Staphylomas

Understanding Staphyloma

Scleral staphyloma is a pathological thinning and bulging of the sclera due to degenerative changes in its structure. This defect can develop in different areas of the eyeball, leading to deformation and changes in intraocular pressure. As the disease progresses, the sclera stretches excessively, making the eye more vulnerable to further degenerative changes.

Staphylomas are classified based on their location:

• Anterior staphyloma – bulging of the sclera in the front segment of the eye.
  
  
• Posterior staphyloma – bulging of the sclera in the back segment of the eye.
  
  
• Equatorial staphyloma – bulging of the sclera in the equatorial region of the eye.
  
  

Posterior staphyloma, particularly myopic staphyloma, is the most common form. It is characterized by progressive stretching of the posterior scleral segment.

Causes of Scleral Staphyloma

The development of staphyloma is influenced by both congenital and acquired factors.

• Congenital factors include genetic abnormalities or intrauterine developmental disorders that predispose the sclera to stretching and bulging.
  
  
• Acquired causes include:
  
  

1. High-degree myopia (nearsightedness);
   
   
2. Inflammatory diseases of the sclera (uveitis, scleritis);
   
   
3.  Eye injuries;
   
   
4. Previous eye surgeries;
   
   
5. Degenerative processes affecting scleral tissue nutrition.
   
   

Symptoms of Staphyloma

In the early stages, patients may not experience noticeable symptoms. However, as the staphyloma enlarges, visual impairments occur, including:

• Reduced visual acuity;
  
  
•  Distortion of objects (metamorphopsia);
  
  
•  Dark spots in the field of vision (scotomas).
  
  

If the pathological process affects the optic nerve or macula, vision deterioration may become irreversible. Additional symptoms include discomfort or pressure in the eye, light sensitivity (photophobia), and increased eye fatigue. In severe cases, complications such as secondary glaucoma, retinal tears, or other ophthalmic disorders may arise, requiring urgent medical intervention.

Diagnosis of Staphyloma

• A comprehensive ophthalmological examination is essential to assess scleral thinning, the presence of bulging, and its impact on vision.
• Eye examination: The initial assessment is performed by an ophthalmologist using standard techniques. The doctor evaluates the shape and condition of the eye, looking for visible deformities, redness, or thinning of the sclera. In advanced cases, staphyloma may be visible to the naked eye.
  
  
• ntraocular pressure measurement: Tonometry is used to measure intraocular pressure (IOP) and rule out secondary glaucoma, which can develop as a complication of the disease.
  
  

Imaging studies: Various visualization techniques are used to determine the exact location, depth, and impact of the staphyloma. These include:

•  Ultrasound examination (B-scan): Provides a layered image of the eyeball, assessing scleral thickness, bulging, and possible complications.
  
  
• Visual field testing (perimetry): Detects defects in the visual field caused by staphyloma, especially if it affects the optic nerve or posterior eye segment.
  
  
• Biomicroscopy (slit-lamp examination): Helps in evaluating the anterior segment of the eye, identifying scleral thinning, color changes, and other pathological alterations.
  
  

Treatment of Scleral Staphyloma

The primary goals of treatment are to stabilize the disease, prevent complications, and preserve visual function. The choice of treatment depends on the disease stage, form, and associated complications.

Conservative Treatment

In the early stages, when progression is slow, medication therapy may help maintain metabolic processes in ocular tissues and strengthen the sclera. Treatments include:

• Medications that improve microcirculation (angioprotectors, vascular agents);
  
  
• Vitamin complexes with antioxidants (vitamins A, C, E, lutein, zeaxanthin);
  
  
•  Eye drops and injections that support connective tissue health;
  
  
•  Protective eyewear or contact lenses to reduce ocular strain.
  
  

While conservative treatment cannot eliminate the pathology, it can slow progression and lower the risk of complications.

Surgical Treatment

Surgery is required for severe staphyloma cases with significant scleral thinning, risk of rupture, or major vision deterioration. The main surgical techniques include:

•  Scleral reinforcement: Strengthening the sclera using donor tissue, collagen membranes, or synthetic materials to prevent further thinning.
  
  
• Vitreo-retinal surgery: Applied when the retina or vitreous body is involved (e.g., in cases of retinal detachment).
  
  

Laser procedures: Occasionally used to coagulate areas at risk of rupture.

Managing Associated Complications

Staphyloma may lead to secondary glaucoma, cataracts, retinal detachment, and other conditions. Additional treatments include:

• Anti-glaucoma medications or surgery to control intraocular pressure;
  
  
• Cataract treatment, including lens replacement if necessary;
  
  

Laser or surgical retinal repair in cases of detachment or tears.

Why Choose Russia for Staphyloma Treatment?

Russia offers advanced medical solutions for treating staphyloma, with a strong emphasis on innovative techniques and patient-centered care. The key advantages include:

• Expert specialists: Russian ophthalmologists are globally recognized for their expertise and research in scleral disorders.
  
• Cutting-edge technology: The latest diagnostic and surgical techniques ensure high treatment success rates.
  
•  Affordable care: The cost of treatment in Russia is significantly lower than in many Western countries, while maintaining high-quality standards.
  
• Comprehensive patient support: Assistance with travel arrangements, medical coordination, and post-treatment care is provided.
  

If you are considering staphyloma treatment in Russia, contact us today to learn more. Our specialists will provide a detailed consultation and recommend the best treatment options tailored to your needs.