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[Extreme (complicated, ultra-high) refractive errors: terminological misconceptions!?]

S E Avetisov1

  • 1Research Institute of Eye Diseases, 11 A, B Rossolimo St., Moscow, Russian Federation, 119021; I.M. Sechenov First Moscow State Medical University, Chair of Ophthalmology, 2 b. 4 Bolshaya Pirogovskaya St., Moscow, Russian Federation, 119991.

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Summary

This study proposes new terminology for refractive errors like extreme myopia. It suggests using "hyperaxial" and "hypoaxial" syndromes to better describe eye conditions based on axial length changes.

Keywords:
axial eye lengthdiagnosishypermetropiakeratoconusmyopiapathogenesis

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Area of Science:

  • Ophthalmology
  • Optometry
  • Medical Terminology

Background:

  • Refractive errors, including extreme myopia and hypermetropia, are often described using terms like "ultra-high" or "complicated."
  • The current terminology for primary ametropias, linked to axial eye length variations, lacks clear diagnostic and pathogenetic definitions.
  • Existing terms may not accurately reflect the underlying anatomical-functional disorders.

Purpose of the Study:

  • To review the development mechanisms of refractive errors with significant retinal defocus.
  • To propose standardized terminology for primary ametropias based on axial eye length.
  • To align terminology with established definitions of "diagnosis" and "pathogenesis."

Main Methods:

  • Literature review of refractive error development and terminology.
  • Analysis of existing terms for extreme myopia and hypermetropia.
  • Proposal of new terminology based on anatomical-functional characteristics.

Main Results:

  • Current terms for severe refractive errors may not precisely align with diagnostic and pathogenetic principles.
  • A discussion exists regarding the justification of terms like "extreme" or "ultra-high" for primary ametropias.
  • The proposed terms "hyperaxial syndromes" and "hypoaxial syndromes" offer a more accurate characterization.

Conclusions:

  • The terms "hyperaxial syndromes" and "hypoaxial syndromes" are proposed to replace expressions like extreme myopia and hypermetropia.
  • This new terminology aims to provide a clearer description of refractive and anatomical-functional disorders.
  • Adopting these terms will enhance compliance with the definitions of "diagnosis" and "pathogenesis."