High myopia

[Littlechia]

Dear Dr. John Hagan
My name is chia

I am from Taiwan and was a new zealand optometry student in 2002,  i didnt manage to graduate. Now i am back and live in Taiwan. My prescription was -7/-7.25 during one demo on non-contact tonometr, my iop were 23/24. The optom supervisor referred me to take an complete eye exam

My iops were masured again with an instrument has a strip that touch my eyes i presumed it was goldman. The iop were 17/18 Visual field and direct ophthalmoscopy revealed heathy retina on both eye except white pressure od

I didnt learn high myopia complications until i immgrated to and studied optom in nz

During on visit last year, i showed vf to a doc he asked why u had vf before and immed perfromed oct macular scans and optic nerve scan. Macular results ok but rnfl results some are in red region. He checked my dic cup but didnt say a thing and then vf revealed no defect except both eyes had some very little  defect superior contour region on both eyes the doc said it doesnt seem like glucoma

In jan 2018, i had exam with and glucoma specialist in Taiwan becuase i was so scared of  risk.  These are my results
Od-7.75 -75 os -8.25 -50
Va 1.0/1.0 with prescription
Cct 598/599
axial 28.13/28.44
Oct rnfl 81/80 and
94/95 axial asjusted
Air puff tonometry
Iop 1st visit 21/23 (21/20)
2nd vist 19/19
Cd 20％ ?? Or 0.4*0.6 od  ;cd <20% os
Good gcc ou
No tear crack and wwp ou
She concluded i dont have.glucoma but is suspected of ocular hypertenion

My question is.are oct rnfl results reliable for high myoia before and after axial adjustment?

Rnfl results are after axial adjust in green but.shifted temporally due to tilted disc

And what is the risk of getting glucoma for me?

Are My corneas considered thick?

Ps.I m an asian, with no.glucoma family history i was not  premature baby
Both parenta are mild moyope

[John C Hagan III, MD, FACS, FAAO]

Having a thick cornea is good. Thick cornea are less likely to get glaucoma and the IOP measured by Goldman/air puff read higher. There are various tables that give a number to subtract based on thickness.  Thin cornea just the opposite. Many hi myopes have think cornea so good thing.  Like the glaucoma specialist I do not think you have glaucoma now. You would be at best "ocular hypertension" or "glaucoma suspect" but your risk factors are very low.  If you have no one related by blood with glaucoma the risk of you getting glaucoma in your life time is probably about 3-5%,   higher than the standard risk of 2% but not scary at all.  Annual exam by ophthalmologist with either NFL (and macula) OCT and/or VF is sufficient.  Asians esp Japanese have much higher rate of  angle closure glaucoma but with your myopia that should not be a consideration.  Hopefully the glaucoma specialist did gonioscopy to rule out pseudoexfoliation or previous injury.   Hope this made you feel better. If you lived here I would not treat and would not feel need more than annual exam with either VF or NFL/Macula OCT

[Littlechia]

Thx Dr. John Hagan
I feel much better now
During my time in nz optomery school, there is a theory called hyperopic defocus in peripheral retina upon eye glass correction which may contribute to myopia progression

Is it still a hotly debate theory?

[John C Hagan III, MD, FACS, FAAO]

I don't know about how hotly but it is one of the theories of why myopia progresses; and prolonged near work accounts for the epidemic of myopia world-wide

[Littlechia]

Many thanks to your responses    Dr Hagan:)

[John C Hagan III, MD, FACS, FAAO]

You are welcome