Farsightedness or hyperopia is a type of refractive error. This pathology is characterized by the fact that the light rays passing through the transparent media of the eye are focused not on the retina, as should happen in a healthy eye, but in a plane conditionally located behind it. The consequence of such a violation can be a significant deterioration in the ability to clearly distinguish objects that are near the eyes.
Farsightedness can affect both adults and children of all ages. Pediatric hyperopia has its own characteristics of the clinical course and the use of therapeutic techniques.
The clinical picture of hyperopia in a child
The ophthalmic term "hyperopia" comes from the Greek words: hyper - "over", metron - "measure" and ops - "eye". Based on this, we can say that such an anomaly is a kind of discrepancy between the sizes of organic structures of the eye to each other, which, naturally, entails the formation of a number of persistent functional disorders.
They can be of varying degrees of severity, and also be of a physiological nature.
Weak degree
A weak degree of hyperopia in childhood may not have pronounced symptoms that would significantly affect the development of the child, since due to the tension of accommodation, a sufficient level of visual acuity is maintained both near and far.
With moderate hyperopia, the child practically effortlessly distinguishes objects that are at a sufficiently large distance from him, but, at the same time, he may have difficulty seeing closely spaced objects... Rapid eye fatigue, headaches (a characteristic sign of hyperopia - pain in the browbone region) may occur, the image may become cloudy and indistinct.
Experiencing such discomfort, the child unconsciously tries to move away from the object or move it away from himself in order to better see.
High degree
A high degree of hyperopia is clinically more pronounced. Here, visual acuity decreases both near and far. All of the above signs are a sufficient cause for concern and immediate seeking help from an ophthalmologist.
If on time to a child with a high degree of congenital hyperopia do not prescribe appropriate treatment, then, most likely, he will develop strabismus... This is due to the fact that the baby is forced to constantly strain the oculomotor muscles, bringing the eyes to the nose in order to achieve a clearer vision of close objects.
If this pathology is left without proper attention, then the probability of the formation of amblyopia or "lazy eye" is high. This functional impairment of the visual apparatus is practically not amenable to correction and needs long-term treatment, therefore ophthalmologists strongly recommend that parents not delay seeking qualified help.
In addition to functional defects, hyperopia in a child often provokes the development of ophthalmic diseases of an inflammatory nature, such as:
- blepharitis (inflammation of the eyelids);
- conjunctivitis (inflammation of the conjunctiva - the mucous membrane of the eye);
- barley (inflammation of the hair follicle in the thickness of the eyelid);
- chalazion (thickening in the thickness of the eyelid associated with a pathological increase in the meibomian gland).
This is due to the fact that children, experiencing visual fatigue and burning in their eyes, often rub them with their hands, often introducing an infection there. Statistics show that almost 90% of children under the age of 4 have some degree of hyperopia. This type of refractive error at this age has a natural physiological character.
Among children of primary school age and adolescents from 12 to 14 years old, the incidence of hyperopia reaches 30%.
In a healthy eye, light rays should converge into a beam strictly on the surface of the retina. Only if this condition is met, the image that the visual analyzer converts will not be distorted.
With farsightedness, the trajectory of light rays is such that conventionally they can "converge" only behind the surface of the retina, so the child sees closely spaced objects not blurry. If any violation of the refractive properties of the eye is compensated by the tension of accommodation, then we are talking about latent hyperopia. If the visual defect cannot be corrected, then this type of hyperopia is called explicit.
Depending on the age limits of the formation of hyperopia, there are several of its main forms:
- children's physiological;
- congenital;
- age (presbyopia).
There are also three types of hyperopia according to the degree of necessary correction (the size of the correcting lenses):
- weak degree - below +2 D;
- medium degree - below +5 D;
- high degree - above +5 D.
Development mechanism
Refraction is the ability of the optical apparatus of the eye, which consists of several organic elements, to refract light rays. The degree of refraction of rays depends on several factors:
- the level of curvature of the lens or its ability to change its spatial position, while changing the direction of light rays passing through the transparent media of the eye;
- the shape of the cornea, since it is also a refractive medium and affects the trajectory of light rays;
- distance between the surface of the cornea and the lens;
- the anteroposterior size of the eyeball, which is the distance from the cornea of the eye to the so-called macular spot (area of best vision) located on the surface of the retina.
Thus, it can be concluded that the decisive influence on the refraction of the eye is exerted by its refractive power and the anterior-posterior size of the eyeball. The optical apparatus of the human eye has a rather complex structure; it includes the lens, cornea, chamber moisture, and the vitreous body.
Heading to the retina, the light beam passes through a number of organic structures of the eye, which have the refractive properties listed above.
There is a concept of "physiological hyperopia of newborns", which can reach from + 2D to + 4D. It is caused by insufficient anteroposterior size of the eyeball. The presence of hyperopia + 4D in infants indicates physiological maturity.
An increase in the degree of hyperopia can be a sign of microphthalmos or accompany other congenital defects of the visual apparatus, for example:
- cataract (cataract);
- colobomas (lack of part of any shell of the eye);
- aniridia (lack of an iris);
- lenticonus (violation of the shape of the lens, in which it takes a spherical or conical shape).
As a child grows up, the size of the eyeball and the proportions of the organic structures of the eye change to normal values. Therefore, most often, hyperopia is converted to emmetropia by the age of 12-13 (normal refraction).
If for some reason the child's eyeball is delayed in growth, not meeting its age norm, then hyperopia is formed, if, on the contrary, it progresses excessively in its development, then myopia (myopia) is formed. The reasons that provoke a lag in the growth of the eyeball have not yet been fully understood.
