Symptoms of myopia (myopia)

Both congenital and acquired myopia (nearsightedness) in the case of progressive course can reach high degrees and are accompanied by complications development on 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 short-sightedness that leads to an irreversible reduction in vision and disability. The second most frequent cause of loss of vision in myopia is retinal detachment, which occurs against the background of dystrophic changes and ruptures in its peripheral parts.

In the vitreous body also there are destructive changes, increasing with the progression of myopia and playing an important role in the development of its complications. When the vitreous body is destroyed, complaints are made about floating opacities ("commas", "spiders"), with high myopia, a posterior detachment of the vitreous humor is possible, in which the patient marks a dark ring floating around the eye in a circle.

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

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

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

With congenital myopia, macular degeneration and even posterior staphyloma can be present already in childhood.

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

There are equatorial (latticed, isolated rupture of the retina, pathological equatorial hyperpigmentation), paroral (cystic, retinoschisis, chorioretinal atrophy) and mixed peripheral vitreochorioretinal dystrophies; according to Saksonova EO classification. And etc.). The most dangerous in terms of the appearance of retinal detachment is latticular dystrophy and retinal ruptures.

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 dystrophy. With the exception of major traction ruptures, manifested by complaints of flashing of lightning or the appearance of a "haze" in front of the eye (vitreous hemorrhage from a damaged retinal vessel), the course of peripheral vitreochorioretinal dystrophies is asymptomatic until the onset of retinal detachment. For timely detection and prevention of the latter, regular examinations of the periphery of the eye fundus by an ophthalmologist are required in all patients with nearsightedness, including in children and adolescents.

[1], [2]

Associated changes in the organ of vision

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

• chorioretinal degeneration;
• degeneration of the trellis plate;
• retinoschisis;
• retinal detachment;
• Fuchs spots (Fuchs);
• oblique disc of the optic nerve and optic nerve dysplasia;
• glaucoma;
• degenerative changes and a posterior detachment of the vitreous humor;
• subretinal neovascularization;
• microcornea;
• chorioretinal colobolism and / or coloboma of the optic nerve disk.

[3], [4], [5],

Concomitant general disorders

Myopia (nearsightedness) is often combined with certain common diseases. When establishing the diagnosis of myopia, especially at the age of 1 year, the main accompanying myopia disorders are:

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

[6], [7], [8], [9], [10], [11], [12]