Myopia in children of school and preschool age and its treatment. Myopia in a schoolchild: causes of development and methods of treatment

Myopia is a serious problem in childhood.

It often manifests itself at the beginning of the child's education at school. It's connected with a sharp increase in eye strain.

We will talk about the diagnosis and treatment of myopia in school-age children in the article.

Concept and characteristics

Myopia is a disease in which a fuzzy image of the surrounding world is created and the quality of vision deteriorates.

Often myopia is congenital. A large load on the visual apparatus at school age can also lead to this disease.

Myopia accompanied fatigue in reading and writing, which results in a deterioration in academic performance. It reduces the active participation of the child in school games and negatively affects his self-esteem. He becomes withdrawn and unsure of himself.

With progressive myopia, you need to select new glasses every year so that the child can see better. But this does not always lead to the desired result and only partially improves vision.

Causes and risk group

Myopia in children can be caused by various reasons:

violation of the rules of hygiene of vision;
weak;
not proper nutrition;
hereditary pathologies;
altered shape of the eyeball;
constant overwork;
close distance of the textbook from the eyes;
weakening of the sclera of the eye.

Why at school age Do children often have myopia?

Now it is myopia that is one of the most common vision problems at this age. This is due to the increased strain on the eyes during training.

Schoolchildren have to write, read a lot, and also sitting at the computer for a long time. The disease most often develops in children who have a hereditary predisposition to it. But big study load can cause false myopia in healthy children.

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What are the symptoms?

Signs of myopia:

Rapid fatigue while reading.
Low position of the head above the book.
Pain in the head.
Frequent blinking.
Visual impairment.

What are the complications?

Myopia changes the shape of the eyeball, so the eyes are poorly supplied with blood. As a result, various complications may appear:

Progressive myopia is accompanied by the development of a divergent strabismus.

With this disease, the pupil of one eye is shifted towards the temple.

There is also an overstrain of the oculomotor muscles. As a result, strabismus develops. at first need to correct myopia, and then proceed to the treatment of strabismus.

Nearsightedness often causes cataracts. Its cause is a violation of the metabolic process in the lens of the eye. The development of myopia leads to clouding of the center of the lens.

Treat this complication with the help of an operation. It allows you to remove the clouded lens and install an artificial lens in its place.

Prolonged progression of myopia is accompanied by malnutrition of eye cells. They begin to develop dystrophic processes. The eyeball becomes larger in size. This can lead to detachment of the retina from the wall of the eye.

As a result of development pathological process often damaged blood vessels eyes. Retinal hemorrhage may occur and vision will deteriorate sharply. Sometimes complete blindness develops.

How is the diagnosis made?

Special equipment is used to diagnose the child's visual system. Great importance in order to make a correct diagnosis, pupil dilation procedure.

Thanks to the external examination of the eyes, it is possible to draw a conclusion about the shape of the eyeballs and their position.

Ophthalmoscope helps to determine the size of the cornea and its shape. It allows you to see the bottom of the eye well.

It can be used to evaluate the anterior chamber of the eye, the vitreous body and the lens. Also, this device sets the degree of myopia and the type of refraction. The presence of complications of myopia helps to identify ultrasound.

Treatment Methods

Is myopia in school-age children curable? Decreased vision in children with speed about 0.5 D per year more favorable forecast. In this case, hardware, that is, conservative methods of treatment, help. It is important to wear glasses, but they can also be replaced with contact lenses.

It must also be observed visual hygiene and do eye exercises.

Proper organization of rest is of great importance. In addition, it is necessary to set up good nutrition child.

Do I need eye drops and which ones?

To reduce intraocular muscle tension, your doctor may prescribe eye drops for up to 10 days. Mostly used medicinal drops Atropine.

Gymnastics for the eyes

Is it possible to cure myopia in a child with the help of gymnastics? good effect with myopia gives special gymnastics for eyes.

It must be performed regularly before working at a computer or studying, as well as after them.

At palming exercise you need to cover your eyes with both hands so that no light comes through. The eyelids must be lowered. You need to breathe calmly.

This exercise can be done during breaks during study. After the exercise, the eyes should get used to the light, after which they can be opened.

To relax the muscles of the eyes and neck, you can use an exercise called "writing with the nose". It can be performed in any position. The main rule is relaxation. You also need to close your eyes and mentally write letters or draw with the tip of your nose.

One more exercise is to look between the eyebrows for a few seconds. Then you need to return your eyes to their original position again. You can also look at the tip of the nose. Then the eyes are closed for a while. There are many options for eye exercises that you need to do in the morning regularly.

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Vitamin complexes

maintenance normal structure eye tissue becomes possible due to vitamin complexes. These include:

a drug "Vesioned", which contains vitamins B, E, blueberry extract, beta-carotene;
"Okovit with blueberries" has an excellent effect on myopia;
used to prevent nearsightedness in children "Blueberry Forte".

All children's eye vitamins contain blueberries, which treat many diseases.

"Alphabet Opticum" represents the best vitamin complex in tablets, which is used for myopia in children.

What does hardware treatment include?

For hardware treatment of myopia, the latest modern equipment is used. Popular procedures are vacuum massage and electrical stimulation.

Popular treatments are laser therapy and magnetotherapy. The treatment program is compiled taking into account all the individual characteristics of the physical and mental health of the child.

Use of "night" lenses Paragon CRT

For vision correction in children Lately has become widely used refractive therapy. It involves the use of Paragon CRT 100 night lenses.

This allows you to get a quick improvement in vision and stop the progression of myopia. Also, night lenses help relieve spasm of accommodation and stabilize refraction.

In this way, eyes begin to work in the correct mode all day. At the same time, it is not necessary to use hardware treatment and constantly visit hospitals. In addition, the child can lead a normal active lifestyle.

Thanks to refractive therapy, children do not need to wear contact lenses or glasses. Since the Paragon CRT 100 night lenses are completely gas permeable, their use does not lead to oxygen starvation cornea.

Night correction is indicated if myopia progresses. It not only slows down, but also stops altogether. Refractive therapy indicated for children with myopia up to -6.0D. This efficient and safe method vision correction has no age restrictions.

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Laser correction

Modern laser technology is now used to correct myopia.

