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Scientifically, nearsightedness is called myopia. According to statistical medical assurances, about 800 million people, including children, suffer from this disease. The structure of the eyes suggests the presence of a cornea and lens in them, which transmit and refract rays. If changes occur in these elements, the picture becomes blurry. In order to avoid a decrease in visual acuity, it is necessary to correctly select the treatment of myopia.

What methods of treatment of myopia are used today

Currently, methods of treating this pathological process are classified into groups:

• Medical direction (the use of drugs to strengthen the sclera, the appointment of drugs that accelerate metabolic functions in the retina and eye, the use of drugs that eliminate the spasm of accommodation caused by high eye loads). For these directions to be effective, an important role is played by course therapy with a frequency of several months.
• Physiotherapy involves various procedures aimed at strengthening the eye muscle. These include activities such as laser stimulation, electricity, electrophoresis. The advantages of this group of methods lie in their harmlessness, they have almost no contraindications and do not cause any adverse reactions.

• Surgical therapies are intended to prevent progression of the disease and generally correct refraction. This method is relevant for patients suffering from a severe degree of myopia, it is prescribed in extreme cases when other methods have been ineffective. Treatment can be aimed at strengthening the sclera, as well as carrying out refractive measures.
• Correction with contact lenses and glasses. In myopia, light rays are focused directly in front of the retina. The main task of the correction is to create focus to occur where it should be by nature. Correction methods include wearing lenses or glasses. This is a quick way to improve vision, but it is short-term and does not aim to solve the problem.

So, there are many options for how to cure myopia, each of them has its pros and cons.

Common progressive treatments for myopia

Medical treatment

The course of this therapy should be taken by all patients suffering from myopia, and this is done 1 or 2 times a year in order to prevent the progression of the disease. Patients are prescribed a general sparing treatment regimen, which involves the use of a vitamin complex (vitamins of groups B, C), drugs that help relieve spasm of accommodation - irifrin, mezaton, calcium-containing drugs, tissue therapy. Drugs aimed at improving cerebral circulation are also widely used. The main means include piracetam, pentoxifylline.

Physiotherapeutic methods for the treatment of myopia

There are several therapies that are effective for the physiotherapy treatment of myopia. CMW therapy involves the use of currents for treatment, it stops the process of the disease. In the course of this technique, heat occurs, which leads to the expansion of capillaries and the normalization of blood flow. As a result, the eyes receive more nutrients and oxygen. The therapy is carried out using special electrodes in the form of half masks, which are applied to the eyelids. Sessions should be carried out every day for 10-12 days. The use of this procedure is contraindicated in case of cataracts, glaucoma, thyroid diseases, pregnancy, current intolerance.

Ultrasonic technique involves the use of ultrasound, which promotes the activation of metabolism in the tissue area. The impact of this nature has a beneficial effect on the entire work of the eye muscles. Vibrators for therapy are shaped like binoculars; they act on the organs of vision for several minutes. The procedure is painless, but is not used for cardiovascular pathologies, endocrine dysfunction, malignant tumor processes.

Electrophoresis is an event aimed at introducing a medicinal substance into the nasal mucosa. When it enters the bloodstream, this substance, called riboflavin, reaches the eyes and has a metabolic effect. There is an increase in the rate of biochemical processes, stimulation of tissue respiration, improvement in visual function. The procedure is carried out in a supine position. During the procedure, the patient may feel a slight tingling sensation. Treatment is contraindicated in the presence of acute infections and impaired blood clotting function. In addition to the above methods, myopia is treated with eye massage and a special gymnastic complex.

Surgical techniques for the treatment of myopia

Laser correction of myopia

Currently, this method is the most popular and effective. It is aimed at treating not only myopia, but also hyperopia, astigmatism. Vision is corrected by influencing the shape of the cornea, during the process it takes the form of the so-called "natural lens". This method helps to eliminate myopia up to 12-15 diopters. Modern devices for carrying out the operation are formed in such a way that they begin to work exclusively in certain climatic conditions - temperature, humidity. If some factors can disrupt the technology, the installation refuses to function.

Performing refractive lens replacement

Scientifically, this event is called a lansectomy and is used to treat a high degree of myopia. During the procedure, the transparent lens is removed, in which the optical power is insufficient or strong. In addition to basic measures, an artificial lens is placed in the eye. This method is relevant when a person has a loss of natural accommodative functions. All manipulations are carried out through a self-sealing incision, which has dimensions of the order of 2.5 mm. To perform the operation, it is advisable to use a multidisciplinary system that allows you to perform operations for a short time - up to 20 minutes.

Implantation of phakic lenses in the treatment of myopia

This method is recommended in situations where the natural process of accommodation is preserved. During the treatment, the natural lens remains in place, and a special lens, which is placed in the eye area, is placed in its anterior or posterior chamber. The operation is carried out in 1 day, a 2.5 mm incision is made, the process does not require suturing. The most commonly used lenses are inserted into the posterior chamber, they are implanted behind the iris and do not require additional fixation. The advantage of the technique is the ability to correct even complex phenomena.

Radial keratotomy and its features

During this event, special radial incisions are made in the peripheral part of the cornea. When growing together, they change their shape, and vision becomes much better. But, despite all the advantages, this method has disadvantages:

• long recovery period;
• inability to perform surgery on both eyes;
• poorly predicted outcome;
• narrow range of use.

In connection with these disadvantages, this method is almost never used in modern clinics.

Carrying out corneal plastic surgery in the treatment of myopia

Vision is corrected by changing the shape of the cornea. The result can be achieved by transplanting donor cornea layers. Thanks to this method, it is possible to carry out the correction of numerous changes.

It is difficult to say how to treat myopia most effectively and quickly. Many factors depend on the individual characteristics of the organism, on the structure of the eye, as well as on the general current state of visual function. Only a highly qualified specialist can provide assistance in terms of treating the disease and suggest the most effective methods of therapy. Sometimes it is effective to use different technologies, due to which it is possible to correct various deviations. Is it possible to cure the disease by 100%? Definitely yes, if you turn to good specialists.

Non-surgical vision correction

The use of night lenses for the treatment of myopia

This method is non-surgical and is aimed at correcting visual function, involves the use of special rigid gas-tight lenses that are worn at night and removed in the morning. In the daytime, you can do without corrective means and at the same time boast good vision. Due to the reversibility of the effect, it is recommended to wear these lenses every night.

Contact lenses for the treatment of myopia

If the question arises of how to stop the development of the disease, then this method is not suitable. However, wearing contact lenses will provide a quick correction. The advantage of the method lies in its invisibility (lenses are not visible to the eyes) and convenience, since a person wearing lenses always has the opportunity to see objects located far away. The disadvantage is that, in the absence of concomitant treatments, the lenses lead to permanent deterioration of vision, and the patient begins to suffer from more severe myopia.

Glasses for the treatment of myopia

Eyeglasses are often prescribed for nearsightedness. The advantage of the correction method lies in efficiency, since in optics stores it will not be difficult to find a suitable model and correct such a phenomenon as myopia of the eye. However, not all people like to wear glasses due to their inconvenience, the impossibility of creating an image and other factors. So whether to wear glasses or not, each patient decides for himself.

No matter how difficult the situation is, it is necessary to contact a competent specialist who will prescribe a full-fledged treatment complex and identify changes in therapy. The implementation of an integrated approach to treatment guarantees a quick positive result and high efficiency of therapy.

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Often, people suffering from myopia turn to clinics that perform laser vision surgery. The disadvantage of this method of treatment is the risk of side effects. In the absence of complications, patients can improve their vision at home.

Visual acuity depends on the refractive power of the lens and. The clarity of the image is affected by the focus length, which in healthy people is 23 mm. With nearsightedness, a person has difficulty seeing distant objects. Due to the increase in the length of focus, the surrounding objects become fuzzy and blurry.

Diet for myopia

Experts have established a clear relationship between nutrition and human visual function. The patient's body with myopia needs natural products rich in protein compounds. The diet should include dishes from meat, eggs and fish, regardless of the method of preparation.

You can adjust the diet at home without resorting to the help of specialists. Plant foods are best consumed raw, as heat treatment destroys nutrients. It is possible to compensate for the deficiency of ascorbic acid through the use of wild rose. Dried fruits can be used at home to make a healing drink.

The symptoms of myopia are exacerbated if a person's diet is deficient in E, K, and B. Patients should avoid carbonated drinks and confectionery, which dramatically raise blood sugar levels. Nutrition for myopia should be varied and include foods that contain vitamins A, D. Visual function is affected by magnesium, zinc, copper and chromium. The progression of myopia may be associated with a decrease in immunity.

When signs of myopia appear, it is necessary to remove white bread from the diet. The patient menu should include:

• black bread;
• dairy products;
• vegetable fats;
• cereals;
• dried fruits.

