——"Myopia Prevention and Control Health Education" Series of Popular Science (1)
Zhao Hongwei, Department of Ophthalmology, Characteristic Medical Center (formerly 306 Hospital).
Edited by Liu Yan/Cui Yan, Medical Science Popularization Center
The problem of myopia in children has risen to the level of national strategy, and how to intervene reasonably from a medical perspective is an important strategy to control the development of myopia in children. At present, medical interventions for myopia in children mainly include: defocus glasses, low-concentration atropine, orthokeratology lenses, light feeding devices, etc. In this article, we summarize the pros and cons of these methods as follows, so that parents of myopic children can make the right choice for themselves.
Defocused-framed glasses
The purpose of using defocus glasses is twofold: on the one hand, to meet the vision needs of children with myopia, and on the other hand, to delay the progression of myopia, which achieves a mechanism similar to that of orthokeratology lenses. By artificially adding peripheral hyperopic defocus to the lens, the focus of the eye is prevented to a certain extent, and the eye axis is slowed down. Compared with orthokeratology lenses, the fitting conditions of defocus glasses are relatively relaxed, do not need to be cleaned and disinfected every day, are more convenient to wear, and the cost is lower than that of orthokeratology lenses, and there is generally no age limit. The most important thing is that defocus glasses can also be used preventively, which means that wearing them without myopia can also have the effect of preventing myopia.
Of course, defocus-framed glasses also have some drawbacks. For example, you need to wear it for more than 12 hours a day, almost except for sleeping, and you need to consider this factor for children who love sports. In addition, defocus glasses have the requirement of alignment between the center of the pupil and the optical center of the lens, if the center of the pupil does not correspond to the optical center of the lens, on the one hand, there will be discomfort to wear, and there will also be the problem of reduced prevention and control effect, so the wearer needs to keep the glasses as stable as possible.
Low concentration of atropine
Low-concentration atropine is currently the only internationally recognized drug to control the development of myopia. However, for a long time, it has been limited to the self-configuration of medical institutions or foreign purchasing, which cannot generally benefit patients. According to the news, Shenyang Xingqi Pharmaceutical's 0.01% atropine eye solution has been approved and will be available nationwide soon, and more and more low-concentration atropine preparations will be approved for application. This method is simple, medication is 1~2 times a day, and patient compliance is high.
In addition, in view of the dose-dependent nature of the drug, the concentration or frequency of medication can be appropriately increased to improve the control effect of myopia. However, any drug has its own limitations, such as: there is not enough data to support it in children without myopia, and long-term use may lead to dry eyes, allergies, abnormal accommodation, etc.
Orthokeratology lenses
Orthokeratology lenses are worn at night through rigid gas permeable contact lenses to introduce peripheral hyperopia defocus, thereby delaying the elongation of the eye axis and achieving the effect of controlling the progression of myopia. It belongs to Class 3 medical products, so the requirements are high. Before wearing, you need to do an eye-related examination, and if possible, you need to conduct a try-on evaluation, and you need to have regular follow-up after wearing.
In general, it is more demanding than the above two methods, but it also has its own advantages: for example, the control intensity is generally considered to be higher than that of low-concentration atropine or defocus glasses, and the second is that there is no need to wear glasses during the day, which can meet the needs of children who love sports and do not like glasses. However, the disadvantage is that if it is not worn properly, it may cause symptoms such as foreign body sensation, pain, and tearing in the eyes, and in extreme cases, it can also induce keratitis. Therefore, the use of orthokeratology lenses requires the cooperation of the child, parents, doctors, and the team of hearing care professionals to achieve the desired results.
Feeder
A photometer is a device that controls the progression of myopia. Its main mechanism is to control the progression of myopia by irradiating the fundus with infrared rays, improving the blood supply to the choroid of the fundus, and improving the stiffness of the sclera. Although in 2022, the mainland published an expert consensus on the use of the photometer. But overall, this approach is still in the exploratory stage. Data on clinical application are limited. Therefore, when choosing a photometer for myopia treatment, it is necessary to go to a regular hospital for treatment, and consider it comprehensively according to the actual situation of the individual and the doctor's advice.
The above methods can also be appropriately combined according to the doctor's instructions, and their effect on myopia control will be increased accordingly. In terms of choice, it is recommended to choose a cost-effective method that can be accepted by the person and his parents. The doctor will also make appropriate adjustments according to the results of the follow-up visit. It should be pointed out that myopia is a developmental disease, and the purpose of medical intervention is to control the development rate of myopia.
(The picture comes from the Internet)