Tag Archives: near-sighted

Lattice Degeneration

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globe anatomy
anatomy of the eye (click on image to enlarge)

What is lattice degeneration?

Lattice degeneration is a condition in which the retina develops areas of abnormal thinning.  The thinning occurs as the retina stretches during growth of the eye.  The retina is a “tissue-paper” thin layer of nerve tissue, which lines the inside of the eye like the film in a camera.  In the eye, light is focused onto the retina, which “takes the picture” and sends the image to the brain.  Lattice degeneration is most common in near-sighted people and affects about 7% of the general population.          

What causes lattice degeneration?

Lattice degeneration appears to be an inherited condition that usually develops in childhood or early adulthood.  The eye, which is round like a ball at birth, becomes oval like an egg.  The elongation of the eye causes the retina to stretch.  As a result, thin areas develop in the retina similar to “stretch marks” that occur in the skin with growth or weight gain.    

Why is it important to know about lattice degeneration?

            Lattice degeneration in itself causes no symptoms or loss of vision.  It is important because lattice degeneration predisposes eyes to retinal detachment, which can cause permanent blindness without treatment.  With age, trauma, or inflammation, the vitreous gel that fills the eye begins to condense and pull away from the retina.  If the retina has become weakened by lattice degeneration, it is more likely to tear when pulled upon.  A tear in the retina allows fluid from the vitreous gel to seep under the retina as the retina detaches.  Fortunately, only one in 200 eyes with lattice degeneration ever develop retinal detachment.  Usually no treatment of lattice degeneration is needed, but symptoms of new floating spots or fibers should be reported to the doctor promptly. An examination may disclose breaks in the retina, which may be treated in the office with laser.  The appearance of a dark curtain or shadow from the side-vision like an eclipse of the moon is an even more serious symptom that may indicate retinal detachment and require major eye surgery to repair. 

By Scott E. Pautler, MD

For a telemedicine consultation with Dr Pautler, please send email request to spautler@rvaf.com. We accept Medicare and most insurances in Florida. Please include contact information (including phone number) in the email. We are unable to provide consultation for those living outside the state of Florida with the exception of limited one-time consultations with residents of the following states: Alabama, Arkansas, Connecticut, Georgia, Minnesota, and Washington.

Copyright  ©2022 Designs Unlimited of Florida.  All Rights Reserved.          

Slow Myopic Progression

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myopia
A myopic eye has elongated somewhat like an egg. Incoming images do not focus on the retina in the back of the eye.

Although most people with myopia (near-sightedness) do not suffer from complications, highly near-sighted eyes (greater than 6 diopters) are at risk of vision loss. Myopia is fairly prevalent, affecting about 25-35% of adults in the United States. Extensive visual tasks focused at near may be increasing the risk of myopia. Highly myopic eyes are at increased risk of myopic macular degeneration, cataract, glaucoma, and retinal detachment. Therefore, treatment to reduce the progression of myopia is important to prevent loss of vision.

The simple act of spending time away from near work appears to offer help in reducing the onset of myopia. In one study the incidence of myopia was decreased by 10% by spending 40 minutes per day outdoors.

Recent studies support the use of dilute atropine eye drops to slow the progression of myopia. Atropine 0.01% must be prepared by a pharmacy with a doctor’s prescription. The cost is about $20-30 per month. The drop is used once per day. This low-concentration eye drop had minimal effects on the eye. A dilated pupil and difficulty focusing at near are rarely encountered. Therefore, light sensitivity is minimized. Very rare side effects of atropine including rapid heart rate, dry mouth, and urinary retention, constipation, and flushing of the skin are not generally reported with diluted atropine used to treat myopia. Allergic reactions with redness and itching are rare with low-concentration atropine, as well.

Eligible patients include children (aged 5-15) with progressively worsening myopia (1 diopter of more in one year).   However, there are no hard and fast rules; a strong family history of high myopia may play into the decision to treat a child with myopia to slow its progression. Treatment may continue until age 18 years. More studies are needed to better define the best time to start treatment and the optimal duration of treatment. For now, however, it appears that atropine may be the safest and most effective pharmacological treatment to slow the progression of myopia.

By Scott E. Pautler, MD

For a telemedicine consultation with Dr Pautler, please send email request to spautler@rvaf.com. We accept Medicare and most insurances in Florida. Please include contact information (including phone number) in the email. We are unable to provide consultation for those living outside the state of Florida with the exception of limited one-time consultations with residents of the following states: Alabama, Arkansas, Connecticut, Georgia, Minnesota, and Washington.

Copyright © 2016-2022 Designs Unlimited of Florida. All Rights Reserved.