With myopia, it is best to stick to fractional nutrition. Prohibited products include:

1. Meat products that contain a large amount of preservatives and salt (smoked meats, sausages).
2. Canned food and marinades.

An increased load on the eye muscles is created by coffee, cocoa and strong tea.

Patients will have to give up pastries and confectionery. Elevated sugar levels have a negative impact on visual function.

How to deal with myopia with gymnastics

Most often, myopia occurs, which experience an increased load on the eyes. To see the text written on the board, they have to put on. Their disadvantage is that the eyes quickly adapt to such conditions.

Experts have developed a special complex that helps strengthen the eye muscles. Thanks to regular training, patients can do without cardinal intervention. Exercises can be done at home.

Stretching

First of all, it is necessary to prepare the eye muscles for the load. Stretching exercise helps to relax the eye muscles and eliminate the symptoms of myopia. First look ahead and concentrate on a particular object. After that, look up and stay in this position for 2 seconds. Repeat the procedure for the objects located on the left and right.

Flexibility

The exercise was developed by experts to improve the flexibility of the visual muscles. The patient should turn the eyeballs clockwise for 1 minute. For convenience, we can imagine that a ball is moving around the face. Now you should repeat the same movements in the opposite direction.

Focus switching

The ability of the visual muscles to concentrate on a particular object affects the quality of the image. People suffering from myopia are forced to wear glasses. With the progression of the disease, the muscles hardly change focus and lose their previous activity. You can use the following method to fix the error:

1. Put the text in front of you in small print. As an object for training, you can use a newspaper or magazine.
2. Now close your left eye with your hand and concentrate on any letter for 2-3 seconds.
3. Repeat the exercise in the same sequence for the other eye.

Video exercises

Folk remedies with recipes

To eliminate myopia at home, you can use an infusion prepared from 2 tablespoons eyebright. Raw materials must be poured into a separate container and pour 2 cups of boiling water. The finished broth must be filtered with gauze and taken 3 times a day, 100 ml.

An effective remedy for myopia is a decoction of chamomile, which has a beneficial effect on the tissues of the eyeball. To get a healing infusion, pour 1 teaspoon of flowers with a glass of boiling water and leave for 30 minutes. The solution should be taken 3-4 times a day for 200 ml.

Positive change can be achieved through the use of blueberry juice. Before use, it must be diluted with boiled water in a ratio of 1: 1. Fresh solution is recommended to be instilled into the eyes 5 drops 3 times a day.

For the treatment of myopia at home, remedies prepared based on honey. The useful product contains a large amount of vitamins and trace elements that the eye muscles need. Grind a few apricots in a blender and add 2 teaspoons of natural honey.

Folk remedies for myopia should be used only after consulting a doctor.

Important! Before using medicinal components at home, you must make sure that there is no allergy.

Hardware treatment

You can strengthen the eye muscles at home with the help of a color pulse therapy device. "Vizulon". The device is used for various disorders of visual function, including myopia, hyperopia and.

This is what Vizulon looks like in gray

Before the procedure, you need to adjust the intensity and frequency of the color signal that affects the nerve endings. The device supports about 40 operating modes, which are selected individually for each patient. The pulses emitted by the device do not adversely affect the retina.

Vision can be improved by using vibration massagers that stimulate facial muscles. Patients can purchase a device called "Vibrotod". Before switching on, the device must be leaned against the outer corner of the eye. The vibrations will be transmitted through the skin to the muscles and stimulate the lens.

As a simulator at home, patients can use the device "Visotronic". The device helps to relax the eye muscles that work with increased stress. The simulator uses special lenses that relieve tension. With regular use of the device, patients' visual acuity improves.

What complications can occur in patients suffering from myopia

Progressive myopia can lead to serious consequences:

1. Some patients begin.
2. Glaucoma is accompanied by an increase in intraocular pressure.
3. Patients need surgical intervention when they occur.
4. The weakening of the eye muscles in myopia provokes the development of amblyopia.

Prevention

To avoid myopia, one should not read lying down, since the eyes in this position are at different distances from the text. Students who start studying educational materials in transport force the eye muscles to work in difficult conditions.

A person can prevent the development of myopia if he distributes the load correctly. One of the reasons for the deterioration of vision is non-compliance with the rules of ergonomics. In the process of working on a computer, people tense their eye muscles. With the appearance of fatigue and pain in the eyes, you should immediately take a break. Eye exercises should be done every 40 minutes of work.

Poor lighting has a negative effect on visual function. At home, it is necessary to use lighting devices that have a power of at least 60 watts. Make sure that the light in the workplace falls on the left side. Eye fatigue may be due to the fact that a person watches TV with the external lighting turned off.

Emmetropia - the focus is on the retina.
Myopia - the focus is in front of the retina.

Nearsightedness is a visual defect, which in professional medical terminology is called myopia. The term myopia comes from the Greek myops, squinting the eyes.

According to statistics, every third person on Earth suffers from myopia. This pathology of refraction of the eye is manifested by a decrease in distance visual acuity. Nearsighted people can't see distant objects well, but they can see close objects well.

In the vast majority of cases, myopia is due to a discrepancy between the refractive power of the optical system of the eye and the length of its axis. In myopia, parallel rays of light entering the eye are focused in front of the retina, and not on its surface, as happens in a healthy eye. Depending on the reasons why this happens, myopia is classified as follows:
. axial - when the refractive power of the optical media of the eye (cornea, lens, vitreous body) is within normal values, but its anterior-posterior size is greater than in the emmetropic eye
. refractive - when, with a normal anterior-posterior eye size, the refractive power of the optics is greater than in an emmetropic eye
. mixed - and the refractive power of the optics of the eye, and its anterior-posterior size exceed normal values
. combined - in cases where the refractive power of the optics of the eye and its anterior-posterior size do not go beyond the values ​​inherent in the emmetropic eye, but are combined in unsuccessful options.

Myopia happens congenital or acquired. Congenital myopia is rare, but is, as a rule, complicated, that is, it is accompanied by anomalies in the development of the eye and low vision (amblyopia) in the absence of correction during the development of the child's eye or a pathology that cannot be treated. Acquired myopia in recent years has become more common, in many cases, due to a number of reasons (for example, during the growth of the body), it can progress, leading to further deterioration of vision. Myopia is recognized as progressive if the decrease in vision every year occurs by one or more diopters.

There are three degrees of myopia: weak - up to 3 diopters, medium - from 3.25 to 6 diopters and high degree - over 6 diopters. The degree of myopia determines the number of diopters by which the refractive power of the eye must be reduced in order for it to become emmetropic.

Usually, myopia develops with increased growth of the eyeball, so the progression of myopia is observed mainly among young children, and the average age when the process stabilizes is approximately 18-20 years.

The development of myopia is facilitated by intense visual work at close range, which explains the very common visual impairment in children in the primary grades of school. Some scientific studies confirm the relationship of excessive accommodation tension with the progression of myopia. Their results underlie the conclusions that habitually excessive tension of accommodation stimulates the development of false myopia in a child, which turns into true myopia in the absence of timely treatment. In recent years, the continued increase in the volume of visual work, including the use of display equipment (computers, e-books, mobile phones, etc.) has led to an increase in the number of patients with accommodation spasm. According to many ophthalmologists, its long-term presence contributes to the growth of the anterior-posterior size of the eyeball and true myopization of the eye.

Physiological myopia does not subsequently lead to a significant loss of visual acuity, but if the process does not stabilize and the eyeball continues to grow, myopic disease occurs. With the greatest intensity, myopia progresses in students - usually at the stage of maximum loads on vision, which occur in parallel with the growth of the body. High myopia, and especially myopic disease, is a serious disease that leads to pathological changes in the vascular and retinal membranes of the eye, predisposing to complications such as, which can lead to complete loss of vision.

Prevention of myopia and its progression is of paramount importance, especially since this pathology leads to a decrease in vision at working age, and this entails extremely negative socio-economic consequences.

Recently, the prevalence of myopia among young people in Asian countries (in particular, Hong Kong, Taiwan, Singapore) has been growing rapidly, where 80-90% of schoolchildren are affected by it. For comparison: in the US and European countries, this figure is much lower, but also high - 20-50%. In recent years, there has been an increase in the incidence of myopia in schoolchildren: more than 50% of graduates of secondary schools and gymnasiums in Russia are currently registering myopic refraction.

Early onset of the disease may indicate an increased risk of developing high myopia. The first signs of myopia are squinting, low tilt of the head, the child's desire to sit closer to the TV. When working at close range, pain in the eyes, headache may occur. It is extremely important to detect vision problems in a timely manner, from the moment a child starts school, it is advisable to check visual acuity annually and, if it decreases, start treatment on time.

