A 28-year-old boy was admitted to our department. He said that recently, he felt a dark shadow floating in front of his eyes. Examination revealed a hole in his retina with a small area of retinal detachment around the hole. The attending doctor advised him to have surgery to repair the retina as soon as possible. Because retinal detachment occurs, as the detachment area increases, vision will gradually decline, and sometimes develop to complete loss of vision. And the longer it goes untreated, the greater the risk of permanent vision loss [1].
Figure丨giphy
It was a week later when I saw him again. At this time, his eyesight declined rapidly. When he saw things in the distance, he was very blurry. He could only see the shadow of the shaking hand 15 cm in front of him. It was only later that I learned that after the last visit to the hospital, he did not receive surgery in time, and went to the playground to play roller coasters and many other large-scale projects . The strenuous activity caused the retinal detachment to become larger, which severely affected his vision.
After surgery, his corrected visual acuity (vision with glasses) only returned to 0.3, a far cry from the 0.8 he had before surgery . Fortunately, the man’s vision has recovered very well , and many patients with retinal detachment have less than 0.1 corrected visual acuity after surgery.
That’s right, it’s a highly myopic pot
Retinal detachment is a serious complication of high myopia and one of the main causes of blindness in high myopia. When the degree of myopia exceeds 600 degrees, it is called high myopia. High myopia can be divided into two types: one is pure high myopia, which appears before adolescence or early adulthood [2], and the degree of myopia tends to stabilize after the age of 18; the other is pathological high myopia, which occurs after adulthood The degree of myopia is still increasing.
The greater the degree of myopia, the longer the eye axis (which can be thought of as the distance from the front to the back of the eye). As the axis of the eye lengthens, the retina thins or degenerates. It’s like a balloon. The bigger you blow it, the thinner it will be and the less tough it will be.
Comparison of the eyeball axis of normal people and the eyeball axis of myopia 丨 Literature [2]
Just wear glasses, can’t you ride a roller coaster?
The retina of the normal eyeball has a certain elasticity and can resist some pressure and external force. Because the retina of highly myopic people is thinner, its ability to resist external force and pressure is relatively poor.
When riding a roller coaster, the eyeballs are subjected to the pressure created by the high-speed flow of air. The pressure at this time is much greater than the pressure the eyeball needs to bear under normal circumstances. Retinal tears and detachments can occur when the pressure exceeds what the retina can handle.
In addition to intense games such as roller coasters, strenuous sports such as boxing or diving may also cause retinal detachment in people with high myopia. Because during strenuous exercise, the eyeball may be hit by external force. External impact can easily cause the vitreous body in the eyeball to separate from the retina, thereby pulling the retina and causing retinal detachment. If the eyeball is compared to a raw egg, the vitreous body is like the egg liquid, and the retina is the membrane wrapped around the egg liquid. When the egg is shaken vigorously, the membrane may break.
Diagram of retinal detachment: If the eyeball is compared to an egg, the vitreous body is the egg liquid of the egg, and the retina is like a membrane.丨Mayo Clinic
People with high myopia are at risk of retinal detachment due to a weak retina. Among them, the incidence of retinal detachment in patients with pathological high myopia is higher . Because simple high myopia, the eye axis basically does not change after adulthood; and pathological high myopia, as the degree continues to increase, the eye axis will become longer and longer, the retina will become thinner and more vulnerable.
These sports are not relevant for people with high myopia
People with high myopia can swim and run.
But avoid strenuous sports that may cause eye contact , such as basketball, football, boxing, bungee jumping, diving, roller coasters, etc.
Afraid of this happening, what to do with high myopia
Although in general, the risk of developing fundus lesions in high myopia is higher than that of normal vision, but this situation is not without prevention.
01
It is recommended that people with high myopia have a fundus examination every year . Doctors may prescribe tests such as mydriasis, slit-lamp fundus examination, and fundus photography.
02
If there is a flash of light in front of your eyes, or if you feel a lot of black shadows floating or fixed in front of your eyes, do not take it lightly. This may be a precursor to retinal detachment. You should seek medical attention immediately , and try to avoid strenuous exercise during this process.
references
[1].Retinal detachment | Mayo Clinic
[2]. Morgan, IG, Ohno-Matsui, K., & Saw, SM (2012). Myopia. The Lancet, 379(9827), 1739-1748.
[3]. Editor-in-chief of Zhao Kanxing and Yang Zengpei, Ophthalmology 8th Edition, Beijing: People’s Medical Publishing House
[4]. The Optometry Group of the Ophthalmology Branch of the Chinese Medical Association, Expert Consensus on Emphasizing the Prevention and Control of High Myopia (2017), Chinese Journal of Optometry and Vision Science, 2017, 19(7): 385-389
Author: Xiaolu
Editor: Mu Yi Yang Yang
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