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These signs are most prominent in high myopia (>-6D) and degenerative/pathological myopia, where axial elongation drives mechanical stretching and atrophy of ocular layers.

1. Tilted (Oblique) Disc The optic disc appears obliquely inserted, often with vertical elongation. This is one of the most recognizable disc features of myopia. Retinal vessels may enter through the nasal part of the optic cup ("situs inversus").

2. Myopic / Temporal Crescent (Conus) A crescent-shaped area of white sclera or exposed choroidal vessels is seen immediately adjacent to the disc (most commonly temporal). It is separated from normal-appearing fundus by a hyperpigmented border line. This is due to peripapillary RPE/choriocapillaris thinning or absence.

3. Temporal Optic Disc Pallor The temporal rim of the disc appears pale due to underlying chorioretinal atrophy.

4. Acquired Optic Disc Pit Occurs as the peripapillary region expands with globe elongation; clinically appears as a small excavation within the disc.

5. Tessellated (Tigroid) Fundus The fundus has a pale, tessellated/tigroid appearance due to diffuse attenuation of the RPE, making the underlying large choroidal vessels visible. This gives the retina a "striped" or "tiled" look.

6. Posterior Staphyloma A focal ectasia (outpouching) of the posterior sclera at the peripapillary or macular region, seen in approximately one-third of eyes with pathological myopia. It results from focal scleral thinning and expansion. Associations include macular hole and dome-shaped macula.

7. Lacquer Cracks Fine, irregular, yellowish lines criss-crossing the posterior pole, representing ruptures through the RPE-Bruch membrane-choriocapillaris complex. Seen in ~5% of highly myopic eyes. They are a precursor to subretinal hemorrhage and myopic neovascularization (MNV).

8. Fuchs Spot (Foster-Fuchs Spot) A dark, hyperpigmented spot at the macula. It represents a pigmented scar that follows resolution of subretinal hemorrhage or regressed myopic choroidal neovascularization (MNV). It signals prior macular damage and is associated with significant central visual loss.

9. Subretinal "Coin" Haemorrhages Small, round subretinal hemorrhages at the macula can occur from lacquer cracks even in the absence of MNV.

10. Focal Chorioretinal Atrophy Patchy areas where both choroid and RPE are absent, revealing underlying sclera. Large geographic atrophic patches are a key cause of legal blindness in degenerative myopia.

11. Macular Retinoschisis (Foveoschisis) Splitting within the retinal layers at the macula, often seen in association with posterior staphyloma due to vitreous traction. Can progress to macular retinal detachment without macular hole formation.

12. Lattice Degeneration Peripheral retinal thinning with crisscrossing white lines (sclerosed vessels) and pigmentation, predisposing to retinal tears and detachment. Much more common in myopia.

13. Peripheral Retinal Thinning / Atrophic Holes Areas of thinned peripheral retina with risk of rhegmatogenous retinal detachment (RRD). RRD risk is significantly elevated in high myopia.

14. Peripapillary Intrachoroidal Cavitation (ICC) Formerly called "peripapillary detachment of pathological myopia." Appears as a small yellowish-orange area typically inferior to the disc. It can produce visual field defects that mimic glaucoma on testing.

15. Vitreous Changes Premature posterior vitreous detachment (PVD) is common; the vitreous is often liquefied and may show fibrillar degeneration.

Sources: Kanski's Clinical Ophthalmology, 10th ed. (Ch. 14 - Degenerative Myopia); The Wills Eye Manual, Section 11.22 - Pathologic/Degenerative Myopia.