She provides fast healing corneal tissue after surgery. The procedure takes place without the use of cutting instruments and does not involve corneal incision.

It is fully automated and is under the control of a given correction program. The indication for laser correction is myopia up to -15.0D.

The operation allows you to excellent results , as patients begin to see much better even compared to glasses or lenses. They don't need them anymore.

The first time after the procedure, you need to wear protective dark glasses outside. To reduce temporary discomfort and prevent infection, the doctor prescribes special drops.

Prevention

It is quite possible to avoid the progression of such a disease as myopia. Desirable visit an ophthalmologist with your child every year.

The child should observe the regime of loads on vision. You need to take breaks every half hour of work when performing training tasks. For children younger age this period is even shorter.

With the help of gymnastics for the eyes, you can relieve eye strain quickly. Worth walking more fresh air and move actively. The nutrition of the child should include a sufficient amount of vitamins and protein.

You have to teach the child proper seating at the table. The incidence of light must be uniform.

Even in the presence of general lighting, you need to use a table lamp.

myopia child not a sentence. It can and should be treated to avoid serious complications.

About the causes of myopia and negative impact Gadgets for children's vision you can learn from the video:

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Treatment of myopia in children of school age is very important, because it is during this period that this disease manifests itself most often. Both true and false myopia. Moreover, in the latter case, if the hygiene of vision is not observed, it is possible to miss the moment of its transformation into the true one. Most often, a child begins to be treated at the age of seven to thirteen, because it is from this age that the load on the organs of vision increases sharply in schoolchildren.

How can you tell if a child has myopia?

Even with the most low degree diseases will show certain symptoms:

The student will complain that distant objects are blurry and fuzzy.
He will constantly squint so that you can better see them.
To view letters or small images, he will move close to the monitor or bring a book to his eyes.
There may be complaints of grains of sand in the eyes, headaches, spasms, fatigue.

When similar symptoms you should go for a consultation with an ophthalmologist and start treatment. It is most important to recognize the case if there is progressive myopia, when the drop in vision goes to half a diopter or more. If, with such a pathology, you start treating the child on time, then there are a lot of chances to maintain and even restore vigilance. Before treating a child for myopia, the doctor will determine to what extent his vision has fallen.

Depending on the severity of dysfunction, three types of myopia are distinguished:

weak degree (drop to three diopters);
medium degree(3-6 diopters);
severe (over 6 diopters).

With the latter degree, the retina and vascular walls become thinner, the disease can lead to complete blindness.

But even a progressive disease is treated, and at a serious stage of the disease modern medicine able to help.

School-age children are often labeled as "false myopia". This means that the loss of vision is temporary and is associated with excessive strain on the accommodation of the visual apparatus during study. This spasm is removed by pharmaceutical means. If you start on time, then false myopia can be cured completely. If not, then against its background, true, progressive myopia can develop and lead to loss of vision. Prevention of myopia must begin even before the disease manifests itself.

TO preventive measures relate:

reducing the load on the visual system in children aged 7 years and older;
proper lighting in the work area (a light bulb of at least 60 W);
the distance from the eyes to the book, notebook or monitor is at least 35 cm;
rest every 45 minutes of intense visual work;
a ban on reading and watching programs in a moving vehicle;
balanced diet from enough vitamins and valuable substances (calcium, zinc, lutein).

If a child has a serious degree of myopia, then many physical exercise and he can be exempted from physical education lessons.

With mild myopia, you can go in for sports, even useful, except for complex jumps and acrobatics.

Therapy with conservative methods

To treat this ailment in a school-age child begins after diagnosing the severity of the disease and calculating the necessary measures by the ophthalmologist. In most cases assigned conservative treatment.

It includes:

Corrective techniques with the use of glasses or contact lenses.
Eye exercises that involve training the visual muscles.
Hardware exposure, including laser stimulation.
Strengthening measures: massage of the cervical-collar zone, feasible sports activities, a clear daily routine, proper nutrition.
Folk remedies (after consultation with the attending physician).

Drug therapy (vitamin-mineral complexes, eye drops, other drugs prescribed by an ophthalmologist).

As for the pharmaceutical treatment of a school-age child, it all depends on the causes of the disease. So, if myopia arose due to dystrophic changes in the retina, you will need funds that improve blood circulation. It can be "Emoxipin", "Ditsinon", "Vikasol", others. If there is hemorrhage, then drugs that dilate blood vessels are prohibited. You will need absorbable agents, for example, Fibrinolysin, Lidaza.

Correction with the help of glasses can stop the development of the disease by relieving eye strain. Contact lenses are also suitable for teenagers. They adapt better to the movement of the pupil and are useful for differences in vision between the eyes.

Together with the student, you can do gymnastics for the eyes. These exercises are game form entertain the child and help stop the development of the disease. Popular with parents is gymnastics according to Avetisov, which develops the ciliary muscle.

It can be done by the whole family:

Circles and eights. Their child should do with his eyes without moving his head.
Eye movements left or right or up and down.
Gentle pressure on closed eye fingertips.

Violent squeezing and abrupt opening of the eyes.
Observation of a mark drawn on a window pane with a periodic shift of gaze to objects outside the window.

There are a lot of eye gymnastics complexes, and you will definitely find a suitable one for your family.

Folk remedies will also help to cure myopia in a weak form. They can be used only after talking with a doctor.

What folk remedies are suitable for school-age children:

Rowan-nettle decoction. To prepare it, 20 g of rowan berries and leaves are mixed with nettle grass (30 g). The mixture is boiled in two glasses of water for 15 minutes over low heat. Then insist 60 minutes, filtered. This drink is taken before each meal for half a cup.
Freshly squeezed carrot juice. It is good to drink this drink before dinner. By adding a little olive or linseed oil for the absorption of beta-carotene.
Lotions from cherry leaves. Treatment with drugs such as drops, for elementary school student always associated with whims. Scalded cherry leaves as a compress at night will not cause discomfort.

And the child will ask for this version of the folk remedy himself. You need to mix chopped apricots and walnuts(100 g each) and add honey (five large spoons). You need to eat a little of it every morning and evening.

