Myopia

Etiological Classification
• Axial myopia :result from increase in anterioposterior length of
eyeball.
• Curvatural myopia :occurs due to increased curvature of cornea or
lens or both.
• Index myopia :increase in refractive index of crystalline lens assotiated
with nuclear sclerosis.
• myopia due to excessive accommodation :occurs in patients with
spasm of accommodation.
Clinical Classification
• congenital myopia.
• simple or developmental myopia.
• pathological or degenerative myopia.
• acquired myopia
Congenital Myopia
• Present since birth.
• Seen more frequently in children who were born prematurely or with
various birth defects.
• Usually error is about 8-10D, which mostly remains constant.
• May sometimes be associated with other congenital anomalies such as
cataract, microphthalmos, aniridia, megalocornea.
• Early correction is desirable to help the children to develop normal
distance vision and perception of world.
• Full cycloplegic refractive error including any astigmatic correction
should be prescribed
Simple Myopia
• Aka physiological or school myopia.
• Physiological error not associated with any disease of eye.
• Etiology: result from normal biological variation in the development
of eye.
Pathological Myopia
• Rapidly progressive error resulting in high myopia usually apparent
during 1st decade of life characterized by increase in volume of
posterior segment.
• Etiology: no satisfactory hypothesis has emerged to explain the
etiology of pathological myopia.
• However it is confirmed that genetic factors play a major role.
• It is said that increased axial length, degenerative changes in retina
and vitreous, and pathological complications are determined by
different genes.
• Inheritance can be AD, AR ,X-LINKED 21
Acquired Myopia
• Causes:
• index myopia : seen in nuclear sclerosis. incipient cataract.
diabetic myopia occurs due to decrease in refractive index of
cortex.
• curvatural myopia increase of corneal curvature in diseased
conditions like corneal ectasias, and conical cornea.
• positional myopia: conditions producing anterior subluxation
of lens
• consecutive myopia surgical overcorrection of hypermetropia
pseudophakia with overcorrecting IOL.
• pseudomyopia also called artificial myopia. produced in a
conditions such as excessive accommodation and spasm of
accommodation. may develop after too full a hypermetropic
correction in children
Types of MYOPIA
• According to amount:
• Classically:
• Very low : upto – 1.00D
• Low : –(-1.00-3.00)D
• Medium : –(3.00-6.00)D
• High : –(6.00-10.00)D
• Very high : above –10.00D
Non- Surgical
• Spectacles – Concave
Lenses
• Contact Lenses – Contact
lenses are used in case of
high myopia as they
provide peripheral
distortion and
minification produced by
strong concave spectacle
lenses
Surgical Techniques
• Radial Keratotomy
• Photo-Refractive Keratectomy
• LASIK
• Fucala’s Lens Extraction
• ICL or Phakik IOL
• ICR ( Intra Corneal Rings)