Symptoms of myopia (myopia)

Both congenital and acquired myopia (nearsightedness) in the case of a progressive course can reach high degrees and be accompanied by the development of complications in the fundus - both in the posterior pole and in the periphery. High myopia with pronounced axial elongation and complications in the central zone of the retina has recently been called pathological. It is this myopia that leads to irreversible vision loss and disability. The second most common cause of vision loss in myopia is retinal detachment, which occurs against the background of dystrophic changes and ruptures in its peripheral parts.

Destructive changes also occur in the vitreous body, increasing as myopia progresses and playing an important role in the development of its complications. When the vitreous body is destroyed, complaints of floating opacities ("commas", "spiders") arise; with high myopia, posterior detachment of the vitreous body is possible, in which the patient notices a dark ring floating in front of the eye in a circle.

Changes in the posterior segment of the eye in myopia concern the optic disc and macula. Its damage is the formation of a myopic cone, peripapillary atrophy of the choroid, changes in the course of the disc vessels, a decrease in their caliber, and the disappearance of tortuosity.

Changes in the macular zone - diffuse or focal chorioretinal atrophy, "varnish cracks", hemorrhages, neovascular membrane, Fuchs' spot, vitreomacular traction syndrome. In the most severe cases of high complicated myopia, posterior staphyloma is formed - a true protrusion of the sclera in the area of the posterior pole of the eye.

In the ectasia zone, gross dystrophic changes in the retina occur.

In congenital myopia, macular dystrophy and even posterior staphyloma may be present already in childhood.

With acquired myopia, complications in the central parts of the fundus usually occur after 30-35 years.

A distinction is made between equatorial (lattice, isolated retinal breaks, pathological equatorial hyperpigmentation), paraoral (cystic, retinoschisis, chorioretinal atrophy) and mixed peripheral vitreochorioretinal dystrophies; according to the classification of E.O. Saxonova et al.). Lattice dystrophy and retinal breaks are the most dangerous in terms of the occurrence of retinal detachment.

Peripheral vitreochorioretinal dystrophies in all forms of myopia occur already in childhood, the peak of their accumulation is noted at 11-15 years; further progression leads to the formation of ruptures, new dystrophic zones, mixed forms of dystrophies. With the exception of large traction ruptures, manifested by complaints of flashing "lightning" or the appearance of "smoke" in front of the eye (hemorrhage into the vitreous body from a damaged retinal vessel), the course of peripheral vitreochorioretinal dystrophies is asymptomatic until the moment of retinal detachment. For their timely detection and prevention of the latter, regular examinations of the periphery of the fundus by an ophthalmologist are necessary for all patients with myopia, including children and adolescents.

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Associated changes in the organ of vision

Myopia (nearsightedness) is often accompanied by other eye diseases, with the most serious of them being associated with high myopia. Myopia-related disorders include:

• chorioretinal degeneration;
• degeneration of the cribriform plate;
• retinoschisis;
• retinal detachment;
• Fuchs spots;
• tilted optic disc and optic nerve dysplasia;
• glaucoma;
• degenerative changes and posterior vitreous detachment;
• subretinal neovascularization;
• microcornea;
• chorioretinal colobomas and/or optic disc coloboma.

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Associated General Disorders

Myopia (nearsightedness) is often combined with certain general diseases. When diagnosing myopia, especially at the age of up to 1 year, the main disorders accompanying myopia are:

• albinism;
• Alport syndrome;
• Alagill syndrome;
• Bassen-Kornsweig syndrome;
• Down syndrome (trisomy 21);
• Ehlers-Danlos syndrome;
• Fabry disease;
• Flynn-Aird syndrome;
• Laurence-Moon-Bardet-Biedl syndrome;
• Marfan syndrome;
• Marshall syndrome;
• Stickler syndrome;
• Wagner's dystrophy;
• choroideremia;
• ectopia lentis;
• lobular atrophy;
• myelinated nerve fibers;
• retinitis pigmentosa;
• retinopathy of prematurity.

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