Do you have weak spots in the eye?

In ciliary staphyloma, the sclera stretches and thins at the location behind the iris. — Wikimedia Commons

I have very severe short-sightedness. It kept progressing, even as I aged into my 50s. I went to see my eye doctor and she said I had posterior staphyloma in both eyes. What is staphyloma?

A staphyloma happens when your sclera (the white part of your eye) or cornea (the clear part in front of your pupil) stretches and thins.

It becomes a weak spot, and the tissue underneath starts to bulge through.

Staphyloma comes from the Greek word, "staphyus", which means bunches of grapes.This can cause you vision problems.

Why did this happen?

If your sclera is weakened, this can lead to staphyloma.

These are some causes:

> Pathologic myopia: This is the commonest cause.

Your near-sightedness (myopia) gets worse over time as your eye gets elongated abnormally and thus, your sclera gets stretched and weakened.

Pathologic myopia occurs in 3% of people in the world. Approximately half of them have posterior staphyloma.

> Eye injury: Anything that injures your eye can cause staphyloma.

For example, if your eye gets poked with a pencil, knife, or scissors, your sclera or cornea can become weak.

Staphylomas that are caused by injury usually need urgent repair because they can puncture easily.

> Eye surgery: Staphylomas can be an uncommon complication of eye surgery.

> Eye infection: If you get infectious keratitis (infection of your cornea) by a bacteria or virus, this can lead to a staphyloma in front of your eye.

Diseases that can cause keratitis such as measles can also lead to staphyloma.

> Congenital diseases of the eye: Some babies are born with retinitis pigmentosa or Alport’s syndrome.

These diseases can damage the middle layer of the wall of the eye.

Can staphyloma occur anywhere in my eye?

Eye doctors classify staphylomas to where the eye weakening occurs and where the eye tissue bulges through.

These are the areas

> Anterior staphyloma: Anterior means the front of your eye, the area of your cornea.

> Posterior staphyloma: The back part of your eye. This type of staphyloma causes the most problems with vision.

> Intercalary staphyloma: This is located in the area between your cornea and your sclera.

> Ciliary staphyloma: This part occurs in your eye structure called the ciliary body, which is located behind your iris (the coloured part of your eye).

The ciliary body’s function is to change the shape of your lens so you can focus on near or far objects.

> Equatorial staphyloma: This one occurs right in the middle of your eye. It is called

equatorial because it occurs midway between the front and back of your eye.

> Peripapillary staphyloma: This is something you may be born with.

The weak part is around your optic nerve, which is normal.

The optic nerve is the structure at the back of your eye that sends what you see to be interpreted in your brain.

How would I know if I have staphyloma? I only discovered it on a routine eye examination because I was worried about my high myopia.

One of the symptoms is markedly worsening vision, especially in very near-sighted people.

This can happen in posterior staphyloma.

If you have one of the more anterior (front) ones, you may notice that your eye is enlarged.

You may also notice a blue/black colour in the usually white sclera of your eye.

I am so scared. Will I go blind?

Many people don’t even require any treatment.

The eye doctor will check your surrounding eye tissues to see if they are healthy.

They will ask you to look out for any complications.

If your vision changes or has issues, you should go see your eye doctor immediately.

Look out for eye pain, or changes to the appearance and shape of your eye.

Also look out for flashing lights or appearance of more floaters in your vision than before.

Flashing lights and floaters may mean retinal detachment, and this is an emergency because it can lead to vision loss.

How do they detect staphylomas? I was never told I had this condition until they ran several tests on my eyes.

A normal general practitioner cannot detect a staphyloma, even if he or she does a funduscopy examination on you.

It's an exam that uses a magnifying lens and a light to check the fundus of the eye (back of the inside of the eye, including the retina and optic nerve).

If you have bad vision, it is best to go to an opthalmologist in an eye center or hospital that has a lot of equipment.

Eye science is so advanced these days that these specialists are everywhere in Malaysia.

You will need to go through an OCT (Optical Coherence Tomography), or a B-scan ultrasound, or an Orbital CT scan/MRI.

Is there any cure for my staphyloma?

Most staphylomas do not need treatment.

Your eye doctor may just ask you to wait and see, and come back for an annual check-up.

Most staphylomas do not get worse.

However, if they do, you can go through a scleral or corneal patch graft, or collagen crosslinking and scleral reinforcement.

You do not need to lose your vision with all these advancements.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, email [e-mail]. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.