Glaucoma: A Long Term Effect of High Myopia

In high myopia, the eye is longer than normal. This changes the shape of the optic nerve and the surrounding tissues. Those structural changes raise the risk of glaucoma—damage to the optic nerve that can quietly steal vision over time.

What is glaucoma?

Glaucoma is a group of conditions where the optic nerve is damaged, often associated with elevated eye pressure, though damage can occur even at “normal” pressures. It typically affects side (peripheral) vision first and can progress without obvious symptoms until advanced.

Why high myopia raises glaucoma risk

• Optic nerve vulnerability: Long eyes often have larger, more tilted optic discs and thinner nerve fibre layers, making the nerve more susceptible to pressure‑related stress.

• Detection challenges: Myopic eyes naturally have features that can mimic glaucoma on scans, making diagnosis trickier; careful, repeated testing over time is key.

• Independent risk: High myopia itself is a recognised risk factor, even when eye pressure isn’t high.

What happens if glaucoma is left untreated

Glaucoma damage is permanent. Without treatment, blind spots enlarge and can progress to severe tunnel vision or complete vision loss. Because it is usually painless and slow, many people don’t notice until late.

How glaucoma is detected and treated

Detection typically involves:

• Eye pressure measurement

• Optic nerve examination (including photos)

• OCT scans of the retinal nerve fibre layer and macula

• Visual field testing to map any blind spots

• Corneal thickness and angle assessment when needed

Treatment aims to protect the optic nerve by lowering eye pressure:

• Prescription eye drops (e.g., prostaglandin analogues, beta‑blockers, carbonic anhydrase inhibitors)

• In‑office laser (e.g., selective laser trabeculoplasty)

• Surgery if needed (minimally invasive glaucoma surgery or traditional procedures)

Regular follow‑up is essential to monitor progression and adjust therapy.

Why preventative myopia management matters

Every millimetre of extra eye length increases lifetime risks, including glaucoma. Slowing childhood myopia progression helps reduce structural vulnerability later on. A comprehensive myopia management plan—combining suitable optical or pharmaceutical options, outdoor time, and healthy near‑work habits—can meaningfully slow eye growth. For people with moderate to high myopia, schedule routine glaucoma screening, even if vision seems fine.