Hardware treatment myopia is also very effective. It can be magnetotherapy, electrical stimulation, color impulse, vacuum massage, computer training to improve vision.

Orthokeratology technique (wearing special lenses that change the shape of the cornea), relaxing glasses and laser vision glasses also represent a hardware effect on accommodation and other parts of the eye.

Hardware treatment of myopia includes laser stimulation, as well as a combination of laser and infrared exposure. These options will restore the functions of the accommodative muscle.

Surgical and laser treatment

Surgical intervention using a laser can now be applied to a child. It can completely cure myopia.

They can be of three types: LASIK, Super LASIK (differs in the type of patterns) and photorefractive keratectomy (offered for mild myopia, but which is already progressive).

Laser exposure helps to correct the cornea, making it flatter, which will change the focus of the visual apparatus and restore vision forever.

If the disease has reached a severe stage or it is rapidly progressing, then it may be necessary surgical intervention.

Such operations are of several types:

Methodology	How is it carried out	When appointed
Strengthening the sclera (scleroplasty)	In the form of an injection to strengthen the sclera.	With the rapid progression of myopia (over 6 diopters) and an increase in the length of the eyeball.
	How to transplant strips of special material to back wall eyes.
Refractive methods	Keratomileusis - surgery removal of a thin layer of the cornea.	At serious pathologies different parts of the eye.
	Keratotomy – Freezing a thin layer of the cornea and then removing it.
	Keratophakia - implantation into the cornea of an implant - an analogue of a divergent contact lens.
	Extraction of the lens.

To avoid such serious treatments and stop myopia in the early stages, regular medical supervision of children and adolescents is very important. A healthy student should visit an ophthalmologist once a year, one who has been diagnosed with eye diseases - once every six months.

Myopia prevention for children is a measure that all parents should be aware of, regardless of whether the child has vision problems. This is due to the fact that everything in the world more people forced to wear glasses and lenses to correct vision. Statistics say: every third person on the planet suffers from myopia. If treatment is not started on time, this threatens not only with a deterioration in the quality of life, but also with disability.

Modern children are especially at risk of earning myopia. Therefore, parents should take care of the hygiene of the child's vision from an early age. preschool age.

Hygiene of vision: prevention of myopia in children

Nearsightedness (myopia) is one of the most common childhood diseases. Most often detected in children of middle school age. However, cases of visual impairment have also become common among preschoolers who experience heavy loads for sight.

Myopia- This is a visual impairment (defect) in which a person sees objects well near, but blurry at a distance. Requires mandatory correction, without which it will progress and cause complications.

Myopia refers to those diseases that cannot be cured. It is possible to correct and stop the deterioration, but it will not work to restore vision. Therefore, it is important not only to regularly check children's vision but also to know what causes myopia.

Causes of myopia in children:

hereditary predisposition. If mom and dad have poor eyesight, then the risk of myopia in a child reaches 50%. Such children should not miss visits to the ophthalmologist and carefully carry out the prevention of myopia.

Lifestyle. This includes weak physical activity and large visual loads near (reading, computer, work with small objects).

Some diseases increase the risk of myopia: head or spine injuries, poor posture, thyroid problems and childhood infections.

Among preschoolers, one of the risk factors was early development . Toddlers have not yet adapted their vision to work at close range. Therefore, early learning to read, write, work at a table with small objects (with excessive passion) leads to the fact that the child begins to see worse.

How to treat myopia in children

Unfortunately, changes in the eyeball are irreversible. It will not be possible to completely cure myopia, but correction methods help to avoid more serious vision problems.

In order for myopia not to progress, the child is prescribed glasses or contact lenses. Depending on the degree of the disease, they may be prescribed to be worn constantly or only while reading and working at a computer. Doctors may recommend eye gymnastics, but it will not correct serious visual defects.

Depending on the degree of violation and complications are also prescribed:

drug treatment (eye drops, vitamins, vasodilators);

scleroplasty - surgical treatment myopia. It is indicated for a high degree of myopia or its progressive form;

physiotherapy – massage, laser therapy, electrophoresis, etc.

The visual apparatus in children is constantly developing, so laser vision correction for children under 18-20 years of age is not prescribed. Sometimes it can be performed for diseases such as anisometropia, strabismus, amblyopia.

How to protect your child from myopia

Prevention of myopia in children is needed both for those who see well and for those who already wear glasses. Moreover, it is necessary to adhere to these rules not only from the beginning of school life, but from birth. Then the child will be more likely to maintain good vision or, at least, reduce the hereditary factor.

Prevention measures:

Since birth the child's room should be bright enough and well lit.

Books for the little ones should be of high quality: with large fonts and clear pictures.

In the first year of a child's life need to visit an ophthalmologist at 3, 6 and 12 months.

Complete nutrition plays an important role for the growing organism, including for the prevention of myopia in children. Vitamins A, B, C, lutein, carotene, calcium are essential for eye health. Therefore, dairy products, apples, citrus fruits, blueberries, black currants, cranberries, pork liver, eggs, butter, fish, vegetables, greens.

Children under the age of three should limit screen time to a minimum.(there are recommendations to completely exclude the TV and gadgets up to 3 years), after 3 years allowable rate- 30 minutes a day, for schoolchildren - 1.5 hours.

Any age the child should move a lot and spend time in the fresh air. Walking and active play outdoors can reduce the risk of developing myopia and may stop its progression. This is due to the beneficial effect daylight on the eyes and the ability to look into the distance, and not just in front of you.

Protect eyes from ultraviolet light. Direct sunlight contributes to the development of myopia, so for protection from the sun, children should wear Sunglasses and wide-brimmed panamas.

The child's table should be by the window, the light should fall from the right side, in the evening it is necessary to turn on additional lighting - table lamps 60-100 W. Furniture should be appropriate for the growth of the child.

When performing any work at the table, teach your child to keep their back straight. The distance from the eyes to the table is equal to the length from the child's elbow to his hand.

Avoid excessive eye strain. The closer the notebook, book, small objects, the more the eyes strain to focus. The optimal distance is 30 cm. When reading, doing homework, watching cartoons, you need to take 10-minute breaks every 30-40 minutes.

It would be useful to do simple exercises for the eyes. Just a few minutes a day can help relieve eye strain and exercise your muscles.

