Myopia (nearsightedness ) - Causes, Symptoms and Treatment .MF .
myopia - refraction in which rays are refracted and collected much ahead of the retina (in the normal eye to the retina).Among patients spread another name for myopia - short-sightedness.This condition is characterized by poor distance vision.
vision for myopia
reasons nearsightedness (myopia)
myopia happens congenital and acquired.The first deals with violations of the eyeball in the prenatal period.
Factors risk of acquired myopia:
- heredity (especially if both myopia parents),
- sedentary lifestyle,
- excessive burden on the eyes (for example, long-term work near),
- failure to comply with the rules of reading and writing (distance, duration of continuous load),
- disorders of the organ of vision (strabismus, astigmatism).
Heredity, nevertheless, is a leading factor in the formation of myopia, the other factors only provoke myopia with existing predisposition to it, especially in the adult.But the formation of the child and adolescent affect all of these factors.
Symptoms of myopia
According to the degree of refraction disorders distinguish 3 degrees of myopia: poor (up to -3 diopters), medium (up to -6 diopters), high (more than -6 diopters).
Adrift nearsightedness is fixed and progressive (if annual increases of 1 myopia diopters or more).
a long time, asymptomatic for myopia.myopia is usually detected during a medical examination, but the patient is not even aware of his illness.Manifested myopia poor distance vision.At school, the child asks transplanted to the front desk, people do not see numbers taxis, the price tags in stores, it is uncomfortable to watch TV.
There is such a thing as false myopia.It is associated with a spasm of accommodation - malfunction of the ciliary muscle, and appears a clear breach of the distance.Diagnosis after cycloplegic refractometry in the state (expanded pupil).Mydriatic contraindicated for people with elevated intraocular pressure, becausemay provoke an acute attack of glaucoma.
For diagnosis will require the following studies:
- visometry (visual acuity with correction),
- perimetry (in complicated myopia may vary),
- skiascopy (using an indirect ophthalmoscope doctor examines the shadow of movement in the areapupil and determines the refraction),
- refractometry (after expansion of the pupil can determine the true refraction of the eye),
- tonometry, intraocular pressure measurement to exclude glaucoma,
- ophthalmoscopy and fundus examination with Goldmann lens (spot Fuchs, myopic cone, can bestaphyloma-bulging of the sclera, may hemorrhage, retinal dystrophy),
- US eyes and definition of anterior-posterior length (about 24 mm in the standard).
An objective study determined a decrease in visual acuity, which is compensated for spread lenses, increased anterior-posterior segment of the eye, the fundus can be formed Fuchs spots (high myopia pigment lesion in the macula) due to increased fragility of blood vessels, myopic cone or staphylomas of-this distension of scleral hemorrhages.
treatment of nearsightedness (myopia)
There are several types of correction and treatment of myopia:
- spectacle and contact
correction - surgical
Drug treatment of myopia
course of medical treatment recommended to place all patients with myopia 1-2 times a year to prevent the progression of myopia.Assign overall gentle treatment, vitamins (C, B), to remove the spasm of accommodation midriatiki (Irifrin, mezaton PA1 in. At night for a month, calcium preparations (eg, calcium chloride intravenously), tissue therapy (FIBS, the vitreous body, aloeintramuscularly), drugs that improve cerebral blood flow (piracetam, pentoxifylline orally). Physiotherapy helps to slow down the progression of the disease (magnetic therapy, laser therapy, massage neck area).
glasses and contact correction of myopia
shown glasses or contact a correction to a particular patientdepends on the willingness of the patient and the doctor's recommendations. Power lens is adjusted so that the portable diopter was weaker refraction. A lot of people prefer to wear glasses. But they are not always comfortable (subside, misted glass, soiled). in contrast, the contact lensesThey have an advantage in terms of quality of life, but have a lot of contraindications, including inflammatory eye disease, intolerance, allergy.When used improperly, causing complications such as keratitis.
almost always use a partial correction to maintain a reserve accommodation.When -3 diopters of myopia over 2 designate a pair of glasses or bifocals.For close to 1.5 - 2.5 diopters less.At high myopia appoint points depending on their tolerance.
Relatively recently appeared orthokeratology lens , who dress up for the night, and 100% vision ensured up to 24 hours.Showing from 6 years of age with myopia mild to moderate.They do not cause allergic reactions and corneal oxygen deficiency.The effect is the same as that of laser surgery, but temporary.
