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Abstract: This patient was seen for high myopia for many years and it deepens every year. The examination revealed vitreous opacities caused by pathological myopia. Vitreous opacities after high myopia are very dangerous, with the possibility of retinal detachment and at worst even blindness, and should be treated promptly. After the patient was treated with posterior scleral reinforcement in both eyes, the myopia and axis growth were effectively controlled, and the vitreous clouding was significantly relieved.
Basic information】Male, 35 years old
Disease Type】Vitreous opacities
Hospital】Shanghai Sixth People’s Hospital
Date of Consultation】May 2020
Treatment plan】Surgical treatment (posterior scleral consolidation in both eyes)
Treatment Period】1 week of hospitalization and regular review
Results】Both eyes recovered well after surgery, the growth of the eye axis was controlled, and the myopia was stable.
I. Initial consultation
After the patient came to the clinic, he reported that he had been employed in the Internet industry for nearly 20 years and his myopia had been increasing year by year, from 1,000 degrees at the beginning of his career to 1,700 degrees, and he spent nearly 10 hours a day working on the computer, which was very intensive.
We observed that the patient’s glasses were thick, his eyes were slightly convex and he was anxious. The patient was given an eye axis measurement of 32.56 mm in the right eye and 32.39 mm in the left eye, which showed significant growth in both eyes. Subsequently, the patient was given a fundus examination, which showed a “leopard-like” fundus appearance in both eyes with extensive atrophy of the retinal pigment epithelium, a myopic arcuate spot around the optic disc, and an atrophic focus next to the macula in the left eye. Ultrasound examination revealed limited long oval posterior protrusion of both eyes, “posterior scleral staphyloma”, and mild vitreous clouding.
In summary, the patient was diagnosed with pathological myopia (axial myopia) in both eyes, posterior scleral staphyloma in both eyes, and vitreous clouding in both eyes.
II. Treatment history
The patient’s eye axis and myopia were increasing every year, with the eye axis greater than 2 mm and myopia greater than 100 degrees, which induced vitreous clouding. Under local anesthesia, an allograft scleral implant was inserted into the posterior part of the eye wall to mechanically strengthen the posterior part of the sclera to prevent the growth of the eye axis and myopia in order to treat vitreous opacities. Regular postoperative follow-ups, including optometry, axial and fundus examinations, are ordered.
III. Treatment results
The patient’s surgery went very smoothly and the patient felt good about himself after the surgery. After 1 week of treatment, the patient was discharged from the hospital with a basic recovery, and 1 year later, the patient came to the hospital for a follow-up examination, and the patient’s myopia and the growth of the eye axis were well controlled, and further fundus examination revealed that the symptoms of vitreous turbidity had been significantly relieved, and the patient’s quality of life had been greatly improved.
IV. Precautions
We are very pleased that the patient’s high myopia can be controlled to such an extent. However, we should not take it lightly in daily life and should do the following.
1. Develop good eye habits, go out for walks more often, reduce the use of electronic products, and look into the distance more often.
2, light diet, avoid spicy stimulating and cold food, more intake of vegetables and fruits diet, drink more water.
3, avoid strenuous stimulating sports, high myopia caused by vitreous turbidity can easily cause retinal detachment, once the bungee jumping and other dangerous sports, there will be a risk of blindness.
4. Pay close attention to the condition of the eyes after discharge, and seek medical consultation if there is any discomfort.
V. Personal insight
Vitreous turbidity is usually caused by trauma and other organic changes, but there are also patients like this case, caused by high myopia, eye axis growth caused by vitreous turbidity, then we should be at the root of the surgical treatment, postoperative focus on eye care. This disease should be treated early to avoid more serious complications such as blindness. It is important to reduce the use of electronic products in life, and more outdoor activities in the sun can be a good way to prevent this disease.