Ophthalmology · Optics and Refraction (Myopia, Hypermetropia, Astigmatism)

A child aged 8 years with high myopia (-10 DS) is found to have an axial length of 28 mm. The myopia is most likely classified as:

  • A Degenerative (pathological/malignant) myopia with structural changes at risk for staphyloma, lattice degeneration, and CNV
  • B Simple physiological myopia — normal variant of emmetropisation
  • C Index myopia due to increase in lens refractive index
  • D Curvature myopia due to increased corneal curvature only
Correct answer: A. Degenerative (pathological/malignant) myopia with structural changes at risk for staphyloma, lattice degeneration, and CNV

Explanation

Degenerative (pathological/malignant) myopia is defined as myopia >-6.0 DS associated with axial elongation (>26 mm) and progressive structural changes: posterior staphyloma, lacquer cracks in Bruch's membrane, myopic CNV (Fuchs' spot), lattice retinal degeneration, and predisposition to retinal detachment. An 8-year-old with -10 DS and 28 mm axial length clearly falls in this category. Simple physiological myopia is <-6 DS with a normal axial length distribution. Index myopia occurs with nuclear lens sclerosis (adults) increasing lens refractive index. Curvature myopia from steeper cornea contributes less significantly.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

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