Many parents, concerned about the health of their child, visit many doctors and steadily follow their advice. And rightly so, since any, even the smallest, problem can subsequently develop into something more.

Treatment of myopia in children is one such case. If the problem is not corrected in time, it can lead to disability and complete blindness.

Children's myopia, or myopia, is a decrease in vision when the baby sees objects located near well and clearly, and sees things that are far away quite foggy (not only letters and numbers, but even toys, trees or people).

The cause of this disease is the lengthening of the eyeball, which becomes like egg, as a result of which the refracted rays do not reach the retina, but are projected in front of it.

The same thing happens when the power of refraction of light rays by the lens is broken.

It turns out that in order to clearly see objects, you need to either reduce the distance from them to the eye, or attach negative lenses, which will increase the distance, allowing the object to fall on the retina.

The causes of myopia in children can be different:

Constant tension of the eye muscles when necessary long time look at something close. In this case, the eye begins to adapt, and the "temporary phenomenon" becomes permanent.
Excessive load on the visual organs, especially during the school period. When you have to watch, read, write a lot, not only at school, but also at home. Here important point is the position of the body when writing and reading, the illumination of the workplace, properly selected furniture, corresponding to growth.
Hereditary predisposition, especially if both parents suffer from this disease.
An unbalanced diet and, as a result, a lack of vitamins and minerals that are so necessary for a growing body.
Not strengthened muscles of the neck and back and general physical weakness of the body.
Transfer of infectious diseases and injuries of the occipital region.

And this is not a complete list.

Types of pathology

Children's myopia can have different etiologies.

For reasons of occurrence:

congenital;
hereditary;
acquired.

By the nature of the violation of the visual organ:

physiological (axial and refractive);
pathological (axial);
lenticular (refractive).

In terms of progress:

progressive (slow and fast);
not progressive.

There is also a division according to the degree of myopia.

There are degrees such as:

weak;
average;
high.

congenital pathology

Congenital myopia appears due to the fact that at the time of birth the baby does not have enough margin of vision. Since babies have a smaller eyeball than adults, they are given a margin of +3.0 or +3.5 diopters. Therefore, for children of the first year of life, farsightedness is absolutely normal.

But if the baby is born with any abnormalities (for example, Down syndrome or Morfan) or is born prematurely, then such a reserve can be significantly reduced (up to 2.5 diopters), or even completely absent. If the reserve is not enough for the process of development and growth of the eyeball, then there is a high probability that in the future there may be problems with clear vision in the distance.

hereditary pathology

Hereditary myopia, more precisely, a predisposition to it, is passed on to the next generations. But even sick parents have a chance of giving birth to an absolutely healthy baby with 100% vision.

But if both dad and mom suffer from this ailment, then they should check their baby more carefully:

do not neglect scheduled examinations with an ophthalmologist;
monitor the schedule and workload of the child's day;
buy him foods rich in vitamins and minerals;
at the slightest symptoms or deviations from the norm, rush to the doctor for advice and vision correction at the earliest stages.

Acquired pathology

Acquired myopia develops most often during school years and affects children between the ages of six and fourteen, when the visual system accounts for huge pressure. Therefore, it is also called school myopia.

Even if your child is completely healthy and has no predisposition, this does not mean that myopia in a child is completely excluded. From the time the baby enters school, parents focus their attention on lessons, circles, sports sections, homework, good academic performance, but they forget that vision suffers greatly. In the first grade, about 5% of schoolchildren have myopia (these are often congenital and hereditary pathologies), but by the ninth grade, the figure increases to 40%.

Myopia is axial, when the refractive power remains normal, but the eyeball has an elongated shape, and refractive, when everything is normal from the anatomical side, but the refractive power is increased. Therefore, physiological myopia can be both axial and refractive, pathological only axial (there is a pathology of the structure), and lenticular only refractive (for example, the refractive power may change due to damage to the lens due to diabetes mellitus).

Myopia in children tends to progress. In this case, vision falls constantly. If for a year it fell by 0.5 - 1.0 diopters, they talk about slowly progressing myopia, and if more than 1.0 diopters, then they talk about rapidly progressing. The second option is the most dangerous, as it can end in complete blindness.

Non-progressive myopia is characterized by the fact that vision falls only to a certain level, and then stops. This happens most frequently in adolescence or even reaching adulthood.

But it also occurs in children who had a small "reserve of vision" at birth. When the eye is fully formed (by about ten years), vision stops at a level that was not enough for the reserve.

Degrees of myopia

According to the degree, there is weak myopia in a child up to 3.0 diopters, average from 3.0 to 6.0 diopters, high from 6.0 diopters and above. Weak and medium often do not bring tangible discomfort to children in life, except during classes, watching movies in the cinema, etc.

But the high one requires mandatory monitoring and timely treatment, walking without glasses or lenses is strictly contraindicated, both for safety reasons of the baby himself (to see a moving car or a pedestrian), and for reasons of eye health (so that the eyeball does not stretch).

A separate place in the classification is occupied by false myopia in school-age children. These are not pathological changes in visual apparatus, and roughly speaking "fatigue". With continuous voltage visual organs there is a spasm of the muscles responsible for normal and clear vision. This is seen more often in teenagers.

But such a disease can be completely eliminated. For this, it is important to make a diagnosis in time and start treatment before the disease progresses to pathological condition. In this condition, there is frequent fatigue, headaches in the temporal region, pain around the eyes, the problem either arises or disappears.

Symptoms

The symptoms will depend on which age group disease begins to appear. So in children up to a year, squinting of the eye will be noticeable, the baby often rubs them with fists, often blinks.

At the age of one to three, the baby also tries to bring toys closer to his face, leans more when he examines something, and comes closer to the TV screen. Preschoolers can already complain of severe eye fatigue, headache. Up to six years old, babies cannot really explain what they do not see, because they do not understand this, so parents should be attentive to such trifles.

The older the child becomes, the easier it is to identify the disease. You can already ask if he sees this or that object, as he clearly sees, and he himself will complain about the deterioration of his condition, because he knows the difference.

How to diagnose the disease

When identifying the first symptoms, you should immediately contact an ophthalmologist. It is important to visit the doctor at least once every six months, and infants should be examined every three months.