Reasons for the development of myopia

Heredity. There are different hypotheses about the mechanisms of development and progression of axial myopia. The proposed causes include excessive accommodation, inconsistent growth of the eyeballs in response to prolonged near visual work. Data from some studies indicate the presence of a genetic component among the factors of early onset of myopia. For example, it has been found that the risk of myopia in a child of nearsighted parents increases. In such children, even if they do not suffer from myopia, the length of the eyeball is greater than that of their peers with emmetropic parents. At the same time, myopic refraction may not be determined in them, since the increase in the anterior-posterior size of the eyes is compensated by the refractive media and structures of the eye (cornea, aqueous humor and vitreous body, lens). The probability of myopia inheritance in this case is 50-92%. However, no genes have been identified, the structural mutation in which is presumably the cause of myopia or allows assessing the family risk of morbidity, and the available data are contradictory. The mechanism of genetic inheritance and regulation of this disease is multifactorial and complex, and is still not fully understood.

Intraocular pressure. According to one hypothesis, an increase in the size of the eye in myopia may be associated with increased IOP. Its proponents argue that children with myopia have higher IOP than their peers with emmetropia. But this view is not supported by conclusive evidence. It is assumed that excessive accommodation or convergence can also increase IOP, the effect of which on the sclera leads to lengthening of the anteroposterior axis of the eye. However, studies have shown that in patients when viewing objects near, that is, when accommodating, intraocular pressure does not change or even decreases.

Accommodation. Opposite opinions are expressed regarding the influence of the accommodative ability of the eye on the progression of myopia. Some ophthalmologists believe that its decrease can contribute to the uncontrolled growth of the eyeball. In this case, wearing plus glasses when working near, facilitating the work of the eye, prevents the further development of myopia. Others, on the contrary, blame it, see the reason in the excessive amount of accommodation. Then wearing a positive correction for near work can only aggravate the situation.

A large delay in the accommodative response may also be associated with the development of myopia. It is determined during skiascopy. The accommodative response delay is the diopter difference between the distance from the eye to the object and the distance at which the light reflex is neutralized. An accommodative response delay of up to 0.75 diopters is considered acceptable. For example, when viewing an object from a distance of 25 cm, the patient requires accommodation of 4 diopters, and the reflex is neutralized from a distance of 33 cm to the patient's eye, that is, the eye accommodates only 3 diopters. The delay of the accommodative response in this case is 1 diopter.

Correction. There is an opinion that in the case when there is no optical correction of myopia and thus the quality of the visual image deteriorates, the so-called “deprivation myopia” (from Latin deprivatio - loss, deprivation) can develop. At the same time, some scientists argue that the correction of myopia in childhood can cause compensatory pathological growth of the eyeball.

Defocus. As you know, babies normally have a hyperopic refraction of about 3-4 diopters. The main focus in this case is behind the retina, which is one of the reasons for low visual acuity in young children. In response to the existing optical defocus, the eye begins to grow so that the light rays entering it are focused in the right place on the retina - in the macula. In this case, the refraction changes towards emmetropia - emmetropization occurs. There is convincing evidence of compensatory growth of the eyeball in response to the so-called lens-induced defocus in various animal species, in which it was achieved by the artificial creation of hypermetropia or myopia. Myopic defocus, in which a visual image is formed in front of the retina, causes inhibition of the growth of the eyeball in animals, but in humans it does not slow down, but, on the contrary, accelerates the progression of myopia.

The surface of the human cornea does not have a perfectly spherical shape and uniform thickness in all areas. This can lead to defocusing of visual images not only in the central region of the retina (macula), but also in its peripheral part (peripheral retinal defocusing). There is a hypothesis that these peripheral ametropias/aberrations also play a role in the development and progression of myopia. Recent animal studies have shown that the presence of a visual signal from the fovea may not be as important for the normal growth of the eyeball as from the peripheral part of the retina, which can regulate the process of emmetropization and cause myopia in response to an incorrect visual signal. Correction of peripheral aberrations can be achieved with specially designed contact lenses or with orthokeratology. Research is currently underway to determine the optimal peripheral myopic defocus, which will help to make the treatment used to correct it more targeted.

Environment. Most scientists agree that environmental factors contribute to the development of myopia. Studies have shown that children who spent more time outdoors had less myopic refraction, and those living in cities were more at risk of developing myopia than those living in the suburbs. It turned out that this can play an even more significant role than physical education or sports.

Myopia treatment

Despite the catastrophic spread of myopia in the world, there are currently no methods of treating this disease. All known means are aimed only at slowing down the progression of myopia, but none of them is able to restore emmetropic refraction to the eye or at least stop the progression. Therefore, at present, myopia is one of the most important socio-biological problems, and the search for ways to stabilize myopia is one of the main tasks of ophthalmology. To solve it, various methods are used, which can be divided into the following categories:
1) medicines:
- acting on accommodation (atropine, tropicamide, cyclopentolate, pirenzepine)
- antihypertensive drugs (timolol, labetalol, adrenaline, pilocarpine)
2) surgical intervention (scleroplasty)
3) optical correction ( , )
3) non-traditional methods (Bates method, training glasses, Chinese medicine)

Since myopia is formed, as a rule, in childhood, the closest attention is paid, first of all, to its prevention and prevention of progression in children and adolescents. Examinations are carried out, optical correction, medication, physiotherapy and surgical treatment are prescribed. All these methods are aimed at stopping the development of myopia, maintaining good visual functions and preventing retinal complications. Progressive myopia should not be ignored, since over time it can lead to irreversible changes in the central parts of the retina and a noticeable decrease in vision. Therefore, it is necessary at least twice a year to undergo an examination by an ophthalmologist, with a check of the fundus. Based on the results of these examinations, the choice of treatment methods will be based.

One of the simplest methods to slow the progression of myopia may be to increase the amount of time children spend outdoors. Although its mechanism of action has not yet been studied, this method can be recommended as a prophylaxis for the development of myopia.

Optical correction and treatment of myopia

Bifocals and multifocals. It has been suggested that bifocals or multifocals that provide clear vision at various distances can reduce retinal defocus and slow the progression of myopia. In clinical trials in the USA, Finland, and Denmark, various degrees of addition from +1.0 to +2.0 diopters were tested, and the sample ranged from 32 to 240 patients. No study showed a significant reduction in myopia progression.

Progressive glasses have a more attractive appearance than bifocals, and also allow you to see well at various distances. The COMET study (Correction of Myopia Evaluation Trial), which involved 469 children of different nationalities aged 6-11 years, revealed a statistically significant, but clinically insignificant decrease in the progression of myopia by 0.2 ± 0.08 diopters over three years. The main effect was observed in the first year of wearing glasses. Additional analysis showed that a more significant effect was observed in children with greater accommodation delay in combination with near esophoria (0.64±0.21 diopters), excessive proximity of the text to the eyes when reading (0.44±0.20 diopters) or initial a small degree of myopia (0.48±0.15 diopters).

Thus, clinical studies on the use of bifocals and progressive glasses have yielded negative results. Their use has no proven efficacy in slowing the progression of myopia. Moreover, when prescribing bifocals and progressive glasses, patients may find it difficult to adapt to wearing lenses of this design. However, wearing the right optical correction often significantly improves the quality of vision.

Glasses mode. The mode of wearing glasses can vary from wearing them all the time to using them only for viewing objects at a certain distance. A Finnish study of 240 schoolchildren aged 9-11 showed that differences in refractive error over three years were negligible among those who wore glasses permanently or for distance, and among those who did not wear them at all.

The same results were obtained by scientists from the United States after a three-year follow-up of 43 patients with myopia. At the same time, groups were compared who wore glasses constantly, who initially wore them only for distance vision, and then switched to a permanent wearing mode, who wore glasses only for distance vision, and also who did not use spectacle correction at all.

These data allow us to conclude that the mode of wearing glasses does not affect the progression of myopia.

Contact lenses. One simple, blind, randomized clinical trial in the United States found no statistically significant difference in myopia reduction in wearers (progression of 0.36 D/year) and monofocals (0.3 D/year). The disadvantage of these studies was that the measurement of refractive errors was carried out without cycloplegia, and 26% of the selected patients were excluded from the analysis.

The results of a three-year study of the effect of wearing rigid gas permeable contact lenses (RCL) on the progression of myopia compared with SCLs showed a statistically significant difference. The increase in the FGPL group was 1.56±0.95 diopters, and in the SCL group it was 2.19±0.89 diopters. The greatest effect was noted in the first year of wearing lenses. The curvature of the cornea was significantly less in those who used LHPL (0.62±0.6 diopters) than in those who used SCL (0.88±0.57 diopters). However, there were no differences in the change in the anterior-posterior size of the eyes in both groups. This led to the conclusion that the effect of slowing down myopia was associated mainly with the flattening of the cornea, the state of which is reversible after the abolition of FGPL, and their wearing itself does not lead to stabilization of myopia.

