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High Myopia - Is there anybody out there?

Hi everyone.

I'm 35,with  really high myopia ( -17 in left eye and -22 in right eye)astigmatism  and cataract in right eye not impairing sight. Use rigid gas permeable contacts and get along "fine".

Have had gas bubble in left eye and laser in both for retinal tears/holes.
The only procedure I'm considering is IOL when absolutely necessary.

I've never heard of anyone with myopia this high. i'm really worried about future prospects.

I know people with similar conditions can have different outcomes but can anyone with high myopia ( even if not like mine) please give any input or useful information?

Many thanks.

Wishing you all the best,
Sophia



91 Responses
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177275 tn?1511755244
There are many blind physicians that practice medicine full time.   An ICL would probably not be a good choice after a RD buckle.  Your risk of a Rd might be 1% that's good odds.  Get on with your life and be more optimistic.
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Avatar universal
Sorry just to add on another question: Would ICL be possible after a scleral buckling surgery?

Thank you Dr Hagan.
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Avatar universal
Yup, I've been accepted to a 6year programme. :) i'm from a country where medicine is undergraduate.
Thanks for the encouragement! I really cant see myself doing anything else, and have been interested in Medicine as long as I can remember. I really hope my eyes wont be a problem.

Just wondering, is it possible for a doctor with a history of retinal detachment / vision problems will be able to get through residency and training? I think surgery may be out of the question due to the need for good vision, but what about specialties like Fam Med / Psychiatry / IM? Do you think its possible to become a successful specialist even if I have retinal detachment and fix it with a scleral buckle?

Sorry for the pessimism, but my doctor has always warned me about the high risks for retinal detachment and it's very alarming. :(

Thanks!
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177275 tn?1511755244
If your heart and brain are up for medical school and a career as a physician do not let your eyes stop you.  See an ophthalmologist every year, lead a healthy lifestyle, eat a great diet, don't use nicotine or cannabis, avoid contact sports and violent amusement rides, don't do head down yoga, exercise, maintain a healthy weight and don't drink alcohol, when you're older no more if you want to drink drink in moderation (<2 drink/day).

I have found Medicine an enormously rewarding career.  How are you able to start medical school at 18? ?Are you entering a 6 year program?

Helpful - 0
Avatar universal
Hi,

I'm 18, and have -15 in both eyes. I have been offered a place in med school (starting really soon) and I'm really worried that something'll happen to my eyes during the long journey (med school + residency). I'm terrified that as a result I'll be unable to pay off the 300K in student loans if that happens.

Do you think I should go to medical school?
Also do you think that even with a scleral buckle or some sort of eye defect, I can stll be a good doctor that is not a hazard to my profession?

Thank you Dr Hagan.
Helpful - 0
2 Comments
hello.i am from india and also suffering from high myopia.i wish i have friends with whom i can share and talk about this.well noone can help but atleast talking to someone suffering from same thing,makes you feel better.
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Avatar universal
I am 25 and just got my prescription of -6 in the right eye and -5.5D in the left. My eyes progressed the fastest last year. I'm pretty scared, because I'm a medical doctor and planning on going into surgery, but now I'm not sure because I could lose my eyesight due to complications.

I plan no seeing an ophthalmologist as soon as possible, hopefully nothing too much is going on inside my eye.

It's been so difficult for me to read lately. I can't use my eyes for too long anymore and I have an increasing number of floaters in my right eye and my vision has been so dim lately. I suspect my visual field has problem of some sort. I hope you can give me some advice. Thanks.
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2 Comments
If you are a medical doctor then get in to see an ophthalmologist as soon as possible. The floaters, dim vision and reading difficulty are symptoms that deserve a proper diagnosis. When you see the ophthalmologist Eye MD ask they do a "post cycloplegic refraction" One possibility is that your glasses are too strong especially if the glasses test (refraction) was done without dilating your eyes. In a young person like yourself it is easy to "over-minus" you when testing without drops. That can cause reading difficulty, dimming and discomfort. It is a common problem often when getting glasses at the mall or shopping center.  