The first examination of the baby falls on the age of three months. The optometrist checks the condition of the eye, notes the shape and size of the eyeballs, their position. Also examines the anterior chamber of the eye and the cornea for changes and distortions.

It is important to check whether the lens and vitreous body are clouded. The fundus is checked for the presence of a myopic cone and staphyloma around the optic nerve. Thus, the specialist conducts a complete examination of all parts of the visual apparatus.

If, during the examination, any changes are detected (turbidity, increased pigmentation, hemorrhages, vasodilatation, retinal or vitreous detachment), then this is a reason for establishing a diagnosis and prescribing treatment.

The doctor should ask the mother how the pregnancy and childbirth went, whether there were complaints and infectious diseases, find out if there were similar cases in the family, how long ago the first symptoms appeared.

If everything is in order and no deviations are found, then the next examination is carried out in six months. Here the same indicators are noted as in three months, compared with the previous ones. If there is any change, it is recorded and carried out additional diagnostics e.g. shadow test.

Instrumental research methods

The ophthalmoscope mirror is installed at a distance of one meter from the child. Red light is directed to the pupil, a shadow appears when the mirror is shaken. Next, the specialist sets a ruler with lenses opposite the pupil (starting with the weakest) and selects the one in which the shadow does not move.

Additionally, you can conduct an ultrasound examination, which will help identify detachment of the retina or vitreous body, displacement of the lens.

Usually, all these studies take place when congenital or hereditary myopia is established, since these are the two main types in this period.

From a year to three, an examination should be carried out every six months by the same methods in order to monitor the development of the disease or identify it at a very early stage of development.

At the age of three, a test is added with pictures and tables that depict well-known objects (cars, cats, trees, and the like, which can be distinguished at that age). If something is suspected, a five-day atropinization is performed, followed by an examination of the fundus.

Myopia in children of school age can be detected at the annual physical examination. Children already know the letters and can look at the table and answer questions. If necessary, skiascopy is performed. But if your child complains that he does not see what is written on the board, his eyes often get tired, it is hard to do something, his head hurts, then it is worth passing the test ahead of schedule.

In this age category, the diagnosis is often made of "accommodation spasm". And if therapy is started on time, then a clear vision will be restored. It is necessary to pick up glasses, conduct physiotherapy. It is possible to add medication, as well as pay attention to nutrition and daily routine.

Therapeutic measures

Having learned the causes and degree of development of the disease, the doctor will tell you how to treat myopia in children.

Therapy should be comprehensive and timely and consist of the following items:

correction with glasses or lenses;
taking medications and vitamins;
surgical intervention;
compliance with the daily routine and proper nutrition.

Correction

Treatment of myopia always begins with the selection of glasses or lenses. This is necessary in order to reduce the load on the muscles and the rate of progression of the disease. If the baby does quite well without glasses, and he needs them only when reading from the board, then there is no need to constantly use them. But if the baby does not see anything “beyond his nose”, then wearing them becomes mandatory. Including this is necessary if the difference between the eyes is more than two diopters.

There is an orthokeratology method, which involves the use of lenses that correct the shape of the cornea. You need to wear such lenses at night, but this helps only temporarily, for a couple of days.

Special glasses with weakly positive lenses will help reduce the accommodation of the muscles and will help them relax. They are used if false myopia is diagnosed in adolescents or schoolchildren.

Medicines and vitamins

The intake of vitamins plays an important role during active growth and development. If the body does not have enough of something, then the likelihood of diseases of the visual system is high. Therefore, the baby's nutrition should include various vegetables and fruits (oranges play a big role - carrots, oranges, apricots, peaches), fish and poultry meat, berries, especially blueberries, are useful, dairy products(kefir, ryazhenka).

But sometimes this is not enough, and you have to resort to taking artificial vitamins (A, C, E, D, group B). Here, the specialist will select the drug for you according to your diagnosis and age norm.

Also, the optometrist may prescribe drops to relieve tension. Them active substance, atropine, helps to relax and reduce the rate of disease progression.

Surgical intervention

If the disease progresses steadily, the optometrist will definitely advise the mother to undergo scleroplasty to strengthen the posterior pole of the eye in order to try to stop the disease before its critical moment. After 18 years, laser correction can be used if the process has stopped at a certain stage of its development.

Physiotherapy

This is a good and effective way to deal with the problem. There are many options here:

vacuum massage;
infrared laser therapy;
amblyocor;
electrical stimulation.

All these methods are absolutely painless and do not bring discomfort and inconvenience, but the effect is colossal, up to a complete recovery.

Gymnastics

Treatment of myopia at school age can and should be carried out with the help of gymnastic exercises. The most common complex developed by Avetistov includes circular rotations; movement to the right and left, up and down, as well as diagonally; close your eyes tightly and relax; press down upper eyelid with several fingers and make rotational movements; fix a small dot on the window, look through it at a tree or other object, and then again at it, repeat for five minutes.

Daily regime

An important role is played by the observance of the correct daily routine.

The child should get enough sleep, go to bed no later than nine o'clock. On weekends, the regime must also be observed.
Working time at the computer should be no more than 1.5 hours with breaks of 5-10 minutes.
TV is also allowed to be watched for no more than 40 minutes a day in good lighting, and not in complete darkness.
You need to spend more time outdoors. Playing games such as table tennis, badminton, ball games are good preventive measures.
Watch how your baby sits at the table: his legs should be at an angle of 90˚ on the floor, his back is even, he should not bend over to see something, his elbows are on the table. When reading, the distance to the book should be 30 cm, and the light should fall on its pages, and not in the eyes.
The workplace should be well lit: for a left-hander, the light should fall on the right, and for a right-hander, on the left.
The height of the table and chair should correspond to the growth, since scoliosis can serve as the development of the disease.
It is necessary to read only while sitting, not lying down, not on your side, not with a flashlight under the covers, but at the table, and preferably using a book stand.
If your child has additional loads outside of school (English, mathematics and other subjects with tutors), try to remove them and allow him to rest more.
Sign up for a pool, as swimming perfectly strengthens the body and serves as a good physical activity.

