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MYOPIA AND ITS COMPLICATIONS
Fayzullayeva Gavhar Jamoljonovna
Bukhara Innovative Education and Medical University.
assistant of the Department of clinical and pre-clinical sciences
Аnnotation.
This review explores current views on the causes and
development of complications related to myopic refraction. It summarizes
domestic and international research using modern diagnostics and highlights that
myopia involves not only refractive and anatomical changes, but also pathological
processes linked to disrupted ocular hemodynamics and hydrodynamics.
Keywords:
Myopia, macular dystrophy, glaucoma, neurotrophins, optical
coherence tomography, fluorescein angiography
Approximately 1.6 billion people worldwide have refractive errors.
According to J.H. Kempen et al., by 2020, around 2.5 billion people were
expected to suffer from myopia. Myopia remains one of the most common eye
disorders globally and is the leading cause of visual impairment. According to the
World Health Organization, the prevalence of myopia ranges from 10% to 90% in
developed countries. In Russia, over 10% of the population is myopic, compared
to more than 25% in the USA and Europe, and up to 80% in some Asian
countries.[1]
The World Health Organization identified uncorrected refractive errors as a
major target in eliminating avoidable blindness by 2020. Uncorrected myopia
impairs visual tasks, reduces professional adaptability, and lowers quality of life.
It may lead to retinal detachment and myopic maculopathy—serious
complications that can cause disability at a young working age. Myopia accounts
for 18.0% of visual disability across all age groups, ranking third among the
causes. Additionally, myopia imposes a significant economic burden; in the
United States, correction-related costs reached approximately $4.9 billion in
2011.[2]
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In 1956, J. Otsuka associated the development of myopic refraction with
pathological ciliary muscle tone, leading to weakened accommodation. As a
result, the ciliary muscle and subsequently the choroid undergo atrophy, causing
scleral elongation. According to the theory proposed by A.I. Dashevsky in 1973,
myopic refraction also results from reduced accommodative ability of the ciliary
muscle, primarily due to autonomic dysfunction and prolonged near work under
unfavorable conditions. This leads to a pre-spasm state and, with progression, to
accommodative spasm, accompanied by suppression of the convergence,
accommodation, and pupillary reflexes. Persistent strain of the extraocular
muscles and increased intraocular pressure during transient convergent elongation
of the eye, along with cumulative micro-deformations of the sclera, contribute to
the development of axial myopia.[3]
A.P. Nesterov emphasized the role of elevated intraocular pressure in the
pathogenesis of myopia. In 1986, Balacco-Gabrielli proposed a hormonal theory,
suggesting that endocrine dysfunction disrupts collagen metabolism, leading to
scleral overstretching. Currently, the most widely accepted and well-substantiated
concept is the three-factor theory of myopia development, proposed by E.S.
Avetisov. This theory identifies two key mechanisms: first, the mismatch between
the weakened accommodative apparatus and visual load; and second, the reduced
biomechanical strength of the sclera, which stretches under intraocular
pressure.[4]
Сonclusions:
Myopia is a widespread visual disorder affecting billions of
people globally and is a leading cause of visual impairment. Its prevalence is
especially high in developed and Asian countries. Uncorrected myopia not only
impacts quality of life and professional functionality but can also lead to severe
complications such as retinal detachment and myopic maculopathy. Various
theories explain its pathogenesis, including ciliary muscle dysfunction (Otsuka,
Dashevsky), elevated intraocular pressure (Nesterov), and hormonal imbalances
(Balacco-Gabrielli). The most comprehensive explanation is provided by
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Avetisov's three-factor theory, which integrates weakened accommodation,
biomechanical scleral weakness, and genetic predisposition. These insights
underline the importance of early diagnosis, preventive strategies, and tailored
therapeutic approaches in managing myopia.
REFERENCES
1.
Akopyan AI, Erichev VP, Iomdina EN (2008). Value of biomechanical
parameters of an eye in the treatment
of glaucoma, myopia and combined pathology [Cennost’ biomehanicheskih
parametrov glaza v traktovke razvitija glaukomy, miopii i sochetannoj patologii].
Glaukoma, 1, 9-14.
2.
Avetisov ES, Kovalevskiy EI, Khvatova AV (1987).
Guidelines for pediatric
ophthalmology. [Rukovodstvo po detskoj oftal’mologii], 296.
3.
Bakutkin IV, Spirin VF, Bakutkin VV
(2012). Experimental and clinical
studies of electrical stimulation of the ciliary div of an eye
[Jeksperimental’nye i
klinicheskie issledovanija jelektrostimuljacii ciliarnogo tela glaza]. Prakticheskaja
medicina, 4 (2), 241-244.
4.
Budzinskaya MV, Gurova IV (2006). Subretinal neovascular membrane in
age-related macular degeneration [Subretinal’naja neovaskuljarnaja membrana pri
vozrastnoj makuljarnoj degeneracii]. Vestnik oftal’mologii, 4, 49-50.