If your eye exam is normal there is no reason you could not be a surgeon or should expect complications.
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Avatar universal
I have had high myopia all my life (-12/-13). I am 60 and have worn gas permeable lenses since I was 18. I do a lot of trekking and have found these to be comfortable and easy to manage. However I have recently been accepted as a trek leader for a company who insist that contact lenses are not allowed due to the risk of infection. In all my life I have rarely had any eye infections and the few I have had were easily treatable with saline and anti-bacterial eye wash. I find glasses uncomfortable and inappropriate for trekking so I am considering having laser eye surgery. I live in the UK and it's expensive for someone with my prescription as I'll have to go to a specialist in high myopia surgery, and I've also been told I must switch to wearing soft lenses for four months before the operation. Other experienced contact-lens wearing trek leaders say the company are being ridiculous and I should ignore their ludicrous rules and wear the lenses anyway or find another company that doesn't over react to risk assessments. I'm trying to weigh up the risks and costs. I have never even considered surgery before. I'd appreciate expert opinion.
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1 Comments
There is no question but that the risks are higher, the expenses higher with proceeding with surgery especially since you're doing well.  It would seem you best bet by far is to find a trek company that does not have this rule/regulation. You can also take glasses, lots of contact lens solution and be extremely careful with hygeine and CTL care when on trek.  Also you can ask your ophthalmologist to prescribe an antibiotic eye drop appropriate for a corneal ulcer to take on the trek. If you had something like an infection you would leave the contacts out, wear glasses, start antibiotic drops and get to eye medical care ASAP.   It's highly unlikely that LASIK or PRK would correct your myopia.  Likely you will, or have already, developed some cataract formation. At some point cataract/IOL surgery can give you better vision than refractive corneal surgery
177275 tn?1511755244
You do have pathological high myopia OR you could have a corneal disease called keratoconus      Your profile indicates you live in NYC  I suggest a consult at New York  I would suggest you make an appointment with a cornea/refractive surgery specialist at New York Eye & Ear Institute of Mount Sinai   http://www.nyee.edu/patient-care/ophthalmology

I would stay away from Columbia University Ophthalmology Department.

NYEE can determine if you have corneal disease, evaluate your retina and discuss options to improve your sight.
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Avatar universal
Im 19.with higher myopia than you have .right eye is -23 and left is 26 and l have astigmatism too.lve been using glasses since im 3 years old.and when l was 15 l started to use lenses for lower power .my eyes arebgetting worse every year. l dont know what to do .l afraid im going blind.
Helpful - 0
1 Comments
hello.i am also suffering from high myopia.i wish i have friends with whom i can share and talk about this.well noone can help but atleast talking to someone suffering from same thing,makes you feel better.
177275 tn?1511755244
John Kim, MD
J. Bradley Randleman, MD

Cornea/Cataract/Refractive surgeons at Emory U Dept of Ophthalmology
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177275 tn?1511755244
You know I don't think there is any "best of the best" when it comes to Medicine and Surgery.  Emory is ranked in the top 10 Ophthalmology Departments in the Country and is strong in refractive surgery and retina.

If you have only seen a retina Eye MD and your "regular eye doctor" then you have not really even scratched the surface of what is possible. You should definitely see a top quality cornea/refractive Surgeon.

JCH MD
Helpful - 0
1 Comments
Thank you! Yes I'm going to investigate my options at Emory. Is there a particular person there you would suggest?
Avatar universal
Its good your vision is 20/20 correctible with contacts, it wasn't clear from your post whether  that was the case.

I wasn't as myopic as you (perhaps -6D and -9.5D before the cataract hit) but I always found contact lenses gave me better vision, I rarely wore glasses unless I had to due to allergies causing problems with contacts at times (GPC issues). If I'd had to abandon contacts I'd have likely been hunting for options as you are.  It may be that clear lens exchange is something to consider, but one tradeoff is that the longer you wait, the better replacement lenses will become. Eventually they'll be able to provide a lens comparable to that of a natural 19 year old lens, they just aren't there yet, the question is whether the current lenses are "good enough" to be worth it for you, or whether to wait a bit longer for a new generation of improved lenses.

I should add that usually it is possible to replace IOLs in the future, even if it adds risks&cost just like the original surgery, but the risks and costs will come down over time. It may be that in a decade I'll decide its worth it to upgrade to a new generation IOL.


