- High myopia means your eyeball has physically grown too long, stretching and thinning the retina. That structural risk stays with you regardless of whether you wear glasses, contacts, or have had LASIK.
- Lattice degeneration, one of the most significant retinal risk factors in high myopes, produces no symptoms and can only be found on a dilated retinal examination.
- LASIK corrects vision at the corneal surface but does not shorten the eyeball. High myopia complications persist after refractive surgery, and post-LASIK retinal screening remains just as necessary.
- Myopic macular degeneration is a distinct condition from age-related AMD. It is structurally driven and can develop in adults in their 30s and 40s, well before AMD typically appears.
- Annual dilated retinal examination is the standard recommendation for high myopes, even without symptoms.
You had your eyes tested last year. The prescription had barely changed, the optometrist said everything looked fine, and you left with updated lenses and the quiet satisfaction of having ticked something off the list.
That check was worth doing. But if you have high myopia (short-sightedness), it may not have included an examination that matters for your long-term sight: a proper look at your retina.
High myopia is not simply a stronger prescription. It means your eyeball has physically grown longer than it should, and that structural change creates specific, serious risks at the back of the eye that a standard prescription check is not designed to detect.
Why Does Eye Length Put Your Retina at Risk?
The anatomy of myopic risk
In high myopia, the eyeball has grown longer than it should. That extra length is the root of the retinal risk. It stretches the delicate tissue at the back of the eye in ways that create real, measurable vulnerability.
Most people think of myopia as a lens problem; light bending the wrong way, blurry objects at a distance, etc. The prescription corrects the optics. What it cannot correct is what drove the prescription in the first place: an eyeball that grew too long during childhood and adolescence.
As the eyeball elongates, the retina is pulled and thinned across a wider surface area than it was designed to cover (Vogels et al., 2026, PMID 42309346).
Research indicates that the risk of retinal detachment increases with each additional unit of myopic prescription. This finding is directly relevant to Singapore, where high myopia rates are among the highest globally (Gerstenberger et al., 2021, PMID 33197918).
For children and young adults, myopia control measures may help limit axial elongation over time (Grzybowski & Lanca, 2026, PMID 42083561).
Singapore's myopia epidemic and what it means for retinal health​
Singapore has one of the highest rates of myopia in the world, and a significant proportion of adults here carry elevated retinal risk simply because of the length of their eyeballs. This makes retinal screening a public health issue, not just a concern for older patients.
Data from SNEC and broader population studies show that myopia prevalence among young adults in Singapore sits well above the global average (Grzybowski et al., 2020, PMID 31937276; Wong et al., 2018, PMID 30242361).
Many of these individuals are now in their 30s, 40s, and 50s, the age when the long-term consequences of a stretched retina begin to appear.
The Retinal Conditions High Myopes Are More Likely to Develop
Lattice degeneration
Lattice degeneration is a thinning of the peripheral retina in a lattice-like pattern that increases the risk of retinal holes and tears. It is often found only during a dilated retinal examination, with no symptoms at all.
Lattice degeneration produces no symptoms in most people. There is no pain, no obvious visual disturbance, and no way to detect it without a dilated examination.
Many patients learn they have it only because they attended a routine screening (Suzuki & Farah, 2004, PMID 15040617).
A specialist will assess your risk and recommend monitoring or intervention accordingly. The presence of lattice degeneration carries significantly elevated odds of both retinal tear and detachment (Morano et al., 2023, PMID 37274012).
If you have high myopia and have never had a dilated retinal examination, you may have lattice degeneration without knowing it. A retinal check is the only way to find out. Contact Angel Eye & Cataract today.
Retinal tears and detachment
High myopes face a significantly elevated lifetime risk of retinal tear and detachment compared to the general population — a pattern seen clearly in Singapore, where myopia rates are among the highest in the world. Early posterior vitreous detachment, which occurs more commonly in myopic eyes, is a key trigger for retinal tears. New flashes or floaters require urgent assessment.
The vitreous separates from the retinal surface over time, a process called posterior vitreous detachment (PVD), and this tends to happen earlier in highly myopic eyes than in the general population (Jindachomthong et al., 2023, PMID 36307014).
When the vitreous pulls away, it can tug on the retina, creating a tear. Left untreated, a tear can lead to retinal detachment, where the retina lifts away from the underlying tissue. Treatment options include laser photocoagulation and cryopexy.
| Treatment | How it works | Purpose |
| Laser photocoagulation | A laser creates a seal around the tear | Prevents fluid passing through the tear and causing detachment |
| Cryopexy | Freezing is applied around the tear | Forms a scar that secures the retina in place |
If you notice a sudden increase in floaters, flashes of light, or a shadow moving across your visual field, seek an urgent retinal assessment the same day. For many patients, early treatment of a tear prevents detachment entirely (Qureshi & Steel, 2020, PMID 31576027).
What to Watch For
- A sudden increase in floaters, particularly new dark spots or strings in your vision
- Flashes of light, especially in low-light conditions or at the periphery of your vision
- A shadow, curtain, or dark area spreading across part of your visual field
- Any of the above appearing after physical exertion, a bump to the head, or eye rubbing
Myopic macular degeneration
Myopic macular degeneration is a distinct condition from age-related macular degeneration (AMD). It results from mechanical stretching of the central retina and can develop in adults in their 30s and 40s. Regular OCT scanning of the macula is the standard monitoring tool.
