Posterior Staphyloma
An outward bulge at the back of the eye
Quick Facts
- Type: Eye / structural retinal condition
- Main cause: Severe (pathologic) myopia
- Effect: Stretched retina, possible vision changes
- Management: Monitoring and treating complications
Overview
A posterior staphyloma is an abnormal outward bulging of the back wall of the eye. It develops most often in people with very high or "pathologic" myopia (severe nearsightedness), in whom the eyeball is longer than normal. As the wall of the eye stretches and weakens, part of it can bow outward, forming the staphyloma.
This bulge changes the shape of the back of the eye and stretches the overlying retina, including the macula that provides central vision. A posterior staphyloma itself may not always cause symptoms, but it is a marker of advanced myopic change and raises the risk of vision-affecting complications, so it is usually monitored by an eye specialist. Staphylomas can vary in their size, depth, and exact location at the back of the eye, and these features influence how much they affect vision and what complications may develop. Because the bulge reflects long-standing stretching of the eye, it is often found alongside other myopia-related changes in the retina.
Symptoms
A staphyloma may cause no symptoms on its own, but related stretching and complications can affect vision.
- Blurred or reduced vision, especially central vision
- Distortion, where straight lines appear wavy
- A blind or dim spot in part of the vision
- Difficulty with fine detail and reading
Because a staphyloma can lead to retinal complications, any sudden change in vision, new distortion, or a sudden increase in floaters or flashes should be checked promptly by an eye specialist.
Causes
The main cause is the stretching that occurs in severe myopia.
- Pathologic myopia: A very long eyeball thins and weakens the back wall, allowing it to bulge outward.
- Progressive stretching: Over years, continued elongation of the eye deepens the bulge.
- Weak supporting tissue: Thinning of the sclera (the white outer coat) and the layers behind the retina contributes to the bulge.
Less commonly, staphylomas can be linked to other eye conditions, but high myopia is by far the most frequent cause.
Risk Factors
- High or pathologic myopia
- A long eyeball (high axial length)
- Older age, as stretching tends to progress over time
- A family history of severe myopia
- Existing myopia-related retinal changes
Diagnosis
An eye specialist identifies a staphyloma through examination and imaging of the back of the eye.
- Dilated eye exam: Allows the doctor to view the shape of the retina and the back wall.
- Optical coherence tomography (OCT): Shows detailed cross-sections of the macula and the contour of the eye wall.
- Ultrasound or MRI of the eye: Can show the bulge and measure the length and shape of the eye.
- Wide-field retinal imaging: Helps map the extent of the staphyloma and any stretching of the retina.
Treatment
There is no treatment that flattens a staphyloma, so care focuses on monitoring and managing complications that affect vision.
- Regular monitoring: Periodic exams and scans to track changes in the retina and macula.
- Treating complications: Anti-VEGF injections for abnormal blood vessels, and surgery for problems such as a macular hole or retinal detachment.
- Vision correction: Updated glasses or contact lenses for the underlying myopia.
- Low-vision support: Aids and rehabilitation when vision is permanently reduced.
Because a staphyloma signals advanced myopic change, ongoing follow-up is the most important part of care.
Prevention
A posterior staphyloma cannot usually be prevented once severe myopia is established, but its impact can be limited:
- Have regular eye exams if you have high myopia
- Report new vision changes, distortion, floaters, or flashes promptly
- Support healthy eye habits and outdoor time in children, which may help slow myopia progression
- Follow your eye specialist's recommended monitoring schedule
When to See a Doctor
If you have high myopia or a known staphyloma, keep up with regular eye exams. Seek prompt care if you notice:
- Sudden blurring or loss of vision
- New distortion of straight lines
- A new dark or blank spot in your vision
- A sudden increase in floaters or flashes of light, which can signal a retinal tear or detachment
Early evaluation of these symptoms gives the best chance of treating complications before they cause permanent vision loss.
Frequently Asked Questions
What is a posterior staphyloma?
It is an outward bulging of the back wall of the eye, most often caused by severe nearsightedness. The lengthened, weakened eye wall bows outward, stretching the overlying retina and sometimes affecting central vision.
Does a posterior staphyloma cause vision loss?
On its own it may cause few symptoms, but it stretches the retina and raises the risk of complications such as macular damage, abnormal blood vessels, or retinal detachment, which can reduce vision. Regular monitoring helps catch these early.
Can a posterior staphyloma be cured?
No treatment flattens the bulge itself. Care focuses on regular monitoring and treating complications, such as anti-VEGF injections for abnormal blood vessels or surgery for a retinal detachment. Updated glasses or contacts correct the underlying myopia.
Who is at risk of a posterior staphyloma?
People with high or pathologic myopia, a long eyeball, a family history of severe myopia, and existing myopia-related retinal changes are most at risk. The risk tends to increase with age as the eye continues to stretch.
How is a posterior staphyloma monitored?
An eye specialist uses dilated exams and imaging such as OCT, eye ultrasound, and wide-field retinal photos to track the bulge and the retina. People are advised to report any sudden vision changes between visits.
References
- National Eye Institute (NEI). Myopia (Nearsightedness).
- American Academy of Ophthalmology. Pathologic myopia.
- National Library of Medicine, StatPearls. Pathologic Myopia.
- MedlinePlus, U.S. National Library of Medicine. Nearsightedness.