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Avatar universal
I' was never given a reason. Over the years I had old glasses rx just to get me by around the house when I got home. This year cutting down my contact use I updated them. With contacts I can see 20/20 but the glasses rx I have not been able to. I told the guy that when I wore them a few days and he told me I would not have as sharp vision with glasses as I do contacts. I've been doing this 14 years and I realize that but my vision is way worse in these glasses. He "fixed" them and it did not resolve the problem so I decided not to go back to that office this year.
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Avatar universal
Thank you Dr. I've only seen one surgeon, but he told me not to let anyone laser my eyes bc I would not have clear vision afterwards. He did not go into any other detail besides that. At this point I would love to just have it improved evenif it doesn't conpketeky correct. I would continue to wear contacts as long as it was healthy for my eyes. I know one day I will have cataracts and will be having the clear lens procedure anyway, but I wondered if he was not willing to do it bc aside from my myopia my lens is ok and it would risk a detachment at a young age. Trying to balance quality of life with my vision with what the true likelihood of a detachment would be. Is Emory the best of the best? I've only ever seen a retina specialist from my pvd 3 years ago and a regular eye dr yearly, so my knowledge of specialties is low. Thank you
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177275 tn?1511755244
=
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Avatar universal
You say you still have blurry vision even up close. Does that mean even with correction your vision isn't 20/20, if so do you know what your "best corrected" vision is? Has the doctor given you a reason for this, have you got some other eye health issue that might impact what treatment you get for your myopia?  I'm wondering if it might be as simple as having some astigmatism and wearing contact lenses that don't correct for it (I don't know if toric astigmatism correcting lenses are available off the shelf for someone that myopic).

The comment about oxygen deprivation from long term contact use is odd with modern soft contacts. Although the doctor mentioned daily disposable contacts, I'm not sure if they come in such a high power (I don't recall seeing the option a couple of years ago when I temporarily had one eye that was -19D, a drastic -10D shift due to a cataract before surgery). However if your eye were partly corrected via laser, as the doctor suggested as one option, that would leave your eyes well within the power of many off the shelf contact lens brands including daily disposables. I don't know how their oxygen permeability compares to  lenses that are designed for extended wear (though you don't need to wear them them as extended wear) that presumably focus on providing more oxygen. (I'd read about the topic a few years ago, but it escapes me offhand).

I'll add that one important side effect of a "refractive lens exchange" that the doctor suggested is that although it is possible it might  provide you with great distance vision, your near&intermediate vision would be impacted. Its usually an option more commonly suggested for those who are a couple of decades older than you who already have presbyopia. Given your high level of myopia and limited other options,  it may be something you'd wish to consider, but I just figured I'd mention that there are tradeoffs to considering it in someone as young as you are.

  Most cataract patients are old enough that they are familiar with the issue since they have some degree of presbyopia,   the reduction in your near vision that starts to  become apparent among those in their early-mid 40s or so which leaves older people needing reading glasses more and more (or progressive glasses or multifocal contacts or monovision contacts).  There are approaches to "refractive lens exchange" that try to provide better intermediate&near vision, such as monovision or premium lenses, but no option is yet perfect and surgeons differ in what the best approach to dealing with the loss of near vision is. In my case with the Symfony lens (not available yet in the US) I can even read my smartphone without a problem, but I definitely don't have the level of near vision I had at 28, e.g. I'd need readers to thread a needle (not that the situation arises much, for most things except very near tasks my visual acuity is good enough).
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177275 tn?1511755244
I would suggest you get a consultation at Emory U Dept of ophthalmology with one of the cornea/refractive surgeons.  The Eye MD there could confirm you are not a candidate for ICL.  With your thick cornea the surgeon could estimate how much of your myopia might be corrected with surface LASIK perhaps 8 or 9 diopters. That would make your glasses RX -7 or -6    You could ask about GP CTL but they let less oxygen through than soft and likely you could not wear them.  You can ask about daily disposable soft contacts. That might allow you to wear them longer than 6 hours.  Lastly you could ask about "refractive lens exchange" or "clear lens extraction"  Its basically doing an cataract operation and putting in an intraocular lens in a lens that doesn't have a cataract. The primary risk is that in everyone that increases the risk of a retinal detachment. In the general population the risk is low maybe one in 3-5,000  In your case the risk even with an uncomplicated case might be as high as 5-8%. Be sure your children are checked regularly as high myopia is frequently hereditary.
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Avatar universal
I am 28 yrs old, f. I started wearing glasses in 2nd grade. Wore soft contacts from 7th grade to today. I'm -15d and this week I was turned down for icl bc there is not enough space in my eye for the lens bc I have a thick cornea. The surgeon said not to get laser surgery bc my vision would not be clear afterwards. I have oxygen deprivation  from long term contact use and the last year I've cut down my wear time to average 6 hours a day and I try to break that up. I've never tried gas perm lenses, I don't know what else is out there. Last year I had my glasses updated, but I still habe blurry vision even up close. I'm very frustrated and looking for support. I'm a busy mom with 2 kids and I want to see!
Helpful - 0
1 Comments
hello.i am from india and also suffering from high myopia.i wish i have friends with whom i can share and talk about this.well noone can help but atleast talking to someone suffering from same thing,makes you feel better.
Avatar universal
I just got meself some GP lenses. Seem to be the best and cheapest option with least risk unless you box. . .!  These are readers and general purpose.  Using additional specs for driving which works well .  my prescription is above minus 20 and Im in my late 60,s.