Properly fitted contact lenses do not contribute to the development of myopia, but can affect the ocular surface changes in tissue that is often accompanied by discomfort and dry eye syndrome.Provide a healthy state of the surface of the eye to help complete solution - the use of ophthalmic gel and eye drops.Eliminates causes discomfort gel "Korneregel".It includes carbomer based on a soft gel that retains the full humidification and dexpanthenol, has a healing effect.For those who feel discomfort and dryness of 3 or more times a day, you should choose a drop "Artelak Balance", which combines the unique combination of hyaluronic acid and vitamin B12.Hyaluronic acid on the surface of the eye forms a film, providing long-lasting hydration.The action of hyaluronic acid extends a special protector.Vitamin B12 - the most powerful antioxidant that protects cells from damage by free radicals.Those who experience the discomfort is not often 2-3 times per day, drops suit "Artelak Splash", having as part of hyaluronic acid, which provides instant hydration.Regardless of the symptoms of discomfort and dryness prevention well be used in combination with data eyedrops gel on the basis of dexpanthenol.
the treatment of myopia used orthoptic treatment, such as training the ciliary muscle with the help of negative lenses, and hardware treatment aimed at increasing the provision of accommodation and the stimulation of the optic nerve.Especially indicated for amblyopia.Types of hardware treatment:. Akkomodotrener, tsvetoimpulsnoy treatment, laser stimulation, etc.
Surgical treatment of myopia
Surgical treatment is indicated in progressive myopia to stop its development.Scleroplasty held if the sclera is increased size of more than 1 mm per year.At high myopia use removal of the lens to its replacement intraocular lens of desired refractive power.Can thermocoagulation incision-made corneas (mikroozhogi) in certain meridians.
Laser vision correction
In recent years become a common refractive surgery or laser vision correction.
- myopia up to -12 diopters
- myopic astigmatism up to 10 diopters
- sightedness to +8 diopters
- hyperopic astigmatism up to 8 diopters
- professional (profession, in which you can not use glasses or contact lenses - pilots, athletes)
- medical (anisometropia, disorders of binocular vision)
- treatment (corneal opacity, degeneration)
- up to age 18 years
- myopia progression
- one eye
- thin corneas (less than 450 microns)
- inflammatory eye diseases (acute and chronic)
- common diseases (diabetes, autoimmune and systemic diseases)
photorefractive keratectomy (PRK) - the first method of laser treatment of myopia.In this corneal epithelium removed with a knife, then evaporated by a laser and a certain amount of fabric wear contact lenses.After surgery may develop irregular corneal astigmatism, becauseepithelium uneven.
LASEK-a laser epithelial keratomileusis - epithelia treated with alcohol and separated.After evaporation, it is returned to the place (helps healing and reduces pain).Dress lenses.
LASIK (laser in-situ keratomileusis insitu) - using a microkeratome form epithelial-stromal corneal flap on the leg, which swings, made epithelium ablation and return it to the place.You do not need the use of contact lenses.Contraindications - thin cornea.Variety-epiLASIK, when formed epithelial flap.
most modern and fastest method - Femto - or IntraLASIK.When this flap is formed by the femtosecond laser, and ablation using an excimer radiation.Less traumatic more physiological method few side effects.
Laser vision correction
percentage of complications is small and all the states are compensated quickly.
Side effects of laser surgery:
- unrealistic expectations, ie,patient first can not get used to normal vision,
- hyper -, gipokorrektsiya,
- corneal astigmatism,
- Dry eye syndrome is about 1 in 5 people,
- keratitis, conjunctivitis.
Complications of myopia
With delayed treatment or incorrect correction of myopia possible progression of the disease and the occurrence of complications such as amblyopia (uncorrectable decrease in visual acuity), education stafilom sclera (protrusion), degeneration and hemorrhages in the retina and vitreous, in severe cases,their detachment.
Complications of myopia
Prevention of myopia
Great importance is given to the prevention of myopia, especially among schoolchildren:
- read book should be at arm's length from your eyes (the same applies to the computer), TV-no less than 3 meters,
- can not be read, or lying in the transport,
- adequate lighting (general and local),
- proper vision correction, if necessary.
In adults, such prevention, in addition to compensation, less effective.
Ophthalmologist Letyuk TZ