What causes fundus changes in high myopia?

With advances in current technology, modern electronic devices have become increasingly sophisticated. However, excessive use—particularly among children—has contributed to a rising prevalence of myopia.

What Are the Fundus Changes Associated with High Myopia?

In high myopia, the eyeball elongates and becomes structurally deformed. This leads to thinning and softening of the macula, making the surrounding macular tissue prone to inward folding (invagination). In severe cases, macular holes may develop, increasing the risk of retinal detachment. These changes often coexist with choroidal atrophy or choroidal neovascularization, both of which predispose patients to intraocular hemorrhage. Additionally, high myopia can cause macular degeneration, epiretinal membrane formation, or macular holes. In other words, fundus changes in high myopia refer to structural, physiological alterations that typically impair visual function and limit the effectiveness of refractive correction. Some subtle changes—such as mild choroidal and macular softening or age-related choroidal atrophy—may not significantly affect visual acuity. Therefore, individuals with high myopia are advised to avoid strenuous physical activity to reduce the risk of serious complications such as retinal detachment.

If high myopia remains uncontrolled, it may lead to various fundus pathologies—including retinal, choroidal, optic nerve, and vitreous abnormalities. Retinal detachment may produce a foreign-body sensation in the eye; choroidal damage may result in ocular pain, redness, and swelling; and optic nerve involvement can cause profound visual loss and blurred vision.

Vitreous degeneration may cause vitreous opacities, manifesting clinically as floaters. All these manifestations represent potential fundus complications associated with high myopia. We hope this information is helpful to you!