If you follow the advice of doctors, undergo scheduled medical examinations and not be afraid to put glasses on your baby, then the disease can be prevented or prevented from gaining strength. And older children will already be able to carry out laser correction, allowing them to forget about glasses and lenses forever. The main thing is to apply for specialized care and not let everything take its course.

More than 90% of full-term babies at birth have farsightedness, which is also called the “farsightedness reserve”. Moreover, this “reserve” should be + 3.0 D - + 3.5 D in a newborn. This is due to the fact that the eye of a newborn is smaller than that of an adult. The anteroposterior eye size of a newborn is about 17-18 mm, a three-year-old baby is 23 mm, and an adult is 24 mm. Thus, the intensive growth of the eyeball occurs at the age of up to three years, and the final formation of the eyeball is completed by the age of 9-10 years. Nature provided for everything: she gave human eye a reserve of 3.5 diopters, which is consumed as the eye grows and by the age of 9-10 the child's eyes, as a rule, have a normal (emmetropic) refraction. Therefore, farsightedness is the norm for children. But, if hyperopia + 2.5D or less or normal refraction of the eye (emmetropia) is detected at birth, then the child has a high probability of developing myopia in the future, because. this “reserve” is not enough for the growth of the eyeball.

In a healthy eye, the image is projected directly onto the retina. But with an increased length of the eyeball (at the same time it resembles a chicken egg) or with increased refraction of light rays in the eye, the image does not reach the retina, but is projected in front of it and as a result is perceived blurry. When an object approaches the eyes or when using negative lenses, the image is projected just on the retina and is clearly perceived by the eye. This is the essence of myopia.

Causes of myopia in children

Myopia can be hereditary, congenital and acquired. Numerous studies have shown that heredity plays a key role in the development of myopia, and not the disease itself is inherited, but the predisposition to its occurrence. It has been established that if one of the parents suffers from myopia, then the risk of its occurrence in the child increases; but it rises even more if both parents suffer from myopia. Thus, it is necessary to take all measures to prevent the development of the disease in such children.

Congenital myopia appears with a disproportion between the length of the eye (anterior-posterior axis) and the refractive power (refraction), but it does not progress only if the child does not have hereditary weakness and increased extensibility of the sclera. But, in most cases, such myopia is combined with weakness of the sclera and its increased extensibility, and it steadily progresses, which can lead to severe irreversible changes in the eye and significant loss of vision, which can cause visual disability. The cause of the development of congenital myopia can be a congenital pathology of the cornea or lens, prematurity, hereditary pathology of the sclera, as well as congenital glaucoma. But one elevated intraocular pressure insufficient for the development of myopia. For its emergence high blood pressure must be combined with weakness of the sclera.

But more often myopia develops and progresses at school age, which is associated with an increase in visual load, impaired posture, unbalanced diet(lack of calcium, magnesium, zinc, etc.), improper organization of the workplace, excessive use of a computer or TV, as well as with the accelerated growth of the child. An important role is played accompanying illnesses(for example, diabetes mellitus) and infections that can provoke the development of myopia.

Thus, the following risk factors for the development of myopia are distinguished:

1. Heredity.
2. Congenital anomalies of the eyeball.
3. Prematurity (myopia occurs in an average of 40%).
4. Increased visual load.
5. Unbalanced diet.
6. Non-observance of visual hygiene.
7. Infections and concomitant general diseases (frequent acute respiratory infections, diabetes mellitus, Down's syndrome, Marfan's syndrome, etc.).
8. Congenital glaucoma.

The immediate causes of the development of myopia are an increase in the anteroposterior eye size of more than 25 mm with normal refractive power of the eye (axial myopia) or an increase in refractive power with a normal anteroposterior size (refractive myopia), as well as their combination (mixed myopia).

Types of myopia

Myopia is physiological, pathological (myopic disease) and lenticular. Physiological myopia can be axial or refractive, pathological - only axial, and lenticular - only refractive.

Physiological myopia usually occurs during a period of intensive growth, and its degree increases until the end of eye growth. Such myopia does not lead to disability.

Lenticular myopia often occurs with diabetes or central cataract.

Pathological myopia can begin as physiological, but it is characterized by persistent progression, with rapid growth eyeball in length. It often leads to disability.

Examination of a child with myopia

At the appointment, the doctor needs to be told about the course of pregnancy and childbirth, about the diseases the child has suffered, about when the first signs of visual impairment appeared and how they were expressed, about complaints about this moment, about the duration and conditions of visual work, about concomitant or previous diseases, including infectious ones, whether the child has relatives suffering from myopia, whether the child used glasses and for how long, whether he changed glasses and how often, whether treatment was carried out and whether there was an effect from it.

At the first examination at 3 months doctor conducts external examination child's eye. On examination, the doctor pays attention to the size, shape and position of the eyeballs, whether he fixes bright toys with his eyes. Then, using an ophthalmoscope, he examines the cornea, notes whether there is a change in its shape and size; examines the anterior chamber of the eye (this is the distance between the cornea in front and the iris in the back). With myopia, the anterior chamber is usually deep, but only a doctor can evaluate this indicator.

Then the doctor pays attention to the lens: is there a central cataract, which can also impair distance vision; and on the vitreous body: are there floating opacities there? At the very end of ophthalmoscopy, the doctor examines the fundus. With myopia, due to stretching of the posterior segment of the eye, changes are almost constantly observed around the optic disc - the appearance of a myopic cone or staphyloma. The myopic cone is located in the form of a crescent around the optic disc. With the progression of myopia, the myopic cone increases and turns into a staphyloma, which covers the optic disc in the form of a ring. Thus, staphyloma, in fact, is a consequence of an increase in the myopic cone.

With a high degree of myopia (more than 6.0 D), an increase in pigmentation can be observed in the fundus, atrophic changes, ruptures, hemorrhages that appear due to stretching and fragility of blood vessels; as well as detachment of the vitreous body and retina. Often the atrophic process captures the central zone of the retina, which significantly impairs vision. Characteristic for myopia is the appearance of a Fuchs spot - pigmentation at the site of a hemorrhage or dystrophic focus in the macular zone of the retina. With congenital myopia, changes occur in the fundus that are characteristic of high degrees. Such myopia progresses rapidly and often leads to disability, so it is very important to diagnose as early as possible for timely treatment.

