1/2 truth: Detached Retina, Myopia and Blindness

Dear Friends,

Subject: BTW, myopes never go blind due to myopia. Dr Judy

I have researched a great number of papers on
the eye's behavior and other topics.

Judy's statement may, or may-not be true -- perhaps.

But she states it as an "absolute".

What happens is that the number of detached retinas
goes "up" proportional to the degree of nearsightedness
is a population of "nearsighted" people.

This was the conclusion reached by Dr. Perkins in his study.

It is a "streach" to state that detached retinas
have NO RELATIONSHIP to the degree of nearsightedness.

At leasd Judy should have said that, "... in my opinion",
and then we would have stated that Dr. Perkins study
was the "second opinion".

If you can work with the plus and keep your distant
vision clear -- you avoid the specific problem.

Judy, I will forward you statement to our
friends -- who disagree with you on your statement.

Best,

Otis
Engineer

 

Dear Friends,

of a "second opinion".

Here is the research paper concerning the effect
that a large (and even small) about of nearsightedness
has on the eye.

Who is more correct on this subject? You decide.

Best,

Otis
Engineer



Morbidity from Myopia

E. S. Perkins, M. D.

****************************

INTRODUCTION

High myopia is recognized as a significant cause of ocular
disease, but most ophthalmologists look upon lower degrees of
myopia as little more than a mild social disability without any
serious consequences. It is the purpose of this paper to review
the morbidity of myopia and to suggest that even the lower degrees
of myopia are associated with conditions resulting in significant
ocular morbidity.


REGISTRABLE BLINDNESS FROM MYOPIA

Sorsby analyzed the causes of blindness leading to
registration in two groups of patients. The first comprised
patients of all ages who were registered during the years
1955-1960 and he found that degenerative myopia was responsible
for 8.4 percent and myopa retinal detachment for 0.4 percent of
blind registration.

Other important causes of blindness were senile macular
generation, cataract, glaucoma, and diabetic retinopathy (Table
1). Myopia was the fourth most common of these causes. However,
if age is taken into account (Table 2), myopia emerges as the most
important cause of blind registration in the age group 50-59 and
is second only to diabetic retinopathy in the 60-69 age group.


*******

END OF PAPER

The follwing conclusions can be drawn from the evidence
presented above:

1. Myopic chorioretinal degeneration is a major cause of
blindness and its incidence can be correlated with the axial
length of the eye.

2. The risk of idiopathic, traumatic, and aphakic retinal
detachment is higher in myopic eyes. Even low myopes are
seven times more likely to develp a detachment than
hypermetropics. (An natural eye with a positive focal status.
OSB)

3. Open-angle glaucoma is more likely to be diagnosed in myopic
eyes than an emmetropic or hypermetropic eyes. (Emmetropic
means a focal state of EXACTLY zero diopters. Hypermetropic
means a positive focal state of the natural eye. Focal states
of young children are considered to be normal if their focal
states run between zero to +2.0 diopters. OSB)

Recognition of a problem, although an essential preliminary,
does not automatically provide a solution. It should, however,
stimulate interest in a solution and even if we do not understand
the etiology (cause) of myopia, the risks of visual loss in myopia
are sufficiently high to warrent serious attempts to reduce its
adverse effects. The only wide-spread efforts in this direction
are in the prophylactic treatment of fellow eyes in patients who
have already developed a detachment in one eye, and the routine
pretreatment of the retinal periphery of myopic eyes before
cataract surgery to reduce the incidence of aphakic (no lens)
detachment.

The problem of unrecognized glaucoma in high myopes has been
partly solved by the use of applanation tonometry instead of
indentation methods so that falsely low tensions do to the low
sclerla rigidity of such eyes are eliminated. Assessment of
cupping and field defects in highly myopic eyes still present some
problems and require further study. The prognostic value of the
refraction (or perhaps axial length) in patients with ocular
hyper-tension which is suggested by the results presented here
deserves further evaluation.

The most serious complication of myopia is chorio-retinal
degeneration. If, as the evidence of Curtin and Karlin suggests,
this is the result of mechanical stretching of the retina,
reinforcement of the sclera seems logical.

Useful results have been reported by a few surgeons in the
United States and England and it is used more widely in the USSR.
Alghough this method sometimes results in visual improvement, the
main success has been in preventing deterioration.

The criteria for surgical intervention before visual loss are
therefore of great importance and deserve further study.

The surgical techniques are probably capable of futher
refinement but scleral reinforcement is the most helpful procedure
yet devised for prevention of blindness from myopic chorio-retinal
degeneration providing it is useed in an early stage of the
condition.


SUMMARY

Myopic chorio-retinal degeneration is one of the major causes
of blindness but myopia is also a facto in ocular morbidity due to
the retinal detachment, glaucoma, and possibility of cataract.
Although the risks increase with the degree of myopia, evidence is
presented that even myopia of less than -5.00 diopters increases
thee probability of retinal detachment and glaucoma. Myopes of
this degree have a seven-fold risk of detachment compared with
hypermetropes and a threefold risk of glaucoma.

 

Dear Mike,


Again you put the cart before the horse!

The goal with the plus is to have the
individual maintain clear distant vision
with the plus, so that he does not
develop "stair-case" myopia, and
the resultant consequences as you state them.

Indeed, the real reason I "arm twisted" my sister's
children to use the plus was specifically so
that they would AVOID the consequences as
you state them.

Best,

Otis
Engineer