Although anecdotal reports suggest that the use of SCL leads to an increase in the progression of myopia (the so-called "myopic creep" phenomenon), clinical studies suggest that there is no significant difference in its progression between SCL and spectacle wearers. Wearing contact lenses has its advantages over glasses. They provide better peripheral vision, are not visible to others, give greater freedom of action. However, wearing contact lenses is associated with certain difficulties when it comes to children, and violation of the rules for their use can lead to the development of infectious and allergic complications.

Orthokeratology. The essence of the technique is to put on a contact lens of a special shape at night, which leads to a flattening of the cornea and provides clear vision during the day without glasses or contact lenses. It is assumed that slowing down the progression of myopia is due to the creation of peripheral retinal myopic defocus. As a result of wearing, flattening of the cornea in the central zone occurs, which increases the number of spherical aberrations. They, in turn, allow the image of objects of central vision to be focused in the fovea, while the image of objects on the periphery is focused in front of the retina. The researchers suggest that this may slow down the process of axial elongation of the eyeball, thereby slowing down the development of myopia.

The study in Hong Kong involved 35 children aged 7-12 who wore OK lenses and 35 who used monofocals (control group). A decrease in the growth rate of the anterior-posterior eye size was found in comparison with the control by 0.25 mm over two years. A disadvantage of this study was the retrospective selection of a control group.

Another study, which included 28 people, compared the growth of the anterior-posterior eye size per year in wearers of OK lenses and SCLs. In the first group, this indicator was less by 0.16 mm. But the number of participants was small, and the dropout was about 30%.

Preliminary results are available from a large SMART study (Stabilization of Myopia via Accelerated Reshaping Technologies), which evaluates changes in the depth of the vitreous cavity in the experimental group (wearing OK lenses) and the control group (using SCLs). Less progression of myopia was noted in the first group, however, no significant difference in the size of the depth of the vitreous cavity was found.

So far, there is insufficient evidence for the effectiveness of long-term use of OK lenses in reducing the progression of myopia. To evaluate the effectiveness of this method, it is necessary to conduct a full-fledged study.

Undercorrection of myopia. Only one blind randomized study was conducted, including 94 children. It compared the results of patients wearing a correction 0.75 diopters weaker than full correction and wearing glasses with a full correction. As a result, progression over two years in the group with complete correction was 0.77 diopters, i.e., less than in the group with undercorrection - 1.0 diopters. It is noted that undercorrection for the distance can bring the nearest point of clear vision closer.

The results of the above study are contradicted by data from two non-randomized studies that compared the progression of myopia in those who wore full correction and in patients with undercorrected myopia. The first concluded that complete correction does not slow down the development of myopia. In the second, the progression in the group with complete correction was 0.83 diopters/year, and in the group with undercorrection it was 0.47 diopters/year.

And yet, in slowing down the progression of myopia, a complete correction of ametropia is recommended. However, achieving it is not always possible with high degrees of myopia and individual intolerance to complete correction.

Medical and surgical treatment of myopia

Atropine. This drug was first proposed for use by Wells in the 19th century. In the course of an experiment conducted on animals, the effect of slowing down the growth of the eyeball during its use was noted and, as a result, the stabilization of myopia. Subsequent studies have confirmed the effectiveness of this drug in slowing myopia in children.

First of all, atropine causes paralysis of accommodation and reduces the influence of its excess tension on the progression of myopia. It also affects the release of growth hormone and dopamine, which can lead to slower growth of the eyeball.

Clinical studies conducted by Dr. Shih in 1999 and 2000 proved the effectiveness of the combination of 0.5% atropine solution and bifocals. The progression of myopia was 0.04 diopters per year, while in the group that used 0.25% and 0.1% atropine solution it was 0.46 diopters. At the same time, side effects in the form of intolerable photophobia occurred only in two patients who instilled 0.5% atropine, and did not occur at all in the other groups.

The effectiveness of the drug in slowing down the progression of myopia was also confirmed in randomized controlled trials in Taiwan and Singapore. One of them compared the effect of using a solution of atropine at various concentrations (0.1%, 0.25%, 0.5%). The 0.5% solution is recognized as the most effective.

The 2000-2003 ATOM study (Atropine in the Treatment of Myopia study), which included 400 children from Singapore aged 6-12 years, showed that instillations of 1% atropine at night for two years lead to significant reduction in the rate of progression of myopia (by 77%). In the experimental group, the anterior-posterior size of the eyes of patients practically did not change, while in the control group it increased by 0.39-0.48 mm. Atropine was well tolerated by patients. Conducted 2-3 months after discontinuation of the drug, electroretinography did not show significant changes in retinal functions. Side effects from the use of atropine included photophobia (photophobia) and decreased near visual acuity. Systemic side effects were not observed. In cases where the drug was instilled into both eyes, glasses with progressive lenses and photochromic coating were prescribed. After completion of treatment, there was a resumption of myopia progression in the experimental group by −1.14 ± 0.8 diopters (for comparison, in the control group it was −0.38 ± 0.39 diopters). However, over the three years of participation in the study (including two years of atropine), the resulting progression of myopia in the experimental group was less than in the control group. The spherical equivalent in the first group was -4.29±1.67 diopters, in the second -5.22±1.38 diopters.

Despite the results confirming the effectiveness of atropine, it remains to be accurately determined the mechanism of its effect on slowing down the progression of myopia, to establish and study in detail the possible side effects of its use, such as ultraviolet-induced damage to the lens and retina, the impact on the psyche, and others; determine the optimal concentration and duration of the drug. And until these questions are answered, when prescribing long-term therapeutic atropinization, it is necessary to choose between the effectiveness of a scientifically proven method of stabilizing myopia and the risk of side effects.

Tropicamide and cyclopentolate. Tropicamide causes relaxation of the ciliary muscle and blocks accommodation. It has a shorter half-life than atropine and therefore less severe side effects. One study, which involved 61 children aged 6-16 years, studied the effect of instillations of 0.4% solution of tropicamide on the course of myopia. As a result, there was a decrease in the degree of myopia progression by an average of 0.23 diopters (from 0.85 diopters to 0.62 diopters). Unfortunately, these data cannot be considered reliable confirmation of the effectiveness of this drug due to the lack of a control group in the study.

Another study involved 25 pairs of twins. Everyone was given a 1% solution of tropicamide instilled into their eyes, but one group wore and the other wore bifocals. As a result, there were no significant differences in the progression of myopia among these groups during the three and a half years of follow-up.

Cyclopentolate (cyclomed) has properties similar to tropicamide. In Taiwan, a study was conducted on the effectiveness of its 1% solution. A decrease in the progression of myopia by 0.3 diopters/year was found in comparison with the control group, but still less pronounced than after the use of atropine - 0.7 diopters/year.

Thus, there are currently no reliable data on the effectiveness of short-acting cycloplegics. According to the experience of using tropicamide in several thousand patients, no adverse effects were noted. However, the shorter duration of action of these drugs requires more frequent instillation for prolonged cycloplegia than with atropine.

Pirenzepine 2% gel. Pirenzepine belongs to the same group of drugs as atropine. However, its effect on receptors is more selective, and therefore it causes mydriasis and cycloplegia to a lesser extent.

Two multicentre, double-blind, placebo-controlled studies were conducted to evaluate the efficacy of this drug. The first was in Asia (Singapore, Thailand and Hong Kong) and involved 353 children aged 6-12. In the group where 2% pirenzepine gel was applied twice a day, myopia progression averaged 0.47 diopters/year, once a day - 0.7 diopters/year, in the control group - 0.84 diopters/year. The second study was conducted in the USA with the participation of 174 children aged 8-12 years. Its results were even more promising: in the group that used the drug twice a day, during the first year, the progression was 0.26 diopters, and in the control group - 0.53 diopters. When using a 2% pirenzepine gel for two years, myopia increased by 0.58 diopters in the experimental group, and by 0.99 diopters in the control group. It is alarming that due to side effects, 13 people (11%) dropped out of the experiment during the first year and one - the second, and only 84 of 174 patients agreed to continue participating in the experiment during the second year.

Although there is a strong case for the effectiveness of this drug in slowing the progression of myopia, its use is currently hampered by legal and financial obstacles.

Antihypertensive drugs. The effectiveness of two beta-blockers (timolol and labetalol) was studied in progressive myopia. Instillation of 0.5% or 0.25% solution of labetalol twice a day for children aged 6-14 years for 2-4 months led to a decrease in myopia by 0.25 diopters in 68% of cases. However, these data are difficult to interpret due to the absence of a control group in the study. Other similar studies also did not include a control group or were not randomized.

