Myopia in children

Myopia is called a disease of civilization. With the advent of computers and high technologies into our lives, which exert a serious load on the organs of vision, myopia has become significantly "younger", and ophthalmologists make such a diagnosis at a very early age to an increasing number of children. Why this happens and whether it is possible to cure myopia in a child, we will tell in this article.

What it is

Myopia is an abnormal change in visual function, in which the image that the child sees is focused not on the retina directly, as it should be in the norm, but in front of it. Visual images do not reach the retina for a number of reasons - the eyeball is too elongated, the light rays are refracted more intensively. Regardless of the root cause, the child perceives the world as somewhat vague, because the image does not fall on the retina itself. Far away he sees worse than up close.

However, if the child brings the object closer to the eyes or uses negative optical lenses, the image begins to form directly on the retina, and the object becomes clearly visible. Myopia can be different in classification, but almost always it is a disease, to one degree or another due to genetics. The main types of eye disease:

Congenital myopia. It is very rare, it is associated with pathologies of the development of visual analyzers, which occurred at the stage of organ laying in utero.
High myopia. With such an eye disease, the severity of visual impairment is at a level above 6.25 diopters.

Combination myopia. Usually this is insignificant myopia, but with it the usual refraction of rays does not occur due to the fact that the refractive abilities of the eye are in imbalance.
Spasmodic myopia. This visual disorder is also called false or pseudo myopia. The child begins to see the image blurry due to the fact that the ciliary muscle becomes more toned.
Transient myopia. This condition is one of the types of false myopia that occurs against the background of the use of certain drugs, as well as diabetes.
Nocturnal transient myopia. With such a visual disorder, the baby sees everything absolutely normally during the day, and with the onset of darkness, refraction is disturbed.

Axial myopia. This is a pathology in which refraction develops due to a violation of the length of the axis of the eyes in a larger direction.
Complicated myopia. With this disorder of visual function, due to anatomical defects of the organs of vision, a violation of refraction occurs.
Progressive myopia. With this pathology, the degree of visual impairment is constantly increasing, since the posterior part of the eye is overstretched.
Optical myopia. This visual disorder is also called refractive vision. With it, there are no violations in the eye itself, but there are pathologies in the optical system of the eye, in which the refraction of the rays becomes excessive.

Despite the abundance of types of pathology, pathological and physiological visual impairments are distinguished in ophthalmology. So, axial and refractive myopia are considered physiological types, and only axial is a pathological disorder.

Physiological problems are caused by the active growth of the eyeball, the formation and improvement of visual function. Pathological problems without timely treatment can lead a child to disability.

Children's myopia is treatable in most cases. But the time and effort that will have to be spent on this is directly proportional to the degree of the disease. In total, three degrees of myopia are distinguished in medicine:

low myopia: loss of vision up to - 3 diopters;
average myopia: loss of vision from - 3.25 diopters to - 6 diopters;
high myopia: loss of vision more than 6 diopters.

Unilateral myopia is less common than bilateral myopia, when refractive problems affect both eyes.

Age features

Almost all newborn babies have a shorter eyeball than adults, and therefore congenital farsightedness is a physiological norm. The baby's eye grows, and doctors often call this farsightedness "farsightedness stock". This reserve is expressed in specific numerical values - from 3 to 3.5 diopters. This reserve will be useful to the child during the period of increased growth of the eyeball. This growth occurs mainly up to 3 years, and the complete formation of the structures of the visual analyzers is completed approximately by the elementary school age - at the age of 7-9 years.

The stock of farsightedness is used up gradually, as the eyes grow, and normally the child ceases to be farsighted by the end of kindergarten. However, if a child at birth this "reserve" given by nature is insufficient and is approximately 2.0-2.5 diopters, then doctors talk about the possible risk of myopia, the so-called threat of myopia.

Causes

The disease can be inherited if mom or dad, or both parents suffer from myopia. It is the genetic predisposition that is considered to be the main reason for the development of the deviation. It is not necessary that at birth the child will have myopia, but it will most likely begin to make itself felt even in preschool age.

If you do nothing, do not provide correction and assistance to the child, myopia will progress, which may one day cause vision loss. It should be understood that visual impairment is always caused not only by genetic factors, but also by external factors. Excessive load on the organs of vision is considered to be unfavorable factors.

Such a load is given by prolonged viewing of TV, playing at the computer, improper seating at the table during creativity, as well as insufficient distance from the eyes to the object.

In premature babies born before the appointed obstetric term, the risk of developing myopia is several times higher, since the baby's vision does not have time to “mature” in utero. If at the same time there is a genetic predisposition to low vision, myopia is almost inevitable. Congenital pathology can be combined with weak scleral abilities and increased intraocular pressure. Without a genetic factor, such a disease rarely progresses, but such a possibility cannot be completely ruled out.

