Pathological Myopia Pathological Myopia Clinical refractive error 6

Pathological Myopia

Pathological Myopia Clinical : refractive error >6 D. • Myopia with degenerative changes especially In the posterior segment. • Myopia caused by pathological axial elongated Of the eye ball. Specific : a rapidly progressive error which starts in childhood at 5 -10 years of age & results in high Myopia

Synonyms l l l Degenerative myopia Progressive myopia Malignant Myopia High degree myopia Magna myopia

Etiology l The rapid growth of axial growth of eye ball is witnessed as the main cause for the pathological Myopia which is unequivocal & outside the normal biological variants of development. l No satisfactory theory has emerged to explain this. l It is definitely linked with : (1) Role of heredity. (2) Role of general growth 1. Role of heredity : it is confirmed that genetic factors play a major role in the etiology.

l It is presumed that heredity linked growth of retina is the determination in the development of myopia. l The retina due to its distensibility stretches with retina. l But the choroid cannot & undergoes degeneration which in turn cause generation of retina.

Symptoms l l l l Image infection Anisometric amblyopia Subnormal visual acuity Visual field defects Impaired dark adaption Abnormal color discrimination Suboptimal binocularity

Signs l l l Prominent eye ball Cornea is large Anterior chamber is deep Large and sluggish pupils Visual field contraction On fundus examination : ü Large and pale optic disc ü Tilted optic nerve papillary atrophy ü Temporal myopic crescent/peripapillary

Signs ü ü ü ü ü Crescent Blond fundus Chorioretinal atrophy Peripheral vitreous detachment Lacquer cracks Lattice degeneration Peripheral retinal holes Macular holes Choroid neovascularization

üLarge and pale optic disc :

ü Tilted optic nerve with peripapillary atrophy :

Temporal myopic crescent/ peripapillary

ü Tigroid/Blond fundus :

ü Choroid retinal atrophy :

ü Posterior vitreous detachment

ü Lacquer cracks :

ü Lattice degeneration :

ü Cobblestone degeneration :

ü Foster-fuchs spots :

ü Peripheral retinal holes :

ü Macular holes :

ü Choroid neovascularisation :

Complications : l l l l Retinal detachment Complicated cataract Vitreous & choroidal hemorrhage Strabismus fixus convergence Normotensive glaucoma Myopic foveoschisis Posterior staphyloma

Treatment :

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