Why high myopia increases the risk of retinal detachment

21/10/2026

High myopia is not just a high prescription. In many cases, it involves structural changes in the eye that affect the retina and increase the risk of complications. One of the most significant is retinal detachment, an ophthalmic emergency that can seriously compromise vision.

Understanding why it occurs helps with prevention and allows us to react promptly to the first symptoms.

A longer eye means a more stretched retina

In high myopia, the eye usually has a greater axial length (in other words, it is longer). This causes the retina, which lines the inside of the eyeball, to become more stretched.

This stretching is associated with:

• Thinning of the retina in peripheral areas.
• Greater fragility of the retina.
• A higher likelihood of developing areas of degeneration.

The vitreous can exert greater traction on the retina

The vitreous is the transparent gel inside the eye. With age, it tends to liquefy and partially separate from the retina (posterior vitreous detachment).

In high myopia, this process may:

• Occur earlier.
• Be more sudden.
• Generate greater traction on the retina.

When this traction is intense, it can cause a retinal tear. If fluid passes through the tear, the retina can separate, leading to a detachment.

More frequent peripheral degenerations

In people with high myopia, certain peripheral abnormalities (areas of weakness) that facilitate the development of tears are more common.

These lesions are usually asymptomatic until traction or bleeding occurs.

Factors that further increase the risk

• Cataract surgery: Vitreous changes and traction.
• Eye trauma: Can cause tears.
• Family history: Predisposition.
• Age: Greater frequency of changes in the vitreous.

Warning symptoms

The most frequently reported symptoms are:

• Sudden appearance of numerous floaters
• Flashes of light
• An advancing shadow or "curtain"
• Sudden loss of vision

If any of these symptoms occur, an urgent assessment is required. At Barraquer Ophthalmology Centre, we provide 24/7 emergency eye care to ensure assessment without delay.

FAQs

Does high myopia mean I will develop retinal detachment?

No, but the risk is higher and requires specific monitoring.

Are floaters always dangerous?

No, but if they appear suddenly or increase significantly, they should be assessed.

Can a retinal tear be treated before detachment occurs?

In many cases, yes, and timely treatment can prevent complications.

Can it also affect central vision?

Yes, if the detachment reaches the macula.

Which symptom is the most urgent?

A fixed, progressive "curtain" or shadow is usually particularly concerning.

In conclusion, high myopia is associated with a longer eye and a more vulnerable retina. The combination of retinal fragility, vitreous changes and peripheral lesions explains why the risk of retinal detachment is higher.

Dr Santiago Abengoechea, ophthalmologist at Barraquer Ophthalmology Centre