In the overwhelming majority of cases, myopia develops by school age, and the occurrence of vision abnormalities is influenced not only by heredity and unfavorable external factors, but also by malnutrition, rich in calcium, magnesium, and zinc.

Concomitant diseases can also affect the development of myopia. Such ailments include diabetes mellitus, Down syndrome, frequent acute respiratory diseases, scoliosis, rickets, spinal injuries, tuberculosis, scarlet fever and measles, pyelonephritis, and many others.

Symptoms

Parents should pay attention to the fact that the child's vision has become worse as early as possible. After all, early correction brings positive results. The child will not have complaints, even if his visual function has deteriorated, and it is almost impossible to formulate the problem in words for kids. However, mom and dad can pay attention to some features of the child's behavior, because when the function of the visual analyzer, which gives the lion's share of the world’s understanding, changes, the behavior changes dramatically.

The kid can often complain of headache, fatigue. He cannot draw, sculpt or assemble the constructor for a long time, because he is tired of the need to constantly concentrate his vision. If the child sees something interesting for himself, he may begin to squint. This is the main symptom of myopia. Older children, in order to make it easier for themselves, begin to pull the outer corner of the eye to the side or down with their hands.

Babies who have begun to see worse, bend very low over a book or sketchbook, trying to "bring" the image or text closer to them.

A child under one year old ceases to be interested in soundless toys, which are removed from them by a meter or more. Since the baby cannot see them normally, and motivation at this age is still not enough. Any suspicions of parents are worthy of being checked by an ophthalmologist at an unscheduled examination.

Diagnostics

Initially, the baby's eyes are examined in the maternity hospital. Such examination allows to establish the fact of gross congenital malformations of the organs of vision, such as congenital cataracts or glaucoma. But it is not possible to establish a predisposition to myopia or its very fact on this first examination.

Myopia, if it is not associated with congenital defects of the visual analyzer, is characterized by gradual development, and therefore it is so important to show the child to the ophthalmologist within the allotted time. Scheduled visits should be carried out in 1 month, in six months and a year. It is recommended for premature babies to visit an ophthalmologist even at 3 months.

It is possible to detect myopia starting from six months, since at this time the doctor gets the opportunity to more fully assess the ability of children's organs of vision to normal refraction.

Visual and test check

Diagnostics begins with an external examination. In both the baby and the older child, the doctor assesses the position and size of the eyeballs, their shape. After that, the doctor establishes the baby's ability to closely monitor a fixed and moving object, fix his gaze on a bright toy, gradually moving away from the toddler, and assessing the distance from which the baby ceases to perceive the toy.

For children from one and a half years old use Orlova's table... There are no letters in it that a preschool child does not yet know, there are no complex images. It consists of familiar and simple symbols - an elephant, a horse, a duck, a car, an airplane, a fungus, an asterisk.

In total, there are 12 rows in the table, in each subsequent from top to bottom the size of the pictures decreases. On the left in each row, the Latin "D" indicates the distance from which the baby should normally see pictures, and on the right, the Latin "V" indicates the visual acuity in conventional units.

Normal vision is considered if a child sees from a distance of 5 meters a picture in the tenth line from the top. A decrease in this distance may indicate myopia. The smaller the distance from the child's eyes to the sheet with the table, at which he sees and names the pictures, the stronger and more pronounced myopia.

You can check your vision using the Orlova table at home, for this it is enough to print it on an A4 sheet and hang it at the level of the baby's eyes in a room with good lighting. Before testing or going to an ophthalmologist's appointment, be sure to show the child this table and tell the name of all the objects depicted on it, so that the baby can easily name what he sees in words.

If the child is too young to check his vision using tables, or some abnormalities were found during testing, the doctor must examine the child's organs of vision using an ophthalmoscope.

He will carefully examine the state of the cornea and the anterior chamber of the eyeball, as well as the lens, vitreous humor, fundus. Many forms of myopia are characterized by certain visual changes in the anatomy of the eye, the doctor will certainly notice them.

Separately, it must be said about strabismus. Myopia is often accompanied by such a well-defined pathology as divergent strabismus. A slight squint can be a variant of the physiological norm in young children, but if the symptoms have not gone away by six months, the child should be examined by an eye doctor for myopia.

Samples and ultrasound

Skiascopy or shadow test is carried out using the ophthalmist's main instrument - an ophthalmoscope. The doctor is placed at a distance of one meter from a small patient and, with the help of a device, illuminates his pupil with a red beam. During the movements of the ophthalmoscope, a shadow appears on the pupil illuminated by red light. When looking through lenses with different optical properties, the doctor determines with great accuracy the presence, nature and severity of myopia.

