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High myopia can be associated with clinical features that resemble glaucomatous damage, which make an accurate glaucoma diagnosis challenging, particularly among patients with normal intraocular pressures. These patients may also present with established visual field defects which can mimic glaucoma, and standard imaging technology is less useful in disease detection and monitoring due to the lack of normative data for these anatomically unique eyes. Progression over time remains the most critical factor in facilitating the detection of early glaucomatous changes, and thus careful longitudinal follow-up of high-risk myopic patients is the most important aspect of management. Here, we review our current understanding of the complex relationship between myopia and glaucoma, and the diagnostic challenges and limitations of current testing protocols including visual field, intraocular pressure, and imaging. Furthermore, we discuss the clinical findings of two highly myopic patients with suspected glaucoma.<\/jats:p>","DOI":"10.3390\/biom13030562","type":"journal-article","created":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T04:33:31Z","timestamp":1679286811000},"page":"562","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":64,"title":["Glaucoma and Myopia: Diagnostic Challenges"],"prefix":"10.3390","volume":"13","author":[{"given":"Michelle T.","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, School of Medicine, Stanford University, Palo Alto, CA 94305, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2104-0218","authenticated-orcid":false,"given":"Matthew","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, School of Medicine, Stanford University, Palo Alto, CA 94305, USA"},{"name":"School of Medicine, University of Nevada, Reno, NV 89557, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuldev","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, School of Medicine, Stanford University, Palo Alto, CA 94305, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, School of Medicine, Stanford University, Palo Alto, CA 94305, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaizhou","family":"Wang","sequence":"additional","affiliation":[{"name":"Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, School of Medicine, Stanford University, Palo Alto, CA 94305, USA"},{"name":"Palo Alto Veterans Administration, Palo Alto, CA 94304, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1016\/j.ophtha.2016.01.006","article-title":"Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050","volume":"123","author":"Holden","year":"2016","journal-title":"Ophthalmology"},{"key":"ref_2","first-page":"e430","article-title":"Associations of near Work Time, Watching TV, Outdoors Time, and Parents\u2019 Myopia with Myopia among School Children Based on 38-Year-Old Historical Data","volume":"100","author":"Kauppinen","year":"2022","journal-title":"Acta Ophthalmol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1111\/j.1755-3768.2011.02210.x","article-title":"The Increased Prevalence of Myopia in Finland","volume":"90","year":"2012","journal-title":"Acta Ophthalmol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/j.1475-1313.2011.00886.x","article-title":"Prevalence of Myopia among Hong Kong Chinese Schoolchildren: Changes over Two Decades","volume":"32","author":"Lam","year":"2012","journal-title":"Ophthalmic Physiol. 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