1/2 truth: Detached Retina, Myopia and Blindness

Discussion in 'Optometry Archives' started by Otis Brown, Aug 4, 2004.

  1. Otis Brown

    Otis Brown Guest

    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.


    Otis Brown, Aug 4, 2004
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  2. Otis Brown

    Otis Brown Guest

    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.



    Morbidity from Myopia

    E. S. Perkins, M. D.



    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.


    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.



    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.

    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)

    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


    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.
    Otis Brown, Aug 5, 2004
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  3. Otis Brown

    Otis Brown Guest

    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.


    Otis Brown, Aug 6, 2004
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