Pathologic myopia is also called degenerative myopia. It is a serious type of nearsightedness. In pathologic myopia, the shape of your eye changes over time. These changes weaken important parts of your eye. If not treated, pathologic myopia can cause permanent vision loss.

Pathologic myopia increases your risk of retinal and macular problems. These parts of your eye help you see clearly. Getting regular eye exams can help protect your vision. This article explains what pathologic myopia is, what causes it, how it affects your vision, and how you can lower your risk.

Pathologic myopia happens when your eye grows too long. This stretching makes the back of your eye, including the retina and macula, thinner and weaker. These layers can be more easily damaged. Vision problems from pathologic myopia often get worse over time.

 

While most individuals with nearsightedness (myopia) achieve good vision with glasses or contact lenses, those with pathologic myopia face a much greater risk of developing serious eye complications, such as:

Pathologic myopia frequently begins as high myopia during childhood or adolescence. The condition typically progresses and worsens with age.

Both genetic and environmental factors contribute to the development of pathologic myopia. While research is ongoing to fully understand all underlying causes, several key risk factors have already been identified.

 

When the eyeball becomes longer than normal, it places additional strain on the retina. This stretching makes the back of the eye thinner and more delicate, increasing the risk of developing eye problems.

Pathologic myopia often runs in families. If your parents or close relatives have high myopia, you are more likely to get it too.

If you become nearsighted at a young age, your eyes have more time to grow and stretch. This makes pathologic myopia more likely as you get older.

Lifestyle and visual habits can influence the rate of myopia progression. Spending a lot of time doing close-up work, not going outside much, and not getting enough natural light can make myopia worse, especially in children.

As you get older, your risk of problems from pathologic myopia goes up. Even if you became nearsighted as a child, complications can show up or get worse later in life.

About 1–3% of the global population has pathologic myopia.

As more children get myopia, more people are at risk for pathologic myopia.

Global Impact

Vision loss from pathologic myopia can make daily activities, such as reading, driving, or moving around independently, difficult. In severe cases, it can cause legal blindness.

If you have pathologic myopia, you may need more frequent eye exams and special treatments to help prevent more damage.

Pathologic myopia usually causes changes that happen slowly, not all at once. Many people notice that their vision is not as clear as it used to be, even when wearing their usual glasses or contact lenses. Some of the most common symptoms are:

Even if these changes happen slowly, it is important not to ignore them.

Some symptoms require immediate medical attention because they may signal a serious complication, such as retinal detachment. Call an eye doctor right away if you notice:

These symptoms may be signs of retinal tearing, retinal detachment, or bleeding inside the eye. These are serious conditions that need urgent attention to help prevent permanent vision loss.

Pathologic myopia is a lifelong condition, and vision changes often get worse over time. Some of the damage can become permanent if complications develop. However, finding the condition early and having regular check-ups can make a big difference. 

With regular eye exams and prompt treatment, many complications can be found early and managed before they cause more serious vision loss.

To determine whether you have pathologic myopia, your eye doctor will perform a comprehensive eye exam. You may also need special tests to look for changes inside your eye.

Common tests include:

Sometimes, your doctor may suggest genetic testing to determine whether you have a higher risk based on your family history.

There is no cure for pathologic myopia, but it can be managed. Treatments help protect your vision, slow the progression of the disease, and detect problems early.

Your eye doctor will help you develop a plan based on your age, symptoms, and findings from your eye exams.

Some problems associated with pathologic myopia, especially those affecting the retina, require medical treatment.

• Anti-VEGF injections:
These injections are used when weak, abnormal blood vessels grow under your retina. This is called myopic choroidal neovascularisation. Anti-VEGF injections help stop these blood vessels from leaking and causing swelling. If not treated, this swelling can harm your central vision.

• Photodynamic therapy (PDT):
Sometimes, photodynamic therapy is used to seal leaking blood vessels. This treatment uses a special medicine and a light. Photodynamic therapy is not used as often now, but it can still help some people.

You may need surgery if pathologic myopia changes the structure of your eye, such as:

• Vitreoretinal surgery:
Vitreoretinal surgery is used to fix retinal detachments or severe myopic maculopathy. This surgery helps keep the retina in place and can help prevent more vision loss.

• Scleral buckling:
Scleral buckling is a surgical procedure in which a silicone band is placed around your eye. This supports weak areas and helps reattach a detached retina.

The first step in correcting vision is to choose the right glasses or contact lenses.

• High-index glasses lenses
High-index lenses are thinner and lighter. They are more comfortable for people with strong prescriptions. 

• Specialty contact lenses
Specialty contact lenses can help you see more clearly and feel more comfortable. They are helpful if your cornea has changed shape.

• Low-vision aids
Low-vision aids such as magnifiers, electronic readers, and better lighting can help people with severe vision loss perform daily tasks more easily.

 

For children whose myopia is worsening quickly, early treatment is important to help slow the rate of eye growth.

These treatments do not cure myopia, but they can slow eye growth and reduce the risk of long-term complications.

• Low-dose atropine drops

Low-dose atropine eye drops can help slow down myopia when used regularly.

• Myopia-control glasses or contact lenses

Myopia-control glasses or contact lenses are made to reduce eye strain and help keep the eyes from getting longer.

• Increased outdoor time
Spending more time outdoors can help slow the progression of myopia in children.

Regular follow-up is important for managing pathologic myopia. Ongoing eye exams let your doctor check for changes and catch problems early.

Going to your regular appointments and telling your doctor about any new symptoms right away can help you keep your vision longer.

See your eye doctor as soon as possible if you:

Getting your eyes checked early makes it more likely you can prevent serious vision loss and keep your eyes healthy.

Not exactly. High myopia means a strong nearsighted prescription (usually -6.00 or higher) or an eye that is longer than normal. Pathologic myopia means you have high myopia plus changes inside the eye, such as thinning of the retina, damage to the macula, or abnormal blood vessel growth. These changes can threaten your vision.

Early signs may include trouble seeing clearly even with glasses, wavy or distorted central vision, new floaters, or difficulty distinguishing between light and dark. If you have sudden flashes of light or a shadow in your vision, get medical care right away. This could mean a retinal detachment. 

Yes. Children who become nearsighted at a very young age are more likely to get high myopia and later pathologic myopia. Early treatment, such as atropine eye drops, myopia-control lenses, and spending more time outdoors, can slow down eye growth and lower the long-term risk.

Yes. Genetics is important. If one or both parents have high myopia, their children have a higher risk of getting it and developing pathologic myopia.

Can pathologic myopia lead to blindness?

Pathologic myopia can cause permanent vision loss if problems such as macular atrophy, abnormal blood vessels, or retinal detachment go undetected early. Regular check-ups can greatly lower this risk.

Pathologic myopia is a serious type of nearsightedness that occurs when your eyeball grows too long. This stretching puts extra strain on your retina and can cause problems with your macula, which is needed for sharp, central vision. Without treatment, these changes can lead to permanent vision loss.

There is no cure for pathologic myopia, but finding it early, attending regular check-ups, and treating problems promptly can help protect your vision. If you notice sudden floaters, flashes, or changes in your vision, contact your eye doctor right away. Getting help quickly can prevent permanent damage.