Myopia and pathological myopia

Myopia, also known as “being short sighted”, causes your vision to be blurry in the distance but clearer when looking at things up close.

Myopia is a very common focusing problem, and for most people it can easily be corrected using glasses or contact lenses, making vision clear and crisp. Most people with myopia have healthy eyes.

Pathological myopia is different from simply being short sighted. Pathological myopia means that you are very short sighted and that this has caused degenerative changes to the back of your eye. Pathological myopia can cause a reduction in your sight that cannot be corrected with glasses or contact lenses.

Our downloadable factsheet has more information about myopia and pathological myopia:

You can also download our full guide on myopia and pathological myopia as a Word document (1.26 MB)

High myopia

If you have myopia higher than -6.00D (a measurement of your glasses prescription), you may be at greater risk of developing the following eye conditions:

However, not everyone with myopia above -6.00D will develop other eye conditions, and for most people their eyes will be healthy.

Pathological myopia

If you’ve been diagnosed with pathological or degenerative myopia, you have very high myopia and your eye also shows degenerative changes affecting the back of the eye (the retina).

How does pathological myopia affect the retina?

  • Retinal atrophy – these are areas where your retina has become very thin and is no longer working.
  • Lattice degeneration – a type of retinal thinning at the far edges of your retina.
  • Lacquer cracks – breaks that occur in the membrane (Bruch’s membrane) between the retina and its underlying blood supply (the choroid layer).
  • New blood vessels (myopic choroidal neovascularisation) – new leaky blood vessels can grow from the blood supply underneath the retina (from the choroid layer), through lacquer cracks or areas of atrophy onto the retina.
  • Myopic macular degeneration – these degenerative changes can develop at the macula (the central part of the retina). Myopic macular degeneration is also known as myopic maculopathy, and can affect your central detailed vision.

What treatments are there for pathological myopia?

The type of treatment you may need will depend upon the degenerative change that has developed. Unfortunately, not all the changes that happen in pathological myopia, such as retinal atrophy and lacquer cracks, can be treated.

If you start to develop new blood vessels at the macula, this can be treated with anti-vascular endothelial growth factor (anti-VEGF) treatment. Anti-VEGF treatments work by reducing the growth of new, leaky blood vessels and the oedema (swelling) they may cause. This treatment can reduce the risk of scarring and damage to the retina caused by these new vessels, which in turn can help to avoid further deterioration in sight.

Download our factsheet for more information about pathological myopia and its treatments:

How can I see better?

The majority of people who have myopia don’t have any complications and will only ever need glasses or contact lenses to make their vision sharper. If your prescription is over -10.00D, then you would be entitled to a NHS complex lens voucher to use towards the cost of your glasses or contact lenses. Your optician would be able to tell you how much this voucher is worth and if your prescription would entitle you to a NHS complex lens voucher.

The higher your level of myopia is, the higher the risk of developing eye conditions associated with myopia and pathological myopia. If your retina has been damaged then your vision may need more than glasses to help you see well.

A low vision clinic, which is usually located in the eye hospital, can be very helpful. A low vision specialist can prescribe low vision aids, such as magnifiers, to help you make the most of your vision by making things bigger and easier to see. They can also provide practical help and advice on how to use your remaining vision. Your optometrist, ophthalmologist or GP would be able to refer you to the low vision clinic for an assessment.