Cataracts: A Long Term Effect of High Myopia

High myopia stretches the eye and is linked with earlier and more frequent cataract formation. A cataract is a clouding of the eye’s natural lens that causes blur, glare and faded colours.

What are cataracts and why they form earlier in high myopia

The lens inside the eye focuses light. With age—and more commonly in highly myopic eyes—the lens becomes cloudy. Possible reasons include:

• Metabolic and structural stress in long eyes

• Oxidative changes that build up over time

• Prior eye procedures or coexisting retinal changes more common in high myopia

  
  

Common symptoms:

• Blurry or hazy vision that glasses no longer fully correct

• Glare and haloes around lights, especially at night

• Colours looking faded or yellowed

• Frequent prescription changes, often a “myopic shift” (stronger minus power)

What happens if cataracts are left untreated

Vision continues to decline. Daily activities like reading, driving and night vision become harder. In advanced cases, cataracts can become very dense, making later surgery more complex.

How cataracts are treated

Cataract surgery removes the cloudy lens and replaces it with a clear artificial lens (IOL). It’s one of the most common and successful surgeries worldwide.

Considerations for high myopia include:

• Pre‑op retinal check: High myopes have a greater risk of retinal issues, so a detailed retinal exam (and sometimes OCT) is advised before surgery.

• IOL power calculations: Long eyes can make lens power calculations less predictable; surgeons use advanced formulas and measurements to improve accuracy.

• IOL choice: Monofocal lenses are common; toric lenses may help if there is significant astigmatism. Multifocal IOLs are used with caution in eyes with macular or retinal changes.

• Post‑op monitoring: High myopia carries a higher risk of retinal detachment after surgery, though overall risk remains low. Prompt attention to new flashes, floaters or a curtain over vision is vital.

Why preventative myopia management matters

Slowing eye growth in childhood doesn’t just help with glasses prescriptions—it can reduce the lifetime risk and complexity of problems like earlier‑onset cataracts and post‑surgical complications. Evidence‑based myopia control (specialised spectacle lenses, contact lenses or orthokeratology, and low‑dose atropine), together with more outdoor time and smart near‑work habits, can significantly slow progression. Regular eye exams allow early detection of lens changes and timely planning for surgery when needed.