MMD and AMD are separate conditions with different causes. AMD is primarily age-driven and typically affects people over 50. MMD is structurally driven and can appear in younger adults (Ohno-Matsui, 2025, PMID 41083732).
In Singapore, approximately one in 26 adults has MMD, with prevalence rising substantially among those with high myopia (Wong et al., 2018, PMID 30242361).
What to Watch For
- Blurring or distortion in your central vision, particularly when reading
- Straight lines appearing wavy or bent when you look directly at them
- A faded or washed-out patch in the centre of your vision
- Difficulty recognising faces or reading fine print despite an up-to-date prescription
What Does a Retinal Screening for High Myopia Involve?
What is checked and how often
Annual dilated retinal examination is the standard recommendation for high myopes, even when there are no symptoms. OCT imaging and axial length measurement add further clinical detail beyond what a standard eye test provides.
A comprehensive retinal assessment for a high myope typically involves three components:
- Dilated retinal examination: drops widen the pupil to give the specialist a full view of the peripheral and central retina. This is the only reliable way to detect peripheral pathology such as lattice degeneration.
- OCT scan of the macula: assesses the structural integrity of the central retina in cross-section.
- Axial length measurement: used in children and adolescents with progressive myopia to track elongation and inform myopia control decisions (Grzybowski & Lanca, 2026, PMID 42083561).
For adults, annual screening is the standard even without symptoms. If you have existing pathology such as lattice degeneration or a previous retinal tear, your specialist may recommend more frequent reviews.
What to Watch For
- Any new visual symptom between annual appointments. Do not wait for your next scheduled check
- A change in the quality of your vision that your current prescription does not explain
- Increased sensitivity to glare or light, particularly indoors
Does LASIK Remove the Retinal Risk That Comes With High Myopia?
An important misconception to address
- LASIK corrects the refractive error at the corneal surface only.
- It does not change the length of the eyeball.
- The underlying retinal risk remains after surgery, and regular retinal checks are just as important post-operatively.
LASIK reshapes the corneal surface to correct the prescription. What it cannot do is shorten the eyeball. Research confirms that high myopia complications persist after refractive surgery (Du et al., 2024, PMID 39036706), and the risk of lattice degeneration, retinal tears, and myopic macular degeneration is unchanged.
For high myopes who have had LASIK, annual retinal screening is arguably more important than before. The glasses are gone, and with them the prompt to return to the clinic.
If you have had LASIK in the past, it is worth scheduling an annual retinal screening. Get in touch with Angel Eye & Cataract Centre to arrange a post-LASIK retinal review.
Book a Retinal Assessment at Angel Eye & Cataract Centre
Dr Allan Fong is a Senior Consultant Eye Surgeon and retina specialist based in Singapore, with over 26 years of experience in ophthalmology and the former Head of the Cataract & Comprehensive Ophthalmology Department at SNEC.
If you have moderate to high myopia, an annual retinal check-up is one of the most important things you can do for your long-term vision. Book an assessment with Dr Allan Fong today.
References
- Vogels DHJ, Ma Q, Boote C, Klaver CCW, LaPointe VLS, Dickman MM. Scleral remodeling in myopia: mechanisms and therapeutic approaches. Progress in Retinal and Eye Research. 2026;113:101486. PMID: 42309346
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- Grzybowski A, Lanca C. Management of myopia: a mini-review. Medical Hypothesis Discoveries & Innovations in Ophthalmology. 2026;15(1):19–39. PMID: 42083561; PMC13135658
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- Grzybowski A, Kanclerz P, Tsubota K, Lanca C, Saw SM. A review on the epidemiology of myopia in school children worldwide. BMC Ophthalmology. 2020;20(1):27. PMID: 31937276; PMC6961361
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- Wong YL, Sabanayagam C, Ding Y, et al. Prevalence, risk factors, and impact of myopic macular degeneration on visual impairment and functioning among adults in Singapore. Investigative Ophthalmology & Visual Science. 2018;59(11):4603–4613. PMID: 30242361
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- Morano MJ, Khan MA, Zhang Q, et al. Incidence and risk factors for retinal detachment and retinal tear after cataract surgery: IRIS Registry analysis. Ophthalmology Science. 2023;3(4):100314. PMID: 37274012; PMC10239011
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- Suzuki CR, Farah ME. Retinal peripheral changes after laser in situ keratomileusis in patients with high myopia. Canadian Journal of Ophthalmology. 2004;39(1):69–73. PMID: 15040617
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- Jindachomthong KK, Cabral H, Subramanian ML, et al. Incidence and risk factors for delayed retinal tears after an acute, symptomatic posterior vitreous detachment. Ophthalmology Retina. 2023;7(4):318–324. PMID: 36307014
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- Ohno-Matsui K. Pathologic myopia. Eye (London). 2025;39(18):3218–3228. PMID: 41083732; PMC12669679
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- Qureshi MH, Steel DHW. Retinal detachment following cataract phacoemulsification — a review of the literature. Eye (London). 2020;34(4):616–631. PMID: 31576027; PMC7093479
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- Du Y, Meng J, He W, Qi J, Lu Y, Zhu X. Complications of high myopia: an update from clinical manifestations to underlying mechanisms. Advances in Ophthalmology Practice and Research. 2024;4(3):156–163. PMID: 39036706; PMC11260019
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- Gerstenberger E, Stoffelns B, Nickels S, et al. Incidence of retinal detachment in Germany: results from the Gutenberg Health Study. Ophthalmologica. 2021;244(2):133–140. PMID: 33197918