Tried wearing my old prescription specs, with my additional specs perched in front.

Suffice to say the result was beyond my wildest dreams and way way beyond my optemitrists ability to achieve.  But it doesnt look cool.  Most assuredly not cool at all

Do I care?  Haha
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177275 tn?1511755244
I would find a new doctor. That is truly one of the worst responses from a doctor ever posted here (you don't need the back of your eye checked because you are not at risk).  Find a new optometrist or ophthalmologist that will yearly dilate your eyes and look at your retina.

Your high myopia increases the risk of retina tears, detachments, holes, lattice, myopic macular degeneration and glaucoma.
JCH MD
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17838258 tn?1460707086
I've always thought my vision is extremely bad, but compared to some of the other posts here, looks like my eyes are fairly okay.
Anyway, I'm OS: -5.50/No Cyl =and= OD: -5.25/ -0.25@90 (Spectacles).
Both eyes: -5.00/No cyl (For contacts).
Every time I go to my doctor, he's more interested in the health of my corneas and doesn't even look at the retina. I get an autorefractor test, then a tune-up with trial lenses, followed by a slit-lamp test (which I'm assuming is for the cornea, as a cycloplegic eye drop is not used prior to the test and my pupils must constrict too much under the super bright illumination to allow a good view of the internals).
Last time I saw him, I  specifically asked him to take a look at my retina, he said it's not required, you have 20/20 with correction and you're not at risk.
I feel awkward trying to argue with a doctor, of course he knows way more than I do, but something tells me it's not right- my correction might not be as high as that of some people here, but they're still fairly high. What do you think, should I go for a second opinion?

I've seen this SAME doctor all my life, and I'm 32 years old now!

Another question, I use B&L monthly disposable soft lenses (not toric) made of Hylafilcon-B (59%water) for 12 hours a day, 6 days a week. My doctor says it's okay, but these are NOT silicone-hydrogels, these are ordinary lenses. Am I damaging my eyes by wearing them 12 hours a day? I never go more than 12 hours, always take a day off every week, and never sleep in them (as suggested by my doc.)

Please suggest.
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177275 tn?1511755244
=
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Avatar universal
I should note that of course I was talking about the "worst case" scenarios, since high myopes do have some slight increased risk of other eye health issues compared to the average person, but that still means most don't have any problem aside from being myopic. The odds are that with correction your vision will remain comparable to other people's vision. As the doctor noted, there are ways to perhaps reduce your myopia surgically via laser or lens implants. Other high myopes cope with a combination of contacts and/or glasses. My point was merely that visual problems don't tend to keep people from working with computers.
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Avatar universal
When I was in school for computer science I recall someone in the year ahead of me who had glasses with attachments on them that seemed almost like a telescope (its been a few decades so my memory is vague), I don't know what his visual issues were (again my memory of it is vague), but despite obviously having some impairment he was able to get through one of the top CS programs.

If you are able to work with computers now then there likely isn't going to be any problem (aside from as the doctor noted any other eye health issues that might arise, but most of them are treatable these days and leave you with some vision).  As long as you have the ability to see at all there is likely a way to work with computers (and in the extremely unlikely case you someday couldn't see, even blind people do work with them, though I've never run across any so I don't have a sense of the scope of what they can do, I suspect the tools for them to use computers are getting better all the time).

These days the  nice thing about the computer world is that if needed you can get high resolution computer monitors and adjust print sizes and position the monitor as close or far as needed, and scroll the view on the screen around, and therefore as long as you have some workable vision you should be able to function. (as long as  you get things adjusted well to reduce any vision issue induced headaches, since headaches can reduce concentration, as I had to deal with after a rare side effect from cataract surgery caused issues with flickering light when reading).
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