However, the majority of people suffering from hyperopia manage to compensate for the reduced functional activity of the ciliary muscle of the eye, which is responsible for the position of the lens in space, by about 40 years of age.
Also, farsightedness can be a consequence of aphakia - a congenital or acquired pathological condition of the eye, which is characterized by the complete absence of the lens. Usually, this phenomenon occurs as a result of an operation to remove a lens damaged by a cataract. Also, aphakia can be associated with all sorts of mechanical trauma to the eye or dislocation of the lens.
With aphakia, the refractive power of the eye decreases very significantly, so vision may fall even to the most extreme indicators (approximately 0.1 at a rate of 1).
Diagnostics and treatment
Farsightedness in children can be detected during examination by an ophthalmologist. First, visual acuity is determined using visometry. This type of research for children suffering from farsightedness is carried out using trial plus lenses. Also, an ophthalmologist assigns a study of the refraction of the child's eye, it can be carried out in two ways: using skiascopy or refractometry.
Skiascopy is an objective method for determining the refraction of the eye. This type of diagnostics is carried out using a special device - a skiascope, which is a mirror with a handle, with a flat and convex surface on both sides. Accurate diagnostic data can only be obtained with cycloplegia (medication paralysis of accommodation, achieved by implanting into the eye means that block the activity of parasympathetic nerves). Skiascopy is suitable for examining refraction in young children, for whom refractometry is rather problematic.
Treatment of hyperopia can be both conservative (spectacle or contact correction, apparatus treatment, visual gymnastics, drug therapy, including vitamin therapy and a course of using medicated eye drops), and surgical.
If the child has no major complaints, the nature of vision is not impaired, and his visual acuity reaches 0.9-1, then in this case the correction is not indicated, and the ophthalmologist may recommend from time to time at home to carry out exercises for the eyes with the baby in order to prevent the development of refractive anomalies. In addition to spectacle and contact correction, hardware treatment and physiotherapy have a good therapeutic effect.
During the course of hardware treatment, the child may be prescribed vitamin therapy, which has a general strengthening effect on the entire visual apparatus, as well as other medications that positively affect the development of the refractive abilities of the visual apparatus.
Pediatrician Komarovsky, well-known in Russia and abroad, has repeatedly touched on the topic of hyperopia in his discussions.
The key to successful treatment of childhood hyperopia is the timely appeal for qualified help from a specialist.
When all appointments are completed and the rules for correcting this refractive anomaly are followed, vision can be restored by adolescence to healthy indicators.
You will learn the opinion of doctors about the treatment of hyperopia in children from the following video.
Hyperopia sports
Children, suffering from mild hyperopia, are recommended playing sports, which is characterized by periodic changes in the focus of gaze at far and near objects, for example, football, basketball, tennis and the like... Thanks to regular exercise in these sports, it is possible not only to improve the accommodative abilities of the eye, but also to stimulate the intensive blood circulation of the entire visual system and the oculomotor apparatus, as well as to prevent the further formation of pathological changes in the eyeball.
To achieve the maximum therapeutic effect from sports, it is necessary that one workout lasts at least 30 minutes.
Parents whose children have been diagnosed moderate hyperopia, it must be borne in mind that physical education for a child should have some restrictions, especially with regard to athletics exercises. It is better if the basic course of school physical education is supplemented with special exercises that strengthen the muscular apparatus of the eye... One way or another, this issue should be discussed in detail with the ophthalmologist, on the basis of his recommendations to adjust the child's physical education program.
For children with a high degree of hyperopia there are a number of restrictions on the ability to engage in certain sports. For example, they are highly discouraged from playing football, doing any martial arts or weightlifting, or skiing. This is due to the fact that with regular loads of this kind, the risk of complete loss of vision is very high, therefore, children suffering from this ailment should find other hobbies for themselves.
In extremely severe forms of hyperopia, an ophthalmologist may prohibit any sports activities.
Farsighted children regular walks in the fresh air are helpful... On the way, you can ask the child to consider various objects that are from him at different distances. These simple steps, if performed regularly, can help strengthen the muscles of the eye and improve visual acuity.
Eye exercises for hyperopia
The eye exercise shows an excellent therapeutic effect for all types of refractive errors in children.
It is especially useful to regularly perform visual gymnastics exercises for children whose eyes are regularly exposed to excessive stress (prolonged work at the computer, reading, wrong position at the desk at school, and others).
The correct and systematic performance of such exercises helps to improve blood circulation in the cervical spine and in the oculomotor muscular system, as well as to train the accommodative capabilities of the eye.
These exercises will help relieve visual fatigue and prevent the further development of visual anomalies, thereby helping to at least partially cure the disease.
- The exercise is performed with closed eyes. The child should try to relax the eyelids as much as possible. Place your palms on the baby's eyes or, if he is old enough, ask him to close his eyes with his hands, but do not press them strongly against his eyes. In this position, he should spend 2-3 minutes. This provides rest and relaxation for the eyes. Next, ask your child to move their eyes in different directions without raising their eyelids.
- The child should try to imagine that a pencil is fixed on his nose, which needs to write his name or draw something in the air.
- Invite your baby to stand up, stretch out his arms in front of him, spread his fingers as wide as possible and try to see objects that are in these intervals. After a few minutes, let him try to shift his gaze to the fingers and examine them. The exercise should be repeated at least 7 times.
The treating ophthalmologist can draw up an individual course of eye exercises, taking into account the child's age and the characteristics of his visual impairment. One way or another, the decisive role here is played by the regularity of the classes and the correctness of the exercises.
