school. Sad, sad, sad.
JCH III MD EYe MD
My myopia is not stable. Right after surgery I needed a half a diopter and a little bit of astigmatism correction in one eye, and a diopter and a half plus astigmatism in the other (that's for distance - for reading I had another prescription, and yet another for computer work). These prescriptions are a bit complicated, because the surgery aimed to give me monovision, and in an imperfect manner it did succeed - at least for the first few years. As of this date, I can still read a bit without glasses, but unless I absolutely had to, wouldn't dare drive a car unassisted.
It's been close to ten years since the surgery, and my myopia has increased by about a diopter. But I'm starting from close to 0.0, so I figure I'll be wearing 4 diopters at the age of 93. I can live with that.
As far as degenerative changes, I - like so many high myopes - have several retinal holes, which were monitored for years and which appear to have healed themselves. Had vitreous detachments in both eyes, including one in Israel where the doctor smoked a cigarette while examining me. That was a trip.
Good health and good eyesight to you too. Be well.
It's been close to ten years since the surgery, and my myopia has increased by about a diopter. But I'm starting from close to 0.0, so I figure I'll be wearing 4 diopters at the age of 93. I can live with that.
As far as degenerative changes, I - like so many high myopes - have several retinal holes, which were monitored for years and which appear to have healed themselves. Had vitreous detachments in both eyes, including one in Israel where the doctor smoked a cigarette while examining me. That was a trip.
Good health and good eyesight to you too. Be well.
Hi,
Thanks for sharing! Hearing from you is an encouragement for me!
I am glad that you are still seeing such good vision. Really hope I can also be like you (still seeing well) when I am at your age, though I think that may not be quite possible due to the already existing degenerative changes at the back of my eyes.
Maybe can you share with me about how old then your myopia began to stabilise?
I wish you good health and good eyesight always! And don't forget to go for regular eye check-up, which I believe is quite important for highly myopic people like us.
Thanks for sharing! Hearing from you is an encouragement for me!
I am glad that you are still seeing such good vision. Really hope I can also be like you (still seeing well) when I am at your age, though I think that may not be quite possible due to the already existing degenerative changes at the back of my eyes.
Maybe can you share with me about how old then your myopia began to stabilise?
I wish you good health and good eyesight always! And don't forget to go for regular eye check-up, which I believe is quite important for highly myopic people like us.
I've worn glasses since the age of 6, probably needed them for many years before that. At the age of 53 I wore -14.5D in one eye and -16D in the other. I started to have problems in my late 40s, seeing double in my left eye. It took four doctors, but finally one detected the cataract that caused the problem. Being so myopic, I was focusing about an inch from my eyeball, so I was seeing a tiny aberration of the lens that wouldn't bother a person with normal vision.
The doctor did cataract surgery, put in an IOL with my prescription, and a month later did the same procedure on the other eye - which didn't have a cataract - to balance the two eyes. Apparently it's difficult to get an exact hit when you're starting with minus 16 diopters, and also he corrected my vision to monovision (distant in my bad eye, close in my good), but I now i am able to read for short periods of time unassisted, and can drive without glasses. However, I prefer wearing glasses, with a minimal prescription, because I like to see as sharply as possible. I'm now 63, and my vision, in glasses, is 20/20 in one eye and 20/25 in the other.
The doctor did cataract surgery, put in an IOL with my prescription, and a month later did the same procedure on the other eye - which didn't have a cataract - to balance the two eyes. Apparently it's difficult to get an exact hit when you're starting with minus 16 diopters, and also he corrected my vision to monovision (distant in my bad eye, close in my good), but I now i am able to read for short periods of time unassisted, and can drive without glasses. However, I prefer wearing glasses, with a minimal prescription, because I like to see as sharply as possible. I'm now 63, and my vision, in glasses, is 20/20 in one eye and 20/25 in the other.
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