What Is the Best Way to Treat Myopia in Children?

Pediatric myopia belongs to myopia and is a type of refractive error, which is different from adult myopia. Myopia (nearsightedness) refers to a state of refraction that occurs when the parallel light passes through the refractive system of the eye and falls before the retina when the eye is relaxing. Pediatric myopia refers to the onset of childhood, which is characterized by abnormal regulation, progressiveness, and susceptibility to multi-factor interference.

Zhaolong

(Attending physician)

Peking University Pediatric Ophthalmology and Pediatric Ophthalmology

Western Medicine Name: Pediatric Myopia
Affiliated Department: Department of Ophthalmology-Ophthalmology

Disease site: Eye
Contagious: Non-contagious

Pediatric myopia disease classification

According to the degree of myopia, it can be divided into mild myopia, moderate myopia, and severe myopia. Structures that change according to myopia can be divided into axial myopia and refractive myopia. According to the course of disease can be divided into primary myopia, progressive myopia, malignant myopia. According to genetic correlation can be divided into hereditary and non-hereditary myopia. According to the category of myopia, it can be divided into simple myopia, myopia astigmatism, and renaturation myopia astigmatism. Divided into true myopia and pseudo myopia according to regulatory factors.

Causes of Pediatric Myopia

Myopia is caused by many factors. In recent years, a lot of evidence shows that environmental and genetic factors are involved in the occurrence of myopia: external factors-long-term close-looking things, the ciliary muscle in the eyeball loses the elastic lens and the lens cannot recover, so myopia occurs.

Pediatric myopia pathogenesis

Pediatric myopia genetic factors

Studies have shown that parents with high myopia have a higher incidence of the next generation of myopia. It is recognized that high myopia has a certain genetic predisposition, but it is not obvious for general myopia.

If you want your baby's eyes to reach healthy development, you must pay attention to your child s eye hygiene after birth. For example, do nt let your child observe things for a long time, including close-up videos, or do Some delicate work, such as calligraphy, drawing and calligraphy, etc., can reduce the possibility of myopia in children.

Pediatric myopia environmental factors

The occurrence and development of myopia are closely related to the use of near-eye. The eyeballs of adolescents are in the stage of growth and development, with strong adjustment ability, and the extensibility of the eyeball wall is relatively large. When working at close distances such as reading and writing, not only the regulation of the eye needs to be exerted, but the eyes must also be cohesive. Extraocular muscles exert a certain amount of pressure on the eyeball. Over time, the front and rear axes of the eyeball may become longer. For every 1 mm increase, it reaches 3.00 diopters (that is, 300 degrees in general). Of course, most of this myopia is simple myopia, and the general degree is relatively low, all below 6 diopters. The incidence is mostly around puberty, and the progress is also It is relatively slow, and some people call this myopia as true myopia to show the difference from false myopia.

1. Use your eyes too close. According to relevant data reports, juvenile myopia is more common due to long-term too close eye distance. Adolescents have strong adjustment power for eyes, and can still see objects when the distance between the book and the eyes is 7 ~ 10cm, but if you often read books at this distance, writing will make the adjustment of the eyes extremely nervous, which can lead to inflexibility (adjustment (Sex) myopia, so-called pseudomyopia. If the long-term adjustment is excessive, the ciliary muscles cannot flex flexibly, and the radial effect is strengthened due to excessive adjustment, which causes extraocular muscles to put pressure on the eyeballs, increase the intraocular pressure, congestion of the eye tissues, and the tenderness of the eyeball tissues of young people, and the wall The pressure gradually extends, the front and rear axes of the eyeball become longer, and the axial myopia is formed beyond the normal value, the so-called true myopia. The normal reading distance should be 30 ~ 35cm.

2. Using the eye for too long. Some adolescents and children read, write, do homework, watch TV, etc. without rest for 3 to 4 hours, or even go to bed late at night. This not only affects physical health, but also overloads the eyes, and the muscles inside and outside the eyes are in a state of tension for a long time. Without getting rest, over time, when looking at the distance, the muscles of the eyes cannot relax and become convulsed, so that when you look at the distance, you feel blurred and form myopia. It is generally advisable to take a break or look into the distance for 30 to 40 minutes while reading a book or watching TV continuously.

