HIGH MYOPIA AND GLAUCOMA - A CHALLENGE IN DIAGNOSIS. REVIEW
The increasing global prevalence of myopia has significant consequences, as it predisposes to severe ocular pathologies. Differentiating early-stage glaucoma from myopia is challenging due to common clinical features. Diagnosing glaucoma in a highly myopic patient who has an abnormal optic nerve and an abnormal visual field, but normal intraocular pressure is a problem. Although the mechanisms responsible for glaucoma in myopic patients are poorly understood, it has been suggested that the optic nerve head in myopic eyes is more susceptible to glaucomatous damage. Mechanical stress induced by increased axial length of the globe and oxidative stress play a key role in the development of glaucoma in myopic eyes. Optic coherence tomography assessment of macular ganglion cells layers rather than retinal nerve fiber layer is valuable. Visual field testing should be used routinely in myopic patients, in order to facilitate the detection of early glaucoma. This review summarizes the difficulties in diagnosis of glaucoma in high myopic patients.
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