Due to the large individual differences, the prevention and control methods of myopia need to be individualized.

Experts suggest that after standardized inspections and comprehensive assessments, choose the method of myopia control based on the doctor's opinion and follow up regularly to monitor the child's progress in order to find the most suitable method for the child.

　　Our reporter Li He

　　With the advent of the school season, the myopia problem of primary and middle school students has attracted attention.

The results of the survey on myopia rate among 14,532 primary and middle school students in 9 provinces announced by the Ministry of Education on August 27 showed that the data at the end of 2019 compared with the survey data in June, the half-year rate of myopia increased by 11.7%.

Among them, the myopia rate of primary school, junior high school and high school students increased by 15.2%, 8.2% and 3.8% respectively.

　　Is the increase in myopia rate related to the form of online education adopted during the new crown pneumonia epidemic?

Which of heredity and eye habits have a greater impact on the formation of myopia?

On September 16, a reporter from Science and Technology Daily interviewed relevant experts.

Outdoor activities can reduce the incidence of myopia

　　Xu Liangde, chief researcher of the Eye Disease Big Data Intelligent Application Research Group of the Eye and Optometry Hospital Affiliated to Wenzhou Medical University, said that consistent with the results of the Ministry of Education's myopia rate survey, the Eye Optometry Hospital affiliated to Wenzhou Medical University and the Wenzhou Municipal Government launched the "Bright Eyes and Bright Teeth" project , The results of myopia screening of millions of primary and secondary school students in the city showed that from the end of last year to June this year, the overall growth rate of myopia in Wenzhou primary and secondary school students was as high as 5.83%.

Compared with June last year, the myopia rate of primary school, junior high school, and high school students increased by 2.66%, 0.43%, and 0.69%, and the high myopia rate increased by 0.16%, 0.50%, and 1.22%, respectively.

It can be seen that, affected by the new crown pneumonia epidemic, not only has the rate of myopia increased, but the severity of myopia has also increased.

　　"The impact of the new crown pneumonia epidemic on the eye health of primary and secondary school students is manifold." Xu Liangde said that due to the increase in the use of electronic products in online lessons, increased visual fatigue is one of the factors that cause the increase in myopia rate and degree; due to the fight against the epidemic Need, primary and secondary school students staying at home for a long time, increased eye intensity at close range, irregular work and sleep, and changes in dietary status may aggravate myopia; insufficient natural light exposure to the eyes will also affect normal eye development.

　　Studies have shown that maintaining outdoor activities for 2 hours a day and 14 hours a week can reduce the incidence of myopia in teenagers by more than 10%.

Dr. Lan Weizhong, a tutor of master's students in the Aier School of Ophthalmology, Central South University and deputy director of the Aier Institute of Optometry, said that the main reason is that the intensity of sunlight is hundreds of times higher than that of indoor light. The stronger the light, the more dopamine in the human body. The more released, and dopamine can inhibit the occurrence and development of myopia.

High-intensity light can also shrink pupils, increase depth of field, and reduce blur, and it can also inhibit myopia to a certain extent.

　　Studies have shown that the probability of myopia in children whose parents are not myopic is about 7%; the probability of myopia in the child increases to 26% if one of the parents is myopia; the probability of myopia in the child is as high as 45%.

Xu Liangde said that this shows that myopia has a certain heredity.

However, the first myopia survey jointly conducted by the National Health Commission, the Ministry of Education, and the Ministry of Finance in 2018 showed that the myopia rate of children and adolescents between the ages of 6 and 18 in my country is as high as 53.6%, which is much higher than that caused by genetic factors alone.

Experts say that myopia is more closely related to social life and eye habits. Parents and teachers should strengthen guidance and pay attention to young people increasing outdoor activity time, reducing close eye intensity, avoiding excessive use of electronic products, regulating learning posture and maintaining good Sleep eating habits.

Mydriatic optometry is one of the accurate optometry methods

　　Lan Weizhong explained that the essence of myopia is the axial lengthening of the eyeball.

Just as a person cannot become shorter after he grows taller, once myopia occurs, it is difficult to reverse.

But after scientific treatment, the progression of myopia can be effectively controlled.

Therefore, if it can be detected and treated early, the degree of myopia may be controlled to a relatively light degree, thereby avoiding the possibility of various blinding complications caused by high myopia.

　　Xu Jingjing, deputy director of the Department of Myopia Prevention and Control at the Eye and Optometry Hospital of Wenzhou Medical University, said that there are many clinical methods to control the development of myopia.