3. The lighting light is too strong or too weak. If the light is too strong, such as sunlight writing, it will cause strong reflections, irritate the eyes, make the eyes uncomfortable, and it is difficult to see the typeface. On the contrary, the light is too weak, the writing is insufficiently illuminated, the eyes cannot see the typeface clearly, and the head will Go forward and get closer to the book. Both of the above conditions can make the eyes easily fatigued, and the eyes can be over-adjusted or convulsed to form myopia.

4. Read a book while driving or walking. Some teenagers make the most of their time, reading while walking or reading in a walking carriage, which is bad for the eyes. Because the carriage is shaking, the body is shaking, the distance between the eyes and the books cannot be fixed, and the poor lighting conditions add to the burden of eye adjustment, which often causes myopia.

5. Lie down and read a book. Many teens like to read in bed, which is a bad habit. Because the human eye should keep reading horizontally, make the adjustment and convergence (convergence) consistent, and reduce eye fatigue. If you read a book while lying down, your eyes are not horizontal, the distance between the eyes and the book is inconsistent, the eyes are inconsistent, and the left and right are not the same. The uneven illumination on the books will make the adjustment of the eyes tight and it is easy to move the books closer to the eyes. My eyes are burdened and myopia develops over time.

6. Malnutrition. Deficiency of calcium, zinc, and other vitamins.

Pediatric Myopia Pathophysiology

The eyes of adolescents and children are in the stage of growth and development, with strong adjustment ability, and the extensibility of the eyeball wall is relatively large. When working at close distances such as reading and writing, not only the play of the eye's regulating function, but also the cohesion of the eyes, In this way, the extraocular muscles exert a certain amount of pressure on the eyeball. Over time, the front and rear axes of the eyeball may become longer and form myopia.

Clinical manifestations of myopia in children

Mild or moderate myopia, with no symptoms other than blurry distant objects. High myopia has a deeper anterior chamber, larger pupils, and eyeballs that slightly protrude due to the length of the anterior-posterior axis. White or off-white crescent-shaped spots can be seen on the temporal side of the optic disc, known as myopia semilunar plaques. This is because the sclera stretches backward, and the retinal pigment epithelium and choroid separate from the temporal edge of the optic disc, exposing the sclera or part of the choroid and sclera . The posterior pole sclera continues to expand backwards. In the macula, knee fissure-like streaks and subretinal neovascularization can occur, and plaque-like atrophy and degeneration of the nearby retina and choroid lead to posterior scleral uvular edema. The macula is often hyperplastic and even bleeds, forming forster-fuchs spots. Such patients are often accompanied by vitreous liquefaction, turbidity, and a few can also develop retinal detachment and concurrent cataracts. Mild and moderate myopia, no special changes in the eye, but occasionally changes in myopia and menstrual spots and leopard-like fundus. Long-term myopia can cause collective insufficiency and exotropia.

1. Vision loss Myopia is mainly caused by gradual decline of far vision, blurred vision and normal vision, but high myopia is often caused by refractive refractive interstitial turbidity and degeneration of the retina and choroid. Accompanied by dark shadows floating in front of me.

2. Patients with moderate or above exotropia have little or no adjustment during near-field operation, and accordingly reduce the convergence effect, which can induce the eye position to deflect outwards and form exotropia.

3. Vision fatigue Myopia patients have good adjustment ability, but they need to use radiating force excessively when working at close range, which destroys the balance and coordination between adjustment and radiating, leading to the symptoms of muscular visual fatigue. It manifests as consciousness such as eye swelling, eye pain, headache, and blurred vision.

4. High degree of eyeball myopia. As the eye axis grows, the eyeball becomes larger, and the outward appearance of the eyeball appears.

Pediatric myopia diagnosis and differential diagnosis

It is not difficult to diagnose based on the examination of the anterior and posterior segments of the eye and refractive power.

Pediatric Myopia Differential Diagnosis

1. Pseudo myopia: Through strict mydriatic optometry, the appropriate choice of mydriatic agent can be ruled out. That is, 0.5% atropine eye ointment for 1-6 years old, 1% atropine eye ointment for 7-12 years old, three days before the optometry, three times a day. After the age of 12 years and above, 2% of matopin eye ointment was taken 5 times an hour before the day before the optometry or compound toppinamide eye drops were taken for 5 minutes and 20 minutes after 6 times.

2. Diseases that cause low vision: Many eye diseases can cause vision loss, which can be easily ruled out by careful inspection of the anterior and posterior sections of the eye.

3 Keratoconus: Can be excluded by corneal topography.

4. Glaucoma: Through intraocular pressure monitoring, visual field and fundus optic nerve examination can be ruled out.

Pediatric Myopia Disease Treatment

At present, there is no particularly effective treatment for myopia in children, and controlling its development is the most important content. Clinically, atropine treatment of ciliary muscle paralysis agent, progressive multifocal glasses, hard contact lens and other treatment methods are commonly used in clinical, and the effect is better. There are some who use post-scleral fixation to control the development of myopia in children. The effect is not good, and it is rarely used now. Corneal refractive surgery should not be performed in children with myopia. Traditional Chinese medicine treatment, eye massage, ear acupuncture and plum blossom acupuncture can improve the visual fatigue, but there is no reliable evidence for the treatment of myopia.

Prognosis of Pediatric Myopia Disease

Generally, the prognosis is good. Individuals develop moderate to severe myopia, and there will also be retinal holes and retinal detachment.

Pediatric myopia disease prevention and care

The myopia of adolescents generally starts as "false myopia." It is a kind of functional myopia caused by excessive use of eyes and tension adjustment. If the spasmolysis treatment is not performed in time, it will develop into true myopia.

Preventive measures must first develop children's good health habits.

1. Cultivate them to read and write correctly. Don't lie on the table or twist your body. Books and eyes should be kept at a city ruler, the body should be kept a fist (adult) away from the desk, and the hands should be an inch from the pen tip. School desks and chairs should be suitable for students.

2, reading and writing should not be too long, lasting 30-40 minutes after a 10-minute break. Look into the distance, look at more green plants, and do eye exercises. (The current use of handheld devices and computers is similar to reading and writing, so pay attention to the use time)

3. There should be proper light for writing and reading, and the light should preferably shine from the left. Do not read or write in too dark or too bright light to reduce the burden on students, and ensure a 10-minute break between classes to reduce visual fatigue.

4. Actively carry out physical exercise to ensure that students have one hour of physical activity every day.

5. Teach students to write, not to be too small or too dense, not to write oblique or cursive characters. Don't write too long.

6, seriously do eye exercises.

7. When watching TV, pay attention to the height should be equal to the line of sight; the distance between the eye and the screen should not be less than 5 times the diagonal length of the screen; when watching TV, a small light bulb should be turned on indoors, which is good for protecting vision After watching TV for 3 to 4 hours, take a short break, look to the distance and do eye exercises.

8. Eat more foods rich in A vitamins, various vegetables and animal livers, egg yolks, etc. Carrots contain vitamin B, which is good for the eyes; eating animal livers can treat night blindness.

Myopia patients generally lack chromium and zinc, and myopia patients should eat more foods containing more zinc. Foods such as soybeans, almonds, laver, kelp, mutton, croaker, milk powder, tea, meat, beef, liver, etc. contain more zinc and chromium, which can be increased in appropriate amounts. Zinc is best taken with protein zinc. Eat less sugary foods.

Myopia should be controlled step by step, catch early and catch small. Actively correct and prevent in-depth development. If myopia has occurred, go to the hospital for optometry and wear appropriate glasses. Pseudomyopia can be corrected by far fog vision, massage or crystal gymnastics, as well as physical therapy and medicine.

9. Playing badminton and table tennis can prevent myopia. During the playing process, the eyes must quickly follow the highly flexible "small ball movement" trajectory changes. This is perfect for 5-9 year old children's eyeball function. Unexpected benefits. ^[1]