The data shows that students at home during the holidays are closer to each other than at school, the reading environment, the light is darker, and the outdoor activities are less time, so after the winter and summer vacations every year, it is a high incidence of "small glasses". So how to cultivate good eye habits? In today's program, we invite Lin Shan, director of the Department of Pediatric Eye Disease and Optometry at Wuhan Puri Eye Hospital, to discuss the prevention and control of myopia in adolescents.
Lin Shan, Deputy Chief Physician
Deputy Leader of the Optometry and Strabismus Amblyopia Professional Group of Puri Eye Hospital Group
Director of Pediatric Eye Disease and Optometry at Wuhan Puri Eye Hospital
Fellow, International Orthokeratology Association Asia Chapter (SIAOA)
Member of the Ophthalmology Committee of the Chinese Association of Non-public Medical Institutions
Member of the Professional Committee of Contact Lens Safety Monitoring Vision Health of China Health Management Association
Good at: all kinds of strabismus surgery, amblyopia treatment, juvenile myopia prevention and control, various complexities of children's optometry and diagnosis and treatment of common eye diseases and difficult eye diseases in children; Especially in pediatric eye diseases and eye muscles, he has a deep understanding.
Topic 1: The rate of myopia among adolescents on the mainland and the harm caused by myopia
Moderator Ruijie:
In the program, we jointly pay attention to the prevention and control of myopia in adolescents. "Small glasses" can be seen everywhere on the road, and now the myopia rate of children is particularly high, is there any data you can tell us?
Director Lin Shan: Every
In age groups, the incidence of myopia is not the same. Kindergartens are relatively few, and the rate of myopia among children from primary school to high school is increasing year by year, from 40% of primary schools to 80% of high schools. There may be minor differences between each region and each child, but most of the areas are within this range.
It can be said that in high school, basically the whole class wears glasses, and the myopia rate is as high as 80%, so what harm will adolescents cause to their children?
Director Lin Shan:
In the case of low myopia, wearing glasses can help him see clearly, but if the degree is relatively high, high myopia above 600 degrees, or the child's eye axis is longer than 26mm, the structure of the entire eye will change, and complications may occur, such as retinal degeneration, macular rifts, retinal hemorrhage, cataracts, glaucoma and other diseases will also be higher than that of non-highly myopic children.
Topic 2: How parents know if their children are nearsighted
Myopia is not only caused by the child's inability to see clearly, the formation of other problems is also very obvious, so we also remind everyone to do regular examination is very important, parents and friends how to find the child's myopia in time?
If the child is older, he will take the initiative to tell the parent or teacher that he can't see clearly. Myopia is mainly manifested by seeing far away is not clear, if the child says that it is not clear to see, especially if it is not clear to see far, it may be myopia. Some children are not very sensitive, but they can be seen from some signs, such as squinting at the blackboard, watching TV, or leaning in front of the TV when watching TV, which indicate that the child can't see clearly, and his far vision is decreasing, which is likely to be myopia.
Topic three: Parents have fallen into a misunderstanding on the issue of myopia prevention and control
But sometimes we also hear some parents and friends say that the child's eyes are a bit problematic, because they are not well developed, and when he grows up, it will naturally be fine, is this right?
This is a misunderstanding. When the child is relatively small, the eyes may not have been developed, which is normal, so this part of the child has farsightedness. As we age, the length of the eye axis gradually increases, which we call a process of facing up. But in this process, parents mistakenly think that their children are normal when they reach a certain age. We have found in clinical work that some children do have a serious lack of eye development, and he may be a state of farsightedness. However, some children's eyeball development is excessive, and now the technology products are more developed, such as mobile phones, computer online classes, etc., with more eyes. Overdevelopment of the eyeball is actually the growth of the eye axis, which is myopia.
So not all problems will be good when they are big, and we must identify the cause of the problem. Myopia prevention and control also has certain rumors or misunderstandings. First of all, let's pay attention to the fact that there is no significant increase in vision, so we don't need to do regular check-ups?
This is not true. The child's body is a state of development, and the eyes are constantly changing. The eye axis is also growing, and regular eye health check-ups are very necessary for children.
Some parents think that wearing glasses can be anywhere, there is no need to go to the hospital specifically, what do you think?
Before dispensing the glasses, you need to do a comprehensive examination to see if he is true myopia, if you determine myopia, what kind of myopia, whether his myopia is consistent with age, whether his progress is too fast, different myopia situations will take different intervention methods, the hospital doctor is more professional, the prevention and control products are more comprehensive, and can give the child a more appropriate prevention and control plan.
Topic 4: The necessity of mydriasis in children's vision examination and the answer to the safety of mydriasis
Don't go directly to the optical shop (glasses), first go to see what the problem is. Some parents are also worried that when they go to the hospital to do vision examination, the doctor will recommend that the child do mydriasis, (parents) will worry about the problem of mydriasis and eye injury, how will you explain it to the parents?
For children who are examined for the first time, the clinical recommendation is to give the child a mydriatic refraction. Mydriasis is the use of a drug to put his ciliary muscles in a relaxed state, and then know the child's true refractive state. In layman's terms, it is to distinguish between true myopia and false myopia, so it is very necessary to say that mydriasis.
After mydriasis, the pupil will be dilated, the light enters the pupil more, there will be photophobia, the other is to see things blurred, 2 to 6 hours can be restored, long if it takes 20 days to recover, parents do not have to worry. The doctor will choose the appropriate pupil dilation method according to the situation of the child, the drug will eventually be metabolized, and some children will have allergies, which is rare and rare, and there is nothing in general.
So security can be guaranteed.
Is very safe.
And we can get a very accurate test result.
yes.
Topic 5: Myopia factors and myopia prevention and control methods
What are some ways to help adolescents prevent and control myopia?
Myopia factors are mainly genetic and environmental factors, and the specific pathogenesis is not very clear. Myopia prevention and control we should try to focus on environmental factors. First, children should do more outdoor sports and look less closely. Outdoor activities exceed two hours per day, and maintain 8 to 15 hours of outdoor activity time per week, which is our preferred prevention and control method. The second point is myopia prevention and control products according to the theory of optical myopia out-of-focus. The preferred orthokeratology lens, followed by soft mirrors or out-of-focus glasses, can control the progression of children's myopia.
Another point is that children should develop good learning and living habits, such as sitting in a correct posture, writing homework and reading books in strict accordance with the standard of one punch and one inch and one foot. When you're in class, after a 45-minute lesson, be sure to look outdoors. At home, also pay attention to 20 seconds after writing homework and looking outdoors 20 meters away. Light is also very important, now the school light is strict requirements, at home parents should pay attention to, light as bright as possible. Finally, children should also pay attention to rest, go to bed early and get up early to ensure adequate sleep. The second is to pay attention to nutritional balance, not picky eating.
Myopia prevention and control is a whole, which needs to be controlled by parents, children, teachers and doctors.
Topic 6: Fitting conditions for orthokeratology lenses
Myopia prevention and control needs the common attention of the whole society, you just mentioned that now many parents choose to wear orthokeratology lenses for their children, so can orthokeratology glasses be fitted anywhere?
Orthokeratology mirror belongs to the third class of medical devices, its fitting is required: 1, need to be a medical institution above the second level; 2. The fitting engineer must be intermediate or above; 3, there must be a perfect inspection; 4. Doctors and fitters must undergo standardized training and assessment. Meet the requirements of these aspects in order to carry out the fitting of orthokeratology.
Topic 7: What should I do if my child is nearsighted?
This is also what we remind parents and friends. Earlier we shared a piece of news to everyone, there is a girl morning morning, in April last year, the degree of examination, binocular vision 0.6, but did not attract attention, did not expect that after a few months, the eye chart can only see 0.3, myopia degree rose by 150 degrees. At first, when the child could not see the blackboard clearly, many parents did not choose to let the child bring glasses, because they felt that the glasses could not be taken off when they were put on, so was there any need to wear glasses for myopia, or in addition to wearing glasses, parents were concerned about whether there was another way to prevent and control myopia?
It is true that some parents have some misunderstandings about the wearing of glasses for their children's myopia. Once the child is myopic, his eye axis growth is unable to go back to the past, seeing things is not clear, if you force him not to wear glasses, he will mobilize more adjustments, the child's myopia degree will grow faster, we recommend that the child dilated after determining myopia and greater than 50 degrees, or choose a suitable correction method, let him see clearly while controlling the degree growth.
If you really don't want your child to wear glasses, other ways are also available. If you are over 8 years old, you can consider orthokeratology lenses, you only need to wear them at night when you sleep, take them off in the morning, and do not affect his life and study during the day, and can also control the progression of myopia.
Orthokeratology is a kind of high oxygen permeability hard mirror, most of which can be adapted, some children are more sensitive, may not be able to adapt to orthokeratology mirrors, wearing uncomfortable. For this part of the child, parents can choose a soft-off-focus soft mirror with high oxygen permeability, water content and lock water, which can also be worn during the day, which can also play a role in controlling the progression of myopia. If they are not adapted, our doctor can choose other correction methods according to his myopia situation and needs. For example, out-of-focus glasses.
You mentioned control, in fact, many parents and friends also want to know and understand how to control the growth of myopia, how to do a good job in the prevention and control of myopia?
Controlling the growth of myopia is fundamentally controlling the growth of the child's eye axis. The eye axis is the length of each person's eyeball from front to back, and the child's body is constantly growing, and the eye axis will also grow. Slow growth of the eye axis controls the increase in myopia, so we want the eye axis to grow a little slower.
Among the existing methods of myopia prevention and control, such as the optical method we mentioned earlier. The orthokeratology mirrors, out-of-focus soft glasses, and off-focus glasses mentioned in the clinically selected intervention methods can play a role in delaying the growth of the eye axis.
In addition, as mentioned earlier, children need to maintain scientific and standardized habits in life and learning, and children's daily physical exercise cannot be reduced, if you can, it is better to increase it appropriately.
Topic 8: Recommendations for the child's vision test cycle
This is some advice for everyone in the overall aspect, but we mentioned earlier that children must be checked regularly after myopia, right, how often do you recommend that you check it?
Clinically, I often encounter some young parents who bring their children to do examinations, and children are not short-sighted, so parents have a good awareness of myopia prevention and control. Regular check-ups for children without myopia are also necessary, once every six months. What do we check? One check the vision to see if there is myopia; Second, check the eye health problems and the growth status of the eye axis. In addition, we will give some advice according to the child's eye conditions, such as whether it is suitable for learning piano, learning to draw, learning to dance, etc.
For children who are already short-sighted, it is necessary to pay great attention to it, and we will recommend that parents bring their children to review once in 3 to 4 months. 8 to 12 years old is a time when myopia progresses very quickly, and it is necessary to pay close attention to the growth of the child's eye axis and the progression of myopia, and when necessary, it is necessary to adjust the correction plan.
Topic 9: Director Lin Shan's outpatient clinic time
Today I would like to thank Director Lin Shan for being a guest in the live broadcast room, sharing so many myopia prevention and control issues with you, and we also pay attention to when is your usual outpatient time?
Winter break is followed by a full day on Thursdays and Saturdays.
During these two periods, you can go to the Children's Eye Disease and Optometry Department of Wuhan Puri Eye Hospital to ask Director Lin Shan about the prevention and control of adolescent myopia, and communicate and communicate with Director Lin face to face.