For example, in the early stage of myopia, attention is paid to improving children's eye habits, and reasonable methods of myopia correction and control are adopted to slow down the development of myopia.

Myopia prevention and control has two meanings. "Prevention" means preventing the occurrence of myopia. Before the occurrence of myopia, take part in outdoor activities, establish refractive files, and reduce the burden of eye use; "Control" means effective intervention after the occurrence of myopia to avoid high myopia.

The ultimate goal is to prevent the eye axis from becoming too long, leading to pathological myopia.

　　The prerequisite for prevention and control is to figure out the refractive power of the eyes, which requires optometry.

　　There is a group of muscles in the human eye called the ciliary muscles. In order to make the eyeballs see close things clearly, the ciliary muscles contract and tighten.

Mydriatic optometry, medically called ciliary muscle palsy optometry.

Xu Jingjing said that mydriasis optometry is one of the accurate optometry methods, the purpose is to relax the eyes and get better refractive power.

Pre-school children are young, have a strong adjustment ability, and have poor coordination. They are more likely to have errors in the examination, and they generally do dilated optometry.

But not everyone needs mydriasis and optometry, the doctor will perform targeted mydriasis according to the child's condition.

Find the most suitable correction and treatment pathway

　　Xu Jingjing said that currently accepted methods for myopia correction include frame glasses, contact lenses and refractive surgery.

Refractive surgery is not suitable when the degree of myopia is not stable. Children and adolescents can choose frames and contact lenses.

　　According to current research and clinical experience, atropine eye drops, orthokeratology (OK lens), multifocal soft contact lenses and peripheral defocusing optical lenses are effective in controlling the progression of myopia.

　　According to Xu Jingjing's analysis, atropine eye drops have not been approved for marketing in China. The myopia prevention and control effect of 0.01% low-concentration atropine will be weaker than that of a slightly higher concentration, but the side effects are also less. Most children have no special reaction after using it, but a few Sensitive children will have obvious symptoms of photophobia, and it is not recommended for patients with poor regulation.

　　Xu Jingjing said that a large number of studies have confirmed that the effect of orthokeratology in slowing the development of myopia is much better than that of ordinary frame glasses, but there are individual differences. Its efficacy is related to the patient’s age, power, lens fit, etc., and the degree of myopia is particularly low or Especially high myopia is not the best choice.

At the same time, the lens itself and the cost of care are relatively high. As a night-wearing contact lens, it is necessary to pay attention to wearing safety.

　　Lan Weizhong reminded that orthokeratology is the most strictly controlled medical device in the country, that is, three types of medical devices. Its fitting has strict indications and clear contraindications, and not everyone can use it. It is also necessary to go to a formal medical institution under the guidance of a professional ophthalmologist to ensure that the lens is safe and effective.

　　Laser surgery for myopia is also a hot way to restore vision in recent years.

Laser surgery for myopia has been recognized by various authoritative organizations around the world.

In 2012, the Ministry of Health of my country promulgated and formally implemented the "Quality Control of Excimer Laser Corneal Refractive Surgery" health industry standards, which regulated the qualifications of laser correction surgery hospitals and surgeons, and the service life of equipment.

Chen Shihao, director of the Clinical Center for Refractive Surgery of the Eye and Optometry Hospital affiliated to Wenyi University, said that the laser energy is stable, the penetrating power is very small, and the action time is very short.

The global operation volume of myopia laser surgery has exceeded 40 million cases. After more than 30 years of global clinical practice, it has been shown to be mature, safe and effective.

　　However, Lan Weizhong said that different operations have their indications and contraindications.

It is necessary to go to a professional ophthalmology medical institution for strict preoperative examinations, and a professional doctor will select the most suitable surgical procedure according to the differentiated eye conditions and eye needs of each myopic patient.

　　"In addition, in the past two years, peripheral defocused soft contact lenses and defocused frame glasses lenses have gradually emerged. With the continuous optimization of the design, the effect of myopia control is also improved, providing more choices for myopic children." Xu Jingjing said, Peripheral hyperopia defocused objects falling out of the retina may stimulate the growth of the eye axis and deepen myopia. Wearing the above two glasses can control myopia.

　　Xu Jingjing reminded that there are many factors that affect myopia. The choice of prevention and control methods for myopia is like choosing antihypertensive drugs for hypertensive patients. Individuals vary greatly and require individualized choices.

She suggested that after standardized inspections and comprehensive evaluations, choose the method of myopia control based on the doctor's opinion and follow up regularly to monitor the child's progress in order to find the most suitable method for the child.