Abstract: teenagers are the window period of the occurrence and development of myopia. At present, we only pay attention to vision correction, ignore prevention and ignore the risk factors of myopia. In this paper, the key concepts in the prevention and treatment of myopia are discussed in order to get the attention of academia and patients.
myopia is not only a refractive problem, but also retinal degeneration and lesions of high myopia have become the first irreversible blindness. Since fundus lesions are the target tissue of myopia, monitoring the changes of myopia arc should become one of the criteria to evaluate the effectiveness of myopia prevention and treatment. It should also be an important way to warn children and their parents in optometry clinic. Glasses only solve the problem of myopia looking far. The main cause of myopia is the excessive adjustment of looking near for too long. Therefore, wearing glasses with reduced adjustment when looking near is the key to prevent myopia.
in recent years, the epidemiological survey of myopia at home and abroad shows that, Modern social mode (less outdoor activities, obsession with mobile phones and games) and exam oriented education system are important factors for the high incidence and early onset of myopia. Teenagers are the window period for the occurrence and development of myopia. At present, we only pay attention to vision correction, ignore prevention and ignore the risk factors inducing myopia. Here, the key concepts in the prevention and treatment of myopia are discussed in order to get academic attention Attention and attention of patients.
is high myopia a cause of blindness?
many doctors believe that myopia is only a problem of the refractive system. The refractive problem can be corrected through glasses or surgery, which can be cured. However, the epidemiological investigation of Beijing eye disease research, Handan eye disease research and Taiwan Shipai eye disease research confirmed that high myopia fundus disease has replaced glaucoma and become the first irreversible blinding eye disease. The concept of
should be known not only to doctors, but also to patients. Teenagers with myopia mistakenly think that wearing glasses can cure myopia. In fact, the risk factors that breed the continuous development of myopia have not been removed. The replacement of glasses with deepened myopia again and again has changed from refractive problems to retinal degeneration and lesions. In order to make children and their parents pay attention to the prevention and treatment of myopia, they should not only be equipped with glasses to correct their far vision, but also show them the widening of fundus myopia arc and retinal degeneration. Warning: if reading and lifestyle are not changed, the retina will age in advance and cause irreversible retinopathy.
what are the criteria for assessing myopia control?
at present, the ophthalmic clinic only focuses on the detection of diopter and anterior segment, and the vast majority of ophthalmic clinics do not have fundus photography and follow-up. It seems indisputable that mydriatic optometry is the standard for myopia control in the international optometry field. However, most patients do not accept ciliary muscle paralysis drugs, which is also the main reason why the clinical trial of myopia intervention is difficult to carry out. In addition, mydriatic optometry confirmed the change of diopter, which is a physiological simple ocular axis extension? Or the widening of myopia arc caused by pathological disconnection of optic disc and retina? The follow-up of mydriatic optometry alone can not answer this question.
when we followed up a large number of adolescent patients with ocular hypertension, we found that less than 10% had glaucoma disc edge changes, while more than 90% had myopia arc changes. Mydriasis free fundus photography is fast, does not need mydriasis, and the patient has a high degree of acceptance. With the use of special image registration software, we can find the small changes of myopia arc. As the majority of axial myopia increases with the increase of diopter, myopia arc increases. Therefore, we suggest taking it as a new method and standard to evaluate whether myopia is controlled or not. It is of great significance to monitor the aggravation of myopia and prevent the occurrence of high myopia.
is the prevention of myopia based on prevention?
myopia correction glasses are used to solve the problem of patients looking far, but the factors inducing myopia such as excessive and long looking near have not been paid much attention. The animal model of myopia is wearing a concave lens of “myopia”, which artificially causes the focus of light to move back. In order to see clearly, experimental animals need to increase ciliary muscle regulation or compensatory ocular axis extension, that is, to form a myopia model with long ocular axis. Therefore, the demand for ciliary muscle regulation and its over regulation are the main causes of myopia. The use of atropine and other ciliary muscle paralysis drugs to prevent the development of myopia is also based on this mechanism. However, cycloplegia will cause mydriasis at the same time, resulting in photophobia and affecting the daily visual quality of children, which is also the main reason why this prevention and treatment method is difficult to be popularized. It is mainly the coordinated regulation of ciliary muscle and convergence. The addition of convex lens can reduce the former regulation, and the addition of bottom inward prism can reduce the latter regulation.
carried out the clinical trial of progressive multifocal lens in the prevention and treatment of myopia many years ago (comet), the conclusion is that it is effective for children with esotropia. Because progressive multifocal lens has the function of adding spherical lens when looking close, it does not solve the problem of eye convergence adjustment when looking close. Children with esotropia do not need convergence adjustment when looking close, so it is effective for the prevention and treatment of children with esotropia. In addition, progressive multifocal lens is difficult to consider personalized esotropia, so we should Further clinical trials of personalized proximity glasses with convex lens and prism may be one of the key factors to prevent myopia.