Of all, some aspects linked to glaucoma are more or less known, such as its silent progress, the loss of peripheral visual field that it entails or that elevated intraocular pressure is the main risk factor and the only one that can currently be fought against.
But more unknown is the close relationship of this disease with some systemic pathologies, such as diabetes or hypertension, or ophthalmological, such as myopia. In this sense, Dr. Elena Arrondo, specialist in glaucoma at IMO Grupo Miranza, recalls that all of them are important risk factors and that the same attention must be paid to all of them to prevent vision loss from glaucoma that, at first, passes unnoticed: “people with myopia should know that they are part of a significant risk group, just like the elderly, with a family history or with elevated IOP,” he concludes.
And when asked if any myopia carries this associated risk, Dr. Arrondo explains that “although the risk affects any myopic person, it is true that it increases as the degree of myopia increases, and can affect 12% of myopic people of six or more diopters and shoot up to 80% in the case of very high myopia, according to some studies and, to a certain extent, we see in our day-to-day consultations”.
For this reason, the ophthalmologists at IMO Grupo Miranza call for people with myopia, especially over six diopters, to undergo regular check-ups that include all the tests necessary to diagnose or rule out the existence of glaucoma.
Likewise, the ophthalmologist specifies that “myopic patients should periodically attend an evaluation of intraocular pressure, examination of the fundus (retina and optic nerve), pachymetry (thickness of the cornea) and visual field”. According to Dr. Arrondo, “on many occasions, the follow-up of these patients remains focused on retinal lesions typical of high myopia, and it is easy for glaucoma prevention to be forgotten. In fact, it is our fellow retinologists who often refer these at-risk patients to us for control and follow-up.”
The doctor places special emphasis on high myopic patients operated on with refractive surgery, since “even though they no longer need glasses, their eye is still anatomically myopic, and for this reason they must also undergo check-ups and glaucoma study tests.” The ophthalmologist notes that it is in these patients “in which we often detect the most advanced cases of glaucoma, because they have stopped their check-ups after surgery.”
And if the early diagnosis of glaucoma is already difficult in itself, since the disease does not offer obvious symptoms to the patient in its early stages, the diagnosis of the pathology is complicated when there is myopia involved.
According to Dr. Arrondo, “in these patients, the pressure can be normal and, in addition, their optic nerve is difficult to assess because they are eyes that frequently have a lot of pathology in the fundus, which adds another degree of difficulty to the diagnosis”.
The specialist explains that the visual field of these patients “may have alterations due to myopia that, likewise, can confuse us, while, for its part, the retina may suffer alterations that may appear to be the cause of the patient’s visual loss – even without these being the ones that are taking away his vision-, which often delays the diagnosis”.
In any case, it is important that myopic patients take this risk factor into account and undergo regular check-ups. “These are patients who also evolve much faster and with more central defects than other patients and who need very low intraocular pressures to be controlled, which is often difficult to achieve, even with surgery”, warns Dr. Arrondo.
For all these reasons, diagnosing and treating these patients on time and carrying out an exhaustive follow-up of their evolution can be key, due to the diagnostic difficulty and the progression of myopia that often causes them to continue losing vision at normal pressure levels, which is not the case. occurs in other glaucoma patients.
