In recent years, the prevalence of high myopia has been increasing year by year, and people of different ages with high myopia will have different "sorrows".
Young people will be worried about their university majors and future career choices, young and middle-aged people will face worries about choosing a mate, and the elderly will face various complications caused by high myopia.
So, what does it mean for children who are still ignorant to have a high degree of myopia?
Next, Xinhuajun will talk about "high myopia in children".
01
What is "high myopia in children"?
It refers to the diopter ≥ 600° for children aged 1-6 years old, and the diopter is what we often call the power of glasses.
How can children observe the diopter?
In fact, the most direct and simple way for children is to roughly guess the child's refractive state through the measurement of the eye axis.
For every 1mm increase in the eye axis, the degree of myopia increases by about 250-300 degrees.
If you want to know the exact refractive status of your child, you can know it by dilating the pupils (including farsightedness, myopia and astigmatism).
During childhood, the eye axis grows fastest within the age of 3 years, with an average annual growth of about 0.09 mm after the age of 6 years.
02
So when should my child start screening for myopia?
Generally speaking, it is best for children to establish a refractive file at the age of 3, and for children with genetic background, refractive examination, detailed fundus screening or full body examination, genetic testing, etc. can be carried out in advance.
03
Which children are susceptible to high myopia?
1. Genetic factors: Children's high myopia is different from adult high myopia, and genetic factors play an important role. At this time, it is not as simple as optometry and glasses, but more importantly, it is more important to discover the causes of high myopia in children, trace the root cause, and intervene in a targeted manner.
Common genetic factors include:
(1) High myopia caused by a single gene variant;
(2) Common hereditary fundus lesions, such as familial exudative vitreoretinopathy (FEVR), X-linked genetic retinitis pigmentosa, congenital quiescent night blindness, etc.;
2. Congenital developmental factors: including fundus diseases (retinopathy of prematurity, congenital small optic disc, congenital large optic disc, permanent primitive vitreous hyperplasia, etc.), anterior segment diseases (congenital cataract, aniridia, spherical lens, posterior conical lens, ocular defects, etc.).
3、全身疾病:包括眼皮肤白化病、Stickler综合征,Wegner综合征、Ehlers-Danlos综合征、Gordon综合症、Noonan综合征、Smith Magenis综合征、Crouzon综合征、Adams Oliver综合征等。
4. Environmental factors: age of onset of myopia, near-range eye load, writing head position, duration of outdoor activities, diet and nutrition, light environment at home and school, duration of use of electronic products, etc.
04
How can children be treated if they have high myopia?
1. For children whose parents have high myopia, establish a refractive file as soon as possible, closely follow up the eye axis, refraction regularly, accurate glasses, and actively treat the primary disease and complications;
2. For children whose parents do not have high myopia, they often have a late detection time, and need to undergo detailed ophthalmic and general examinations or genetic tests to trace the source, diagnose the original disease as soon as possible and prevent corresponding complications;
3. Genetic testing: It is necessary to emphasize the necessity of genetic testing, which not only helps to reveal the causes and molecular mechanisms of diseases from the molecular level of genetic material, but more importantly, it can exclude other diseases in the body, and if combined, it can be actively intervened early. Of course, the era of gene therapy is expected to bring light to babies with genetic diseases in the near future.
It should be emphasized here that for children with high myopia, most of them are caused by fundus diseases, anterior segment or systemic diseases, such as FEVR can lead to irreversible visual damage such as retinal detachment, and spherical lens requires early surgical intervention, so early diagnosis and intervention are very important for the prognosis of vision!
05
How can I prevent high myopia in children?
The goal (two-pronged): not only to slow the progression of high myopia, but also to prevent serious complications caused by high myopia and its primary disease.
(1) Establish children's refractive files as soon as possible, conduct eye health examinations every 3 months, and actively treat the primary disease and its complications;
(2) Three magic weapons for myopia prevention and control: shorten the working time in close proximity, reduce the use of electronic products, and increase the time for outdoor exercise;
(3) Follow the doctor's advice to accurately match glasses. For example, orthokeratology lenses, multifocal soft contact lenses, myopia prevention and control related glasses and low-concentration atropine have a certain myopia control effect and can delay the progression of myopia.
(4) Eat a reasonable diet and get enough sleep.
Source: The Paper