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Degenerative myopia: The basics

Degenerative myopia is a form of myopia (nearsightedness) that causes visual acuity to worsen at a more constant rate than what is considered “normal.” Over time, this change in vision can become so severe that it can cause blindness.

While myopia is a common vision impairment that makes it difficult to see faraway objects and signs clearly, degenerative myopia can impact other parts of the vision system.

What is degenerative myopia?

Degenerative myopia (also called myopia degeneration, or pathological or malignant myopia) is an extreme form of nearsightedness that usually begins in early childhood. The condition is rare (affecting about 2% of the population) and is considered to be hereditary.

Degenerative myopia can be treated with eyeglasses or contact lenses, but it is not curable. Because of its severe and complex nature, it can also lead to serious vision problems, including the following:

Degenerative myopia causes a constant change in vision that should be monitored by an eye doctor to ensure it is corrected properly. Regular checkups will also ensure that any new complications that develop can be treated as soon as possible.

The frequency of eye doctor visits depends on each individual patient. If you have degenerative myopia or a related condition, talk to your eye doctor about how often you should have exams for your personal case.

Signs and symptoms

Decreased vision and vision fatigue are some of the most common symptoms associated with degenerative myopia. These particular symptoms may be especially apparent during activities that require constant visual focus, such as driving or playing a particular sport.

Some other common signs and symptoms of degenerative myopia include:

Retinal detachment can occur with some cases of degenerative myopia when the refractive error is high enough. If this happens, you may also experience retina-related symptoms such as floaters and flashes.

SEE RELATED: What is high myopia?

Causes

When the eye is longer than normal, vision is affected in a way that makes faraway objects and signs difficult to see or read. Mild eye elongation can result in myopia, while constant and/or severe eye elongation results in degenerative myopia. 

With continued growth of the eye over time, such lengthening can cause the retina and sclera (the white portion of the eye) to stretch and further lead to retinal problems, such as retinal tears or detachment.

Degenerative myopia is considered a genetic disorder, so the chances of developing it are higher if there is a family history of the condition.

Diagnosis

Degenerative myopia is diagnosed through a routine eye exam. During the exam, your eye doctor will look for signs of nearsightedness (among other conditions). If severe nearsightedness is detected, the doctor will also likely perform a retinal examination. 

During a retinal exam, your eye doctor will dilate your pupils, allowing the doctor to get a clearer image of the retinas, which is necessary to make an official diagnosis. Since degenerative myopia typically begins in early childhood, it is likely that a diagnosis of the condition is made before adulthood begins.

SEE RELATED: Why myopia progression is a concern

Treatment

There is no cure for degenerative myopia, but this vision impairment can be treated in the same fashion that mild myopia is — with eyeglasses and contact lenses. Some severe or advanced cases of degenerative myopia may be past the point of being corrected. 

Corrective lenses

Eyeglasses and contact lenses help correct the vision impairment brought on by degenerative myopia. Many who have the condition prefer contact lenses to glasses, however, because eyeglass lenses can be very thick due to the degree of the prescription.

Note: if you are diagnosed with degenerative myopia, it is important to let your doctor know if you play contact sports or work in an active environment that could potentially be a danger to your eyes in any way. Since degenerative myopia affects the retinas, eyes are more prone to injury and damage and should be protected as much as possible.

Can laser treatment correct degenerative myopia?

LASIK eye surgery is typically performed to treat a stable prescription. With degenerative myopia, however, a prescription may not ever be stable enough to undergo this corrective laser eye surgery. 

Various laser treatments and other therapies have been performed to treat retina conditions associated with degenerative myopia, according to the American Academy of Ophthalmology, but many of these are no longer recommended, as they can cause further complications in patients. 

When to see an eye doctor

If your vision becomes impaired due to headache, sensitivity to light or more noticeably blurred vision, consult an eye doctor — even if you are not due for an annual eye exam. Because degenerative myopia affects the retinas, it is important to take note of any flashes or floaters you may experience as well, as this could be related to retinal detachment.

Annual eye exams are encouraged for everyone, but since degenerative myopia causes rapid changes in vision, it may be necessary to have more frequent visits with an eye doctor to make sure the condition is treated properly.

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