The next stage of the examination is skiascopy (or shadow test). Skiascopy is carried out as follows: the doctor sits opposite the child at a distance of 1 meter and illuminates the pupil with an ophthalmoscope mirror, while the pupil is illuminated with red light. When the ophthalmoscope is rocked, a shadow appears against the background of the red glow of the pupil. Observing the nature of the movement of the shadow, the doctor determines the type of refraction (myopia, emmetropia or hypermetropia). To determine the degree of refraction, the doctor substitutes a skiascopic ruler, consisting of negative lenses (for myopia), starting with the weakest one, and marks the lens at which the shadow stops moving. Then, having made certain calculations, the doctor determines the degree of myopia and makes an accurate diagnosis. But at the age of up to a year in 15 minutes. before this study, it is necessary to instill tropicamide 0.5% to determine more than accurate diagnosis. There are three degrees of myopia: weak - up to 3.0 diopters, medium - 3.25-6.0 diopters, high - 6.25 and above.

Via ultrasound(ultrasound) can detect lens displacement, changes and detachment of the vitreous body, retinal detachment, determine the type of myopia (axial or refractive) and measure the anteroposterior size of the eye.

If in 6 months and older parents notice that the child has exotropia, then this is a reason to contact an ophthalmologist, since exotropia in some cases can be a sign of myopia. At the second scheduled examination, the doctor uses the same techniques as at the first. In this case, it is necessary to compare the results of skiascopy with previous results. And, if myopia was detected at 3 months, then it is necessary to establish or exclude its progression, tk. the consequence of it may be an irreversible visual impairment, which requires immediate treatment.

Since the year parents may notice that their child does not see well into the distance and tends to bring everything closer to the eyes, which squints or blinks frequently. In this case, parents must definitely show the baby to an ophthalmologist in order to exclude the development of myopia, especially if one of the parents suffers from it.
Up to about three years, the examination for myopia is limited only to the above methods.

From the age of three in addition to the above methods, the visual acuity of each eye is determined using tables. After identifying reduced visual acuity, the doctor selects corrective lenses that improve distance vision. With myopia, these are negative lenses. To determine the degree of myopia, the power of the lenses is gradually increased until the best visual acuity is achieved. Instead of skiascopy, from this age, the autorefractometry method can be used, after five days of atropinization. It is also possible to examine in detail the anterior structures of the eye with a slit lamp, and with the help of ophthalmoscopy, a more detailed examination of the central and peripheral departments eye fundus. Skiascopy is carried out after preliminary atropinization for 5 days. 2 weeks after the last instillation of atropine, the correction is specified. But the most detailed examination of the fundus can be done with the help of an examination with a fundus lens.

The vision of schoolchildren must be checked annually, because all of them belong to the risk group for the development of myopia. More often, schoolchildren develop mild or moderate myopia, which, as a rule, does not progress and does not cause complications. The first sign of the development of myopia may be a temporary and sudden deterioration in distance vision, while maintaining good vision close. Schoolchildren complain that they began to see badly what was written on the board, and when transplanted to the front desks, it becomes better to see, they complain about fatigue eye. This condition is called accommodation spasm. It occurs with spasm of the ciliary muscle, which regulates the curvature of the lens and, accordingly, the refraction of rays. Spasms may be caused vegetative dystonia often found in individuals young age, non-compliance with the rules during visual work, asthenia, hysteria and increased nervous excitability. As a rule, it is not possible to clearly determine visual acuity and refraction during accommodation spasm, because she hesitates. But, having dripped atropine for 5 days and, having found normal acuity and refraction, after atropinization, a diagnosis can be made - a spasm of accommodation. The doctor will prescribe treatment to relieve this spasm and refer you for a consultation with a neurologist.

With a weak and moderate degree of myopia in a child, the symptoms are the same as with accommodation spasm, but it is constant. With skiascopy, myopic refraction is determined, and vision improves only with negative glasses. Often such children squint, which slightly improves distance vision. With a high degree of myopia and with myopic disease, vision is usually significantly reduced, especially if complications appear; also, the child may note the presence of “floating flies” before the eyes, which may indicate possible availability destruction of the vitreous body.

A child suffering from myopia should be registered with an ophthalmologist and observed once every 6 months. At the same time, the doctor compares the results of the examination with the results of previous examinations. At mild myopia(up to 3.0 diopters) changes in the fundus are minimal, only sometimes you can see the myopic cone at the optic nerve head. At medium degree- changes in the fundus are more pronounced: retinal vessels are narrowed, there may be initial dystrophic changes, pigment deposits, initial changes in the macular region, myopic cones or staphylomas. At high degree of myopia changes are even more pronounced, up to extensive retinal atrophy and its detachment.

If during the year myopia increased by 0.5-1.0 diopters, then this is slowly progressive myopia, if by 1.0 diopters or more, then this is rapidly progressive myopia. On average, progression begins at the age of 6 and ends at 18. The progression of myopia can lead to irreversible changes in the fundus of the eye, leading to significant deterioration and even complete loss of vision. With the rapid progression of myopia, the posterior pole of the eye lengthens, while the retina lining the eye from the inside is not as elastic as the sclera, it stretches up to a certain point, and then, against the background of dystrophic changes and thinning, breaks appear and in the future, its detachment may occur. When the retina is stretched, the blood vessels are also stretched. They become inferior, unable to provide the retina with nutrients and oxygen. Due to stretching, they become very brittle and as a result, hemorrhages occur. Changes are also taking place in vitreous body- floating flakes appear, its structure changes, in the future, vitreous detachment may occur, which is often a harbinger of retinal detachment. Such myopia is also called myopic disease. If progressive myopia is suspected, it is necessary to periodically (every 6 months) repeat ultrasound of the eyes to assess the course of the disease.

Treatment of myopia in children

Treatment of myopia depends on its degree, progression and the presence of complications. The main task of treatment is to stop or slow down the progression of the disease, prevent the occurrence of complications, as well as correct vision. There is no cure for myopia in children. Special attention should be drawn to progressive myopia. The sooner treatment is started, the greater the child's chances of maintaining vision. It is permissible to increase myopia by no more than 0.5 diopters per year.