The results of clinical studies in Denmark comparing the use of a 0.25% solution of timolol and monofocal spectacle correction for two years showed no significant differences in stopping the progression of myopia, which was 0.59 diopters / year in the first group and 0.57 diopters /year in the second. At the same time, 5 children complained of a burning sensation and discomfort in the eyes, and one child developed bronchial asthma.

Studies have also been conducted on the effectiveness of epinephrine and pilocarpine. Summarizing all the known research results, we can conclude that at present there is not enough evidence to support the hypothesis that lowering IOP can slow down the development of myopia. At the same time, the use of the above drugs entails the risk of developing serious side effects, such as, for example, bronchospasm, in people predisposed to this.

Scleroplasty operations. Scleroplasty is a preventive surgical intervention developed about 80 years ago in Russia, aimed at preventing further stretching of the sclera and elongation of the eyeball. The essence of the operation is to artificially strengthen this shell with implants inserted into the region of the posterior pole of the eye.

Over the past time, several methods have been proposed for its implementation. However, most experts in Western European countries and the United States recognized scleroplasty as ineffective, refusing to use this method. The lack of convincing data on its safety and efficacy has led to the fact that scleroplasty is used to stabilize myopia, mainly in Eastern Europe and Asia.

Along with this, the results of studies conducted in Russia give certain grounds to talk about the effectiveness of the method. According to various data, a slowdown in the rate of progression of myopia is observed in 92-95% of cases. But the reliability of these data is not sufficient, because. the design (methodology) of research differs from modern world standards.

Reports began to appear in foreign sources about the successful results of applying the method of scleral filling of the posterior pole of the eye, which is similar in essence to scleroplasty. Patients showed stabilization of the growth of the eyeball in comparison with the control group, the absence of serious postoperative complications over a five-year follow-up period.

Obviously, the discrepancy existing in modern ophthalmology, up to diametrically opposed opinions, in assessing the effectiveness of scleroplasty does not allow us to give an unambiguous answer to the question of the appropriateness of using this method in the treatment of progressive myopia. It is necessary to conduct full-fledged studies in the framework of evidence-based medicine.

Non-traditional methods of treatment of myopia

NeuroVision. The term "perceptual learning" describes the process by which the performance of certain visual exercises leads to an improvement in visual perception. The flexibility of the visual functions of the brain has been described in various studies.

NeuroVision technology is a non-invasive, individually developed for each patient, available on the Internet, a training program based on visual stimulation. It contributes to the formation of interneuronal connections in the cortical substance of the brain. Although this method is indicated to improve visual acuity and contrast sensitivity in adults with mild myopia, it does not affect the refraction of the eye and its ability to accommodate.

A pilot study involving 31 children aged 7-9 years showed an increase in uncorrected visual acuity and contrast sensitivity. After a year of its use, the progression of myopia in this group was 0.5 diopters, which is less than the average progression rates for children of this age according to the Singapore Cohort Study of Risk Factors for Myopia (0.944 diopters).

Despite this, NeuroVision cannot be used to slow or prevent the development of myopia, as more research is needed.

EyeRelax. EyeRelax is a microscope-like device designed to improve vision in emmetropia, myopia, and even presbyopia, as well as to prevent vision deterioration in myopia and treat amblyopia. This method has no proven effectiveness in slowing down the progression of myopia.

Training glasses. They are glasses with black opaque lenses that have many small holes. Such glasses pass only coherent rays having the same wavelength and synchronously occurring maxima and minima of light intensity (or interference), and also increase the clarity of the image on the retina. Manufacturers assure that their use improves vision by 10-20 percent, and even up to the complete disappearance of myopia.

However, there is no evidence to slow the progression of myopia with these glasses.

visual training. Back in 1940, W. Bates suggested that excessive tension of the extraocular muscles could affect accommodation. The method is based on the use of a set of exercises, which, according to the author, relaxes the eye muscles, improves color vision and depth perception. It is believed that visual training can correct the regulation of the process of accommodation by the autonomic nervous system. However, the principles underlying the methodology are very different from the traditional interpretation of these issues by official medicine and the scientific understanding of the problems of the pathogenesis of refractive errors.

At the moment, the effectiveness of this treatment method has not been confirmed by clinical studies.

Chinese medicine. Eye exercises "Qi Qong" were developed in 1950 in China. They are based on the assumption that massaging various acupuncture points around the eyes improves blood flow, relaxes muscles, and reduces eye strain. Students in most Chinese schools do this set of exercises twice a day for 10 minutes.

In one non-randomized study of 295 patients in Beijing, balsam seeds were glued to certain points on the body with a patch, which exerted a pressure on these points. According to the researchers, this gave a significant therapeutic effect.

This method belongs to alternative medicine. Currently, there are no reliable data confirming its effectiveness in slowing the progression of myopia in the scientific literature.

Conclusion

The lack of convincing data on the efficacy and safety of certain methods makes it difficult to develop effective recommendations for the prevention and slowing of the progression of myopia in children and adults. This problem remains urgent, despite all the efforts made to solve it. It is necessary to conduct full-fledged large-scale studies to judge the effectiveness of various methods, as well as the presence or absence of side effects of their use.

In connection with all of the above, it is very important not to forget that myopia is a chronic disease that requires regular monitoring by an ophthalmologist. Only this approach gives a certain guarantee to avoid the occurrence of complications leading to low vision and even complete loss of vision.

The treatment of myopia is one of the most difficult areas in ophthalmology, because it requires a lot of clinical experience and knowledge in order to correctly determine the causes and type of myopia.

Correction of vision for myopia is necessary to restore good vision. Today, patients are offered a very wide choice of methods for non-surgical correction of myopia, surgical and laser methods for restoring vision. All methods have their advantages and disadvantages, we will consider each of them so that you have a clear picture of the treatment of myopia.

Laser vision correction is the most modern and safe way to correct myopia, which allows you to get rid of glasses and contact lenses. The essence of myopia laser treatment is to change the shape of the cornea. By making the cornea flatter, the laser reduces its refractive power. In simple terms, the laser beam creates a negative glass in the cornea, which acts like glasses for myopia - it scatters light. As a result, the image falls exactly on the retina and the patient sees perfectly into the distance.

Laser correction of myopia is the fastest, safest and most effective way to permanently get rid of distance glasses and contact lenses. The most modern method is Super LASIK.

To date, the following methods of laser correction of myopia and myopia with astigmatism are used:

• Super LASIK is the "gold standard" of myopia laser correction worldwide. Using the individual parameters of the patient's cornea, the laser creates eye optics that are close to ideal. Often, visual acuity can exceed 100%
• PRK is used for patients with thin corneas or low degrees of myopia, when there are contraindications for Super LASIK. The PRK method can also be carried out according to the individual parameters of the cornea obtained during the study on a topographer - personalized PRK.

There are more budget options for laser vision correction, such as conventional LASIK, which do not take into account the personal characteristics of the patient. Correction is carried out according to standard templates for all patients. We believe that if there is an opportunity, then it is better not to save on it.

Optical correction of myopia

Optical correction is a non-surgical method of restoring vision for nearsightedness that helps while you wear it. This correction is available in the following options:

• Glasses- the easiest and most versatile way to correct myopia. Scattering minus glasses weaken the optics of the eye and shift the focus of the image to the retina. Glasses can be with simple minus glasses for normal myopia, and with cylinders, if the patient's myopia is combined with astigmatism.
  Any shape and color of frames, hardening, anti-reflective and tinted lens coatings make glasses indispensable assistants in the correction of myopia.

For optical correction of vision in the treatment of myopia, glasses, contact lenses and orthokeratological night lenses are used.

• Contact lenses- modern materials and design of contact lenses make them almost imperceptible to the eye, which creates a comfortable environment for the patient. Vision in contact lenses is better than in glasses, they are used for any degree of myopia, including those with astigmatism.
  The use of disposable contact lenses is the safest for the eyes. In addition, lenses can be tinted and colored to create your unique look.
• Orthokeratology lenses These are overnight contact lenses. You sleep with special, custom-fitted lenses on your eyes. During the night, the lenses flatten the shape of the cornea, in the morning you take them off and walk all day with good vision without anything. This method is much less common than all the others, but it is very suitable for some patients, for example, athletes.

Surgical correction of myopia

With very high degrees of myopia, it is impossible to improve vision with traditional methods. Laser correction does not remove myopia anymore - 15 diopters, the glasses have very thick lenses, the lenses can also be uncomfortable.

In difficult cases with high degrees of myopia, myopia is treated with the help of operations - replacement of a transparent lens with an IOL or implantation of phakic lenses.