Ultrasound diagnostics (ultrasound) allows you to make all the necessary measurements - the length of the eyeball, the anteroposterior size, and also to establish whether there are retinal detachments and other complicating pathologies.

Treatment

Treatment for myopia should be prescribed as soon as possible, since the disease tends to progress. By itself, visual impairment does not go away, the situation must be under the control of doctors and parents. Myopia of a slight mild degree is well corrected even with treatment at home, which is only a set of recommendations - massage, gymnastics for the eyes, wearing medical glasses.

More complex forms and stages of myopia require additional therapy. The doctors' predictions are quite optimistic - even serious forms of myopia can be corrected, the decline in vision can be stopped and even the child's normal ability to see can be restored. True, this becomes possible only if the treatment is started as early as possible, while the structures of the eye have not undergone irreversible changes.

The choice of a therapeutic measure is a doctor's business, especially since there is plenty to choose from - today there are several ways to correct myopia.

Doctors rarely stop at only one method, since only complex treatment shows the best results. It is possible to restore vision, correct the violation by wearing glasses and contact lenses, using laser correction methods. In some cases, doctors have to resort to refractive lens replacement and phakic lens implantation, surgical alignment of the cornea of the eye (keratotomy operation) and replacement of a part of the affected cornea with a graft (keratoplasty). Treatment on special simulators is also effective.

Hardware treatment

In some cases, hardware-based treatment avoids surgical intervention. It is shrouded in an aura of rumors and opinions ranging from enthusiastic to skeptical. Reviews of such techniques are also very different. However, the harm of this method of correction has not been officially proven by anyone, and even ophthalmologists themselves are increasingly talking about the benefits.

The essence of hardware treatment is to activate the body's own capabilities and restore lost vision through exposure to the affected parts of the eye.

Apparatus therapy does not give painful sensations to young patients. It is acceptable from a security point of view. This is a complex of physiotherapy procedures that a baby with myopia will undergo in several courses on special devices. In this case, the impact will be different:

magnetostimulation;
stimulation with electrical impulses;
stimulation with laser beams;
photostimulation;
optical training of accommodation;
training of the eye muscles and optic nerve;
massage and reflexology.

It is clear that gross malformations of the organs of vision, serious diseases, such as cataracts or glaucoma, cannot be treated with the apparatus method, since a mandatory surgical operation is required. But myopia, hyperopia and astigmatism lend themselves well to correction in this way. Moreover, it is the treatment of myopia that is considered the most successful with the use of special devices.

Several basic types of devices are used for therapy. These are macular stimulants, vacuum eye massagers, a line according to Kovalenko, the "Sinoptophor" apparatus, devices for stimulation with color spots and a laser.

Numerous reviews about hardware treatment mainly concern the cost of such procedures and the duration of the effect. All parents assert that the sessions are not cheap pleasure, as well as that the lasting effect of the apparatus treatment is achieved only with systematic repetitions of treatment courses.

After one or two courses, the improvement effect that appears may disappear after a couple of months.

Drug treatment

Treatment of myopia with medicines is prescribed when the child is in the postoperative period after eye surgery, as well as to eliminate false or transient myopia. Eye drops are commonly used "Tropicamide" or "Scopolamine". These drugs act on the ciliary muscle, practically paralyzing it. Due to this, the spasm of accommodation decreases, the eye relaxes.

While the treatment is underway, the child begins to see up close, read, write, and work at the computer even worse. But the course usually lasts about a week, no more.

These drugs also have one more unpleasant effect - they increase intraocular pressure, which is undesirable for children with glaucoma. And therefore, the independent use of such drops is unacceptable, the appointment of an attending ophthalmologist is imperative.

To improve the nutrition of the environments of the eye, the drug is often prescribed as part of a complex treatment.Taufon". Despite the fact that manufacturers indicate the minimum age for use - 18 years, these eye drops are widely used in pediatric practice. Almost all children with myopia are prescribed calcium supplements by doctors (usually “Calcium gluconate"), Agents that improve microcirculation in tissues ("Trental"), As well as vitamins, especially vitamins A, B 1, B 2, C, PP.

Glasses and lenses for myopia

Myopia glasses help to normalize refraction. But they are prescribed to children only with mild and moderate degrees of the disease. In the high stage of myopia, glasses are ineffective. Glasses of glasses for myopia are indicated by a number with a "-" sign.

Eyeglasses are selected by an ophthalmologist. He will bring different glasses to the child until the child sees the tenth line of the test chart from a distance of 5 meters. Depending on the severity of the disease, the doctor recommends wearing glasses at a certain time. If the child has a weak degree, then glasses should be worn only when you need to consider objects and objects located in the distance. The rest of the time glasses are not worn. If you neglect this rule, myopia will only progress.

With an average degree of myopia, glasses are prescribed to be worn while studying, reading, drawing. Quite often, so as not to aggravate the loss of vision from constant use of medical glasses, doctors recommend that such children wear bifocal glasses, the upper part of the lenses of which is several diopters higher than the lower part. Thus, when looking up and into the distance, the child looks through the "therapeutic" diopters, and reads and draws through the lenses, which have smaller numerical values.

Contact lenses

Contact lenses are more comfortable than glasses. Psychologically, wearing them is more easily perceived by children than wearing glasses. With the help of lenses, you can correct not only mild to moderate visual impairment, but also high myopia. The lenses fit more tightly to the cornea, this reduces possible errors in the refraction of light that occur when wearing glasses, when the child's eyes can move away from the glass lens.

Parents are often puzzled by the question at what age children can wear lenses. This is usually recommended when the child reaches the age of 8. Soft daytime or hard nighttime lenses should be prescribed by a doctor. Disposable lenses are best suited for children and do not require careful hygienic treatment before reuse.

When choosing reusable lenses, parents should be prepared for the fact that they will require very close care so as not to infect the baby's eyes.

Hard night lenses are not worn during the day, they are used only at night when the child is sleeping. At the same time, they are removed in the morning. The mechanical pressure exerted on the cornea by the lenses during the night helps the cornea to "straighten", and the child sees almost normal or normal during the day. Night lenses have quite a few contraindications, and doctors still do not agree on whether such correction means are useful for a child's body.

Laser correction

This is a fairly widely used method for myopia. With mild and moderate stages of the disease, as well as with a high degree with loss of vision up to 15 diopters, the procedure gives visible positive results. However, it should be well understood that correction does not cure vision, but only makes it possible to compensate for its loss.

The procedure takes only a few minutes. Pain relief is achieved using eye drops. During the correction, a part of the curved cornea will be removed, this will allow to align its layer, and to bring the optical ability of the eye to refract rays to normal values. After correction, the child is prohibited from rubbing his eyes with his hands, washing his face with dirty water, overexerting his eyes and doing physical exercises.

Surgical operations

Surgical treatment of myopia is indicated for complex and severe forms of ocular pathology. An important condition in order to offer parents surgery for the child is the progress of the disorder. If the baby loses about 1 diopter per year, then this is an absolute indication for surgery.

The most common intervention is lens replacement. Under local anesthesia, the child's own affected lens is replaced with a lens, which is implanted into the lens capsule. Any operations that are performed on the organs of vision for myopia have one goal - to strengthen the back of the eye in order to stop the decline in vision. Using a curved needle, a special gel or softened cartilaginous tissue is injected into the back of the eye to prevent the sclera from stretching.

Scleroplasty can stop the decline in visual function in about 70% of operated babies. They are shown further complex treatment, including wearing glasses, hardware treatment (at the request of the parents), medications that the doctor will prescribe.

Eye gymnastics for myopia

For many forms of myopia, doctors recommend teaching children daily eye exercises. It includes exercises for circular and axial movements of the eyeballs, examining close and distant objects. The most interesting and effective for children, in which visual impairment is corrected, is gymnastics in method of professor Zhdanov.

It is not necessary to do the full range of exercises provided for in the method every day. Just 10-15 minutes a day is enough to do 2-3 exercises with your child in a playful way. With mild myopia, such gymnastics allows you to stop a further drop in vision and even correct it without any other treatment.

Prevention

The World Health Organization believes that there is no specific prevention of myopia. Indeed, with the existing hereditary predisposition, the disease sometimes develops regardless of external factors.

However, it is still possible to save the eyesight of most children and avoid a high degree of myopia.

You also need to follow simple and important rules:

Children under one year of age don't hang toys too close to your face. The distance to the rattles and the mobile should be at least 45-50 cm.
Children from one and a half years old you need to instill a good habit of keeping all objects that need to be examined (books, drawings, toys) at a distance of at least 30 centimeters from the eyes. It is impossible to read lying down, as well as to use a mobile phone, looking at something on its screen while walking or while traveling by transport.

Preschoolers, schoolchildren and adolescents it is necessary to provide proper lighting of the workspace where the child plays, reads, draws, does homework. To do this, you need to not only buy a good table lamp, but also take care of the background lighting of the entire room.

The child's eyes should not be overworked. In a healthy baby, when sitting at a computer for a long time, visual analyzers experience fatigue after two hours. In children with myopia, this time interval is even less - it is only 35-45 minutes. It is clear that it will not be possible to completely avoid stress on the eyes, especially for a student. But when reading or writing, as well as while working in front of a computer monitor, you need to pause for 5-10 minutes every 20-30 minutes in order to switch to another activity that does not require significant visual concentration.
The child's nutrition should be rich in vitamins, balanced.