In the treatment of myopia, all methods are used in combination, which gives the best result. So physiotherapy, optical exercises are combined with drug treatment, and with a high degree or progression of myopia and with surgery.

First of all, the doctor selects glasses. The appointment of glasses is not a treatment, it is only a vision correction for greater patient comfort. But with myopic disease, glasses somewhat reduce progression by reducing eye strain. Therefore, when congenital myopia is detected, glasses should be prescribed as early as possible. With mild and moderate myopia, glasses are prescribed for distance, there is no need to wear them all the time. If the child feels comfortable without glasses (this is mainly for a weak degree), then there is no need to force him to wear them. With a high degree of myopia, as well as with progressive, glasses are prescribed for permanent wear. This is especially important when a child develops exotropia to prevent the development of amblyopia. In addition to glasses, older children can use contact lenses, this is especially true with a large difference in refraction (more than 2.0 diopters) between the eyes, the so-called anisometropia.

The orthokeratology method consists in the periodic wearing of special lenses that change the shape of the cornea, flattening it. But this effect lasts only for 1-2 days, after which the shape of the cornea is restored.

Also, with a weak degree of myopia, you can prescribe the so-called “relaxing” glasses - these are glasses with weakly positive lenses that help to relax accommodation. In addition, there are computer programs, relaxing accommodation, which can be used at home.

A good effect is given by training the ciliary muscle. In this case, alternately positive and negative lenses are substituted for the eye.
Non-drug treatment of all types of myopia includes adherence to a restorative regimen, outdoor walks, swimming, visual load regimen, a balanced diet rich in vitamins and microelements, and eye exercises(exercises with lenses, exercise “mark on glass”).

A good effect is provided by electrophoresis with dibazol or with a myopic mixture (calcium chloride, diphenhydramine, novocaine), reflexotherapy.

There are such glasses - laser vision, which somewhat improve distance vision when worn. The essence is the same as when squinting with myopia, but they do not have a therapeutic effect.

Also, with myopia, in combination with non-drug, drug treatment is also prescribed. With a weak degree of myopia, vitamin-mineral complexes are prescribed, especially those containing lutein (okuvayt lutein, vitrum vision or any others).

Calcium preparations, vitamins contribute to the prevention of progression and the appearance of complications. a nicotinic acid(both in tablets and injections), trental. But vasodilators should not be prescribed in the presence of hemorrhages. With initial dystrophy, askorutin, dicynone, vikasol, trental, emoxipin are prescribed - these drugs help improve blood circulation in the retina, thereby slowing down the dystrophic process. With the formation of pathological foci, absorbable preparations are prescribed (collisin, fibrinolysin, lidase).

In the event of complications or rapid progression, surgery- scleroplasty. Indications for this operation are: myopia of 4.0 diopters and above, amenable to correction, rapidly progressing (more than 1 diopter per year), with a sharp increase in the anteroposterior size of the eye and in the absence of complications in the fundus. The essence of the operation is not only to strengthen the posterior pole of the eye, to prevent further stretching of the sclera, but also to improve its blood supply. To do this, either a transplant is sutured to the posterior pole, or a liquid suspension from crushed tissue is injected into the posterior pole of the eye. Grafts can be donor sclera, collagen, or silicone. But it does not lead to recovery, but only reduces the progression and improves the blood supply to the structures of the eye.

Laser surgery is now widely used. In the treatment of myopia, it is especially effective in preventing the occurrence of tears and retinal detachment with the rapid progression of the disease. In this case, the “soldering” of the retina occurs in places of its thinning and around existing gaps. Retinal detachment is also an indication for surgery.

If the child has an average, high degree of myopia or myopic disease, then there is a visit to a special kindergarten. Children at risk should undergo periodic examinations by an ophthalmologist in order to detect and prevent the progression of myopia as early as possible. Any degree of myopia should be seen by an ophthalmologist every 6 months.

Beginning with early age children need to be taught to “correct reading”: the distance from the eyes to the book (pictures, toys) should be at least 30 cm; to correct posture. The height of the table (desk), chair should correspond to the height of the child. Correct and sufficient lighting of the workplace is necessary. Due attention should be paid to the physical education of children. Food should be complete and varied.

With myopia, it is necessary to change glasses in a timely manner, because. excessive tension of accommodation contributes to the progression of myopia. Be sure to do eye exercises at home. Here is a set of exercises for the ciliary muscle according to Avetisov:

1. Circular eye movements to the right and left.
2. Eye movements up, right, left, diagonally.
3. Light pressure with three fingers on the upper eyelid with eyes closed.
4. Strong squinting of the eyes.
5. A round mark with a diameter of 3-5 mm is glued onto the glass. A person stands at a distance of 30-35 cm from the window, fixes an object (a house, a tree, etc.) outside the window for 1-2 seconds, then the gaze is shifted for 1-2 seconds. on the mark on the glass, then look back. This exercise must be repeated at least 2 times a day from 3 minutes at the beginning of the course to 7 minutes at the end. Courses are repeated monthly. The duration of the course is 10-15 days.

High degrees of myopia, and especially in the presence of complications, are a contraindication to active species sports, running, jumping and any body-shaking exercises are prohibited. Children with such a diagnosis are assigned a special set of physical exercises.

Forecast

Weak and moderate myopia that occurs at school age, as a rule, does not progress and does not lead to complications. She corrects herself well with glasses. The prognosis for her is quite favorable. At high degrees myopia, visual acuity even after lens correction remains reduced. With congenital and progressive myopia, and with the occurrence pathological changes in the fundus and in the vitreous body, the prognosis for vision worsens. It is especially unfavorable in case of changes in the central zone of the retina - in the macular zone, when vision deteriorates significantly. In the absence of correction of myopia, divergent strabismus may occur.

If myopia has stabilized, then after 2 years you can perform refractive surgery and get rid of the glasses. But this only applies to patients over 18 years of age. Refractive surgery is now very common. Doctors already have enough experience in this area, plus medical equipment is being improved, so these operations are now a success among those suffering from myopia, especially since they are painless and safe.

Ophthalmologist Odnochko E.A.