Surgical correction of vision comes to the aid of such patients, which is possible in 2 options:

• Removal of the transparent lens with the installation of an artificial intraocular lens (IOL) in its place is a well-established and effective method. An artificial lens can completely correct any degree of myopia. Premium IOL models also perfectly correct astigmatism, and also allow you to see without glasses at all distances.
• Phakic lenses are the second type of surgery for myopia, it is less common than the previous one. This is a kind of contact lenses for the lens. They are implanted inside the eye either in front of the lens or directly on it, while the natural lens remains in place.
  This method is quite young and does not have a long observation period, although the manufacturers claim that it is quite safe.

Treatment of myopia (myopia) at home

As such, the treatment of myopia at home, in our professional opinion, does not exist. Here it is more correct to talk about prevention, or about drug treatment, which the doctor prescribed to be done at home.

Myopia cannot be cured at home, but it is possible and necessary to prevent the progression of this disease

As you know, the most common causes of myopia are related to the wrong mode of visual stress, so home treatment for myopia may include:

• Arrangement of the workplace
• Proper lighting
• Breaks in visual work
• Visual gymnastics from sets of exercises for the eyes
• Proper sports activities for myopic patients - swimming, running

Folk remedies for the treatment of myopia (myopia)

Folk remedies for the treatment of myopia include eating various foods that have a fruitful effect on the structures and membranes of the eye, for example:

• Blueberries and carrots are very beneficial for the retina as they contain essential vitamins and antioxidants. The retina undergoes the greatest changes in myopia.
• Sea fish and vegetables contain polyunsaturated fatty acids, which are also indispensable for the normal functioning of the retina.
• Eating dairy products rich in calcium strengthens the connective tissue membrane of the eye - the sclera, which slows down the growth of the eye length.

Folk recipes and eating natural foods rich in vitamins, microelements and antioxidants nourish the vessels and retina in myopia, but do not reduce the length of the eye.

Also useful for strengthening the sclera of the eye are various jelly, cartilage, broths that strengthen the connective tissue.

After reading a detailed review of all the main ways to get rid of myopia and restore vision, you should clearly understand that only a doctor can prescribe the treatment of this complex disease. Left unattended by an ophthalmologist, myopia can progress, which will only complicate the process of restoring vision in the future.

Each method of correcting myopia has its own contraindications, which can only be identified by an experienced doctor, otherwise, serious problems or complications in treatment cannot be avoided.

We urge you to trust myopia restoration only to experienced experts in the field and reputable eye clinics so that your eyes receive the best treatment.

Nearsightedness (myopia). Treatment, prevention, consequences and complications

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The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Correction and treatment of myopia

Treatment myopia ( myopia) should be started as early as possible, as visual acuity will decrease as the disease progresses, which can eventually lead to complete blindness.

Can myopia be cured?

Developed true myopia is not resolved on its own and persists for the rest of life without medical intervention. At the same time, compliance with certain rules and restrictions will prevent further progression of the disease. With mild myopia, this may be enough for the patient to live a normal life, without limiting himself in anything. At the same time, with more pronounced myopia, it is necessary to use various methods of correction or treatment of the disease, since otherwise the risk of developing severe complications increases.

It should be noted right away that at the present stage of the development of medicine, it is possible to restore normal vision even to patients with a high degree of myopia, however, only with the timely start of treatment, until complications from the retina and other intraocular structures have developed.

For the correction and treatment of myopia, you can use:

• glasses;
• phakic lenses;
• laser correction;
• lens replacement;
• surgery;
• eye drops;
• medical treatment.

Glasses for myopia

The simplest and most affordable method of correcting myopia is wearing glasses with special diverging lenses. This method allows the patient to see normally into the distance, and also interrupts the chain of pathological processes in the eye that could lead to the development of complications. It should be noted right away that spectacle correction is indicated only for mild and moderate myopia.

The selection of glasses for myopia is carried out during the study of visual acuity. The patient sits down in front of a special table with letters of various sizes, and a frame with removable lenses is put on his eyes. Then the doctor begins to place lenses with a certain scattering power in front of the patient's eye, first weaker, and then stronger. For the manufacture of glasses, a minimum ( by strength) diverging lens that provides optimal visual acuity ( 0.9 - 1.0, that is, almost 100%). At the same time, the patient should easily read the letters in the 10th row of the table used to determine visual acuity.

It is important to note that indications for wearing glasses depend on the degree of myopia. So, for example, with mild myopia ( up to 3 diopters) glasses should be used only when viewing distant objects ( for example, they can be used by drivers while driving). While reading, working at a computer or watching TV, glasses should be removed, otherwise this will aggravate the severity of myopia and lead to its progression.

With moderate myopia, glasses can be used while working with objects located at a closer distance ( for example, being at a lecture in the classroom). At the same time, such patients usually do not need reading glasses. In this case, bifocal glasses can be an ideal solution, in the lenses of which two diffusing hemispheres are installed ( one above and one below), and the lower hemisphere should be 2-3 diopters weaker than the upper one. In this case, if it is necessary to look into the distance, the patient looks through the upper part of the lens, and when working with objects at a closer distance, through the lower part. This helps to prevent the progression of myopia, which can occur with the constant use of excessively strong lenses.

Contact lenses for myopia

Contact lenses can be used to correct mild, moderate, and high myopia. The main advantage of contact lenses over glasses is that they fit snugly to the cornea, forming with it almost a single refractive system. This allows for more accurate and permanent correction of myopia ( when using glasses, divergent lenses can move away from the eye or, conversely, approach it, which will affect visual acuity to a certain extent).

Also, lenses are recommended for use in anisometropia - a pathological condition in which the refractive power of the right and left eyes differs. Anisometropia up to 3 diopters can be corrected with ordinary glasses ( in this case, the refractive power of each lens must correspond to the refractive power of the eye, opposite which it will be installed). With anisometropia more than 3 diopters, preference should be given to contact lenses.

The selection of contact lenses is made according to the same rules as the selection of glasses. It should be noted that with a high degree of myopia, it is not recommended to carry out a complete correction immediately ( especially in children and adolescents), since the accommodative function of the patient's eyes may simply be underdeveloped. In this case, complete correction of myopia ( that is, the appointment of glasses that ensure that the patient reads letters from the 10th row of a special table) will slow down the further development of accommodation, thereby reducing the likelihood of a decrease in the degree of myopia in the process of growth and maturation. That is why at the first appointment of glasses it is recommended to correct myopia only by 80 - 90%, and in the future ( in the absence of positive dynamics) increase the strength of the lenses used until an optimal result is achieved.

Phakic lenses for myopia

According to the mechanism of therapeutic action, phakic lenses practically do not differ from contact lenses. The difference between them lies only in the fact that the phakic lens is installed not outside, but inside the patient's eye ( in the region of the posterior wall of the cornea). This technique allows to achieve a more accurate correction of myopia, and also eliminates a number of problems associated with the need to care for contact lenses and the need for their periodic replacement. However, it should be noted that in the case of progression of myopia, the phakic lens will have to be removed and a new one installed, therefore, this technique should be resorted to only in case of stable myopia. It is also recommended to select the optimal strength of corrective lenses for several months, using ordinary contact lenses for this.

Laser correction of myopia

Laser treatment is one of the modern and highly effective methods of eliminating myopia and restoring normal visual acuity. The essence of the method is to change ( decrease) curvature of the central part of the cornea with a laser. This leads to a decrease in its refractive power and the restoration of normal vision. Laser correction can be used for mild and moderate myopia, as well as for a high degree of myopia, not exceeding 12-15 diopters.

In preparation for the procedure, a thorough examination of the patient is carried out, including computerized keratotopography and other high-precision research methods. The obtained data on the state of the cornea, lens and eyeball are entered into a computer, which calculates the optimal parameters for laser correction. The procedure itself is also controlled by computer programs, and therefore the risk of accidental error is minimized.

The procedure for laser correction of myopia is performed within a few minutes. First, the patient enters a specially equipped room and lies down on a table, above which a laser device is installed. Drops of a local anesthetic are instilled into his eyes, which temporarily block all types of sensitivity. This is necessary so that during the procedure the patient does not blink and does not react to the actions of the doctor. Also, drugs that dilate the pupil are instilled into the eyes, which is necessary for the accuracy of the manipulations performed.

After the anesthetic has taken effect, the patient is asked to fix the head in a strictly upright position and not move it. To prevent accidental blinking during laser operation, the patient's eyelids are fixed with special clamps ( the procedure is painless, but may seem uncomfortable). Then the doctor once again checks the position of the patient's head, sets the laser device directly above the operated eye and asks the patient to fix his gaze on the blinking red light of the device.

When all preparations are made, proceed directly to the correction. First of all, a shallow circular incision is made on the surface of the cornea, after which its upper layer rises in the form of a flap. After that, the laser comes into play. According to a predetermined program, it deletes ( evaporation) a small layer of corneal tissue, reducing its curvature. This step of the procedure can take a few seconds or minutes. After the completion of the correction, the separated flap is returned to its place. At the same time, the patient must remain motionless for a few more minutes so that he ( flap) dried up and firmly fixed on the cornea.

After the operation, the patient's vision and general condition are checked, which take no more than two hours. The patient can recover home on the same day, but within 7-10 days he must strictly follow all the recommendations that the doctor will give him.

After performing laser correction of myopia, it is recommended:

• Instill antibacterial drops in the eyes, which the doctor will prescribe, strictly observing the dosage prescribed by him ( usually 1-2 drops in each eye for 3-5 days). This will prevent the development of infectious complications in the postoperative period.
• During the first 3-5 days after the procedure, sleep only on your back, as otherwise the risk of squeezing or injury to the eye increases ( e.g. hand or pillow).
• Visit a doctor 1, 3, 7 and 14 days after the operation to monitor its effectiveness and identify possible complications. The last control visit to the ophthalmologist is carried out one and a half months after the correction.
• If excessive redness occurs, if severe burning or pain occurs, or if vision deteriorates, you should immediately contact your doctor.

After performing laser correction, it is strictly prohibited:

• Wash eyes with dirty water. Patients are advised to refrain from visiting the pool, sauna, bath. You should also temporarily postpone swimming in open water, including the sea. Soap, shampoo or other personal care products should not be allowed to get into the eyes. Eyes should be washed only with warm boiled water, and wiped with sterile wipes, lightly touching them to the surface of the closed eyelids.
• Rub your eyes. In the postoperative period, increased lacrimation or mild burning sensation in the eye area is possible. It is strictly forbidden to rub your eyes or wipe them with dirty towels, handkerchiefs or other materials. In case of excessive lacrimation, the tear should be blotted with a sterile napkin, which should not come into contact with the eyeball itself. Failure to comply with this rule increases the risk of injury to the anterior surface of the cornea and infection.
• Do physical exercises. You should temporarily refrain from visiting the gym, as well as avoid any work related to lifting weights or excessive physical exertion.
• Use cosmetics. Women are forbidden to paint their eyes for several days, as cosmetics that accidentally get into the eye can lead to the development of adverse reactions. It is also recommended to refrain from using hairspray, as its sprayed particles can also get on the cornea.
• Be in the sun. Walking during the daytime should be avoided whenever possible, especially on sunny days. Sunglasses should be worn when going outside.
• Overstress your eyes. During the first day after the operation, it is forbidden to read, work at a computer or watch TV. Further ( over the next 7 - 14 days) this type of activity is allowed, but in a strictly limited amount ( no more than 15 - 20 minutes of continuous work or reading, after which you should take a short break and give your eyes a rest).

Lens replacement for nearsightedness

Lens replacement is indicated for a high degree of myopia, not exceeding 20 diopters. The essence of the operation is as follows. Under local anesthesia, the doctor makes a small incision in the area of ​​​​the edge of the cornea. Then, using a special ultrasound machine, the substance of the patient's lens is destroyed, that is, it turns into an emulsion, which is removed through the existing hole. Then in place of the lens ( in his capsule) an artificial lens is placed with the required refractive power ( usually less than the refractive power of the lens).

After the procedure, the hole made in the anterior eye wall spontaneously closes. The patient is given lifestyle advice over the next few days ( do not wash your eyes with dirty water, do not rub them with your fingers, and so on) and appoint dates for control visits to the ophthalmologist, after which they are allowed to go home.

Surgery for myopia

Surgical treatment is resorted to in severe forms of myopia, which continue to progress at a rate of more than 1 diopter per year, despite ongoing corrective and therapeutic measures. The main objective of surgical intervention in this case is to strengthen the posterior wall of the eyeball ( scleroplasty), which will slow down its stretching and the development of related complications from the retina and choroid. In order to strengthen the posterior sclera, various plastic substances can be used ( crushed cartilage tissue, special sponges, collagen, various gels and so on). They are inserted into the area behind the eyeball using a special curved needle.

The operation itself is relatively simple, has practically no contraindications and is performed within 1 day, after which the patient can go home. After the operation, eye strain should be avoided ( i.e. long, continuous reading or computer work) within 1.5 - 2 years, as this may contribute to the further progression of myopia. Other restrictions ( refusing to visit the pool, limiting physical activity, and so on) should be observed for 2 to 4 weeks after the procedure.

It should be noted that after the operation, myopia itself is not eliminated, but its further development slows down or stops. This technique allows you to stop the progression of myopia in 70% of children and 95% of adults. After scleroplasty, it is possible to use other techniques aimed at eliminating myopia ( use of glasses, lenses or laser correction).

Eye drops for myopia

Special drops can be used to treat ( cupping) false myopia. This condition is characterized by a spasm of accommodation, in which a person sees poorly far objects due to an overly pronounced and persistent contraction of the ciliary muscle ( which increases the refractive power of the lens).

The spasm of accommodation usually goes away on its own after the elimination of the cause that caused it. If this does not happen, the doctor may prescribe special drops that relax the ciliary muscle.

For the treatment of false myopia, you can use:

• Tropicamide drops- instill 1 - 2 drops into each conjunctival sac 4 - 6 times a day.
• Scopolamine drops- instill into each conjunctival sac 1-2 drops of a 0.25% solution 1-2 times a day.

The course of treatment usually does not exceed 1 week. It is important to remember that these drugs lead to pupil dilation and accommodation paralysis ( that is, the ciliary muscle relaxes and remains in this position during the entire period of action of the drug). At the same time, a person will not be able to see closely located objects, that is, he will not be able to read, work at a computer, and so on.

It is also worth noting that the use of these drugs can lead to an increase in intraocular pressure ( IOP) and provoke exacerbation of glaucoma ( disease characterized by a persistent increase in IOP). That is why they should be used only as prescribed by a doctor and after a thorough examination.

Vitamins for myopia

Vitamins are special substances that are not formed in the human body and enter it only with food consumed, but are vital for the functioning of almost all organs and systems, including the organ of vision.

Undoubtedly, all vitamins in their own way affect the condition and function of the eyeball, retina, optic nerve and other components of the visual analyzer. However, a deficiency of some of them can significantly impair the function of the organ of vision and even contribute to the development of various complications in progressive myopia.

Vitamins for myopia

Vitamin name	Mechanism of therapeutic action	Dosage and administration
Vitamin A(retinol)	It is necessary for the normal functioning of the retina, as well as for the adaptation of the eye in the dark.	Inside, 10 - 15 minutes after eating, 50 - 100 thousand International Units ( IU) per day.
Vitamin B1(thiamine)	Regulates metabolism in the body, and also ensures the normal conduction of nerve impulses along nerve fibers, including the optic nerve.	Adults are prescribed inside, 20-30 minutes after eating, 10 mg 2-5 times a day. Children under 3 years of age should take the drug 5 mg 3 times a week ( in one day), and children from 3 to 8 years - 5 mg 3 times a day. The course of treatment is 20 - 40 days.
Vitamin B2(riboflavin)	It relieves fatigue and tension in the eyes, and is also necessary for the normal adaptation of the eye in the dark.	The drug is administered orally, after meals, for adults - 5-10 mg 1 time per day, for children - 2-5 mg 1 time per day. The course of continuous treatment should not exceed 45 days.
Vitamin C(vitamin C)	Improves metabolic processes in the tissues of the eye, and also helps to strengthen the sclera.	Inside, 50 - 100 mg 3 - 4 times a day for 25 - 30 days in a row.
Vitamin PP(a nicotinic acid)	Expands small blood vessels, thereby improving blood supply to intraocular structures and preventing retinal damage in progressive myopia.	Inside, 5-50 mg 3 times a day after meals.

Medical treatment for myopia

Taking certain medications can slow down the progression of myopia, as well as prevent the development of a number of formidable complications.

Medical treatment of myopia

Name of the drug	Mechanism of therapeutic action	Dosage and administration
Calcium gluconate	Increases the strength of blood vessels, thereby preventing retinal hemorrhages in case of excessive stretching of the eyeball. Also, this drug increases the strength of the sclera.	Inside, 500 mg, 15-20 minutes before a meal. Children from 7 to 9 years old are recommended to take the drug 3-4 times a day, children from 10 to 15 years old - 4-6 times a day, adults - 6 times a day. The course of continuous treatment should not exceed 10 days.
Trental	Improves microcirculation in various tissues, including intraocular structures. Improves blood flow. It is prescribed for progressive myopia of a high degree.	Inside, after meals, 50-100 mg 3 times a day ( without chewing). The course of treatment is 30 days.
Rutin	Reduces the permeability of small blood vessels, thereby preventing the development of retinal hemorrhages.	Inside, 1 tablet ( 20 mg) 2-4 times a day for 1 month.

Prevention of myopia

Prevention of myopia includes a set of measures, rules and restrictions that should be observed to prevent the development of this pathology. If myopia has already developed, the implementation of preventive measures will not eliminate the existing defect, however, it will slow down the further progression of the disease and prevent the development of complications.

• To develop in children a "reading reflex" from an early age. The essence of this reflex lies in the fact that from 2 to 3 years old, a child should be taught to hold absolutely all objects ( toys, pictures, books, drawings and so on) at a distance of at least 30 cm from the eyes. In addition to preventing the development of myopia, this contributes to the formation of correct posture. If this rule is not followed, the child develops the so-called “bow head” reflex, when he tilts his head too low for reading or drawing. Over time, this "reflex" leads to the development of myopia, scoliosis ( curvature of the spine) and other pathologies.

• Maintain eye hygiene. Vision hygiene includes a set of measures aimed at creating optimal working conditions in which the visual apparatus will not overwork. One of the main hygiene measures in this case is the correct lighting of the workplace. While reading or working at a computer, you should illuminate not only the desktop ( e.g. with a table lamp) but also to create the so-called background lighting of the entire room. This reduces the strain on the eyes, as a result of which fatigue does not occur so quickly during prolonged work. Also, an important rule of visual hygiene is the observance of the distance from a person’s eyes to a book or monitor ( normally it should be 30 - 50 centimeters). That is why patients with myopia are not recommended to read in the supine position ( the distance from the book to the eyes is usually less than 30 cm).
• Eliminate visual fatigue. Visual fatigue can develop even in a healthy person if he sits at a computer for several hours in a row. In a patient with myopia, this process usually develops after 40-50 minutes. That is why when reading or when you need to work with objects at close range for a long time, it is recommended to regularly ( every 20 - 30 minutes) take a break for 5 - 10 minutes. During this break, you should put aside the work you are doing and walk around the room or go outside, while doing a few simple exercises.
• Read only in the right environment. Reading, as well as the use of phones or other electronic devices in transport or while walking, significantly increases the load on the eyes, as a result of which signs of overwork may appear after 15 to 20 minutes. That is why work that requires high visual concentration should be done only in a calm environment, sitting at a desk.
• Maintain correct posture in children. If a child begins to stoop from the first school years, this leads to a curvature of posture, as well as to the development of the “bowed head” reflex, which contributes to the progression of myopia. That is why from the earliest years the child should be taught to sit upright and only slightly tilt his head while reading. Children from 7 to 10 - 12 years old are also recommended to use special bookends.
• Observe the regime of work and rest. Intensive visual work for a long time can lead to overwork, even if a person regularly takes small breaks. That is why people who spend most of their working time at the computer or reading books are not recommended to work more than 8-10 hours a day. Also an important point is a normal, full-fledged eight-hour sleep ( for an adult), during which the restoration of the visual analyzer, the central nervous system and all other systems in the body occurs. It is worth noting that primary school children may need 8 to 9 hours of sleep a night to fully recover, while teens and young adults may need 7 to 7.5 hours.

Exercises ( gymnastics) for eyes with myopia

Special exercises for the eyes will help prevent the development of myopia or slow down the progression of the disease with already developed myopia.

The mechanism of preventive action of special exercises includes:

• relaxation of the ciliary muscle;
• improvement of microcirculation in the ciliary muscle;
• normalization of metabolism in the ciliary muscle;
• improvement of microcirculation in the choroid of the eye;
• improvement of blood supply to the retina;
• normalization of metabolism in the retina;
• improvement of microcirculation in the oculomotor muscles.

The list of exercises for myopia includes:

• Exercise 1. Starting position - sitting on a chair, leaning back in the chair and slightly tilting your head back. First, close your eyelids tightly and hold them in this position for 3 to 4 seconds, after which open your eyes as wide as possible. Repeat the exercise 3-4 times with an interval of 5-10 seconds.
• Exercise 2. Sitting on a chair look up without raising your head), then make a circular motion with the eyeballs ( first clockwise, then against it). Repeat the exercise 4-5 times.
• Exercise 3 Starting position - standing, legs together, head pointing forward. Stretch out both hands in front of you and fix your vision on your fingertips. During a slow breath, raise straight arms up, trying to follow their movement with your eyes ( the head must remain still). Then, while exhaling slowly, lower your hands down, also following your fingertips. Repeat the exercise 3-5 times.
• Exercise 4 Starting position - standing. Stretch your right hand forward and fix your vision on the tip of your index finger. Slowly bend your arm at the elbow and bring your finger closer to your eyes until it ( finger) will not begin to double. After that, you need to straighten your arm just as slowly. Repeat the exercise 3-4 times.
• Exercise 5 To complete this exercise, you will need a ball ( football, volleyball or any other) and a small playground near the house. The essence of the exercise is that a person must throw the ball into the wall from a distance of 5 - 8 meters, and then catch it. During such an exercise, tension and relaxation of accommodation occur, which improves nutrition and blood supply to the ciliary muscle.
• Exercise 6 Throw the ball into the basketball hoop from different distances ( first with one hand, then with the other, then with both). This exercise also stimulates the work of the ciliary muscle and the accommodation apparatus.
• Exercise 7 After a long work at the computer, you should go to the window, find the most distant point on the horizon and look at it for 1 - 2 minutes. This helps to relax the ciliary muscle and improve its blood supply.
• Exercise 8 Starting position - lying on your back, arms apart, head pointing straight up. During the exercise, you should slowly bring your hands together and cross them on your chest, and then return to the starting position. In this case, you need to follow your eyes first for one brush, and then for the other.

It is not necessary to perform all of these exercises daily. In breaks between work or during a break at school, you can complete 3 - 5 of them ( it will take no more than 2-3 minutes), which in itself will already reduce eye strain and prevent the progression of myopia.

At the same time, it is important to remember that the rapid implementation of a large number of exercises can lead to the development of various side effects, so it is best to start classes gradually, adding 1 new exercise every day. If this causes visual discomfort or other alarming symptoms ( e.g. eye pain, headaches), it is recommended to reduce the load or temporarily stop the exercise. If these symptoms do not go away within 2-3 days, you should consult your doctor.

Consequences and complications of myopia

Prolonged progressive myopia leads to a change in the shape of the eyeball and deterioration of the blood supply to various intraocular structures, which is the direct cause of the development of complications. It should be noted that complications most often occur with a high degree of myopia, while with a weak and moderate degree, the frequency of their development is much lower.

Myopia can be complicated by:

• retinal hemorrhage.

Amblyopia with myopia

Amblyopia is a pathological condition characterized by impaired visual acuity in one eye, even with correctly fitted corrective lenses. The exact reasons for the development of this condition have not been established. It is believed that amblyopia develops as a result of a functional lesion of various intraocular structures with long-term myopia. Treatment consists in eliminating the causative factor, as well as in symptomatic therapy.

Strabismus in myopia

With progressive myopia, divergent strabismus most often develops, in which the pupil of one eye constantly shifts somewhat outward, towards the temple. The reason for this phenomenon is that the accommodation apparatus ( adaptations for clear vision of objects at different distances) is closely related to the convergence apparatus ( convergence) eyeballs. When a person looks into the distance, the pupils of both eyes diverge slightly, allowing both eyes to focus on a distant object. When looking at a closely located object, accommodation stress occurs ( that is, an increase in the refractive power of the lens) and the simultaneous convergence of the eyes, which is necessary for focusing near vision.

With a high degree of myopia, the distance at which a person can clearly focus both eyes is limited. When such a patient tries to look at more distant objects, the accommodation apparatus relaxes as much as possible, but the images of objects still remain fuzzy. As a result, there is tension in the oculomotor muscles, which try to "tune" both eyes to a clear image. However, this cannot be achieved with myopia. Over time, the oculomotor muscles overstrain and pathological changes begin to develop in them, as a result of which strabismus occurs.

Correction of this condition may require considerable effort, but it should be started only after the correction of myopia, otherwise the treatment will be ineffective.

Cataract with myopia

The cause of damage to the lens in myopia is a violation of the metabolic process in it. This develops as a result of a violation of the contractility of the ciliary muscle, a violation of microcirculation in the ciliary body and a violation of its production ( ciliary body) aqueous humor, which normally provides nutrition to the lens and regulates metabolism in it. With a long-term progressing myopia, as a result of the described phenomena, turbidity zones begin to form in the center of the lens, that is, a cataract develops. The only effective treatment for this complication is surgery, during which the clouded lens is removed and an artificial lens is installed in its place.

Retinal detachment in myopia

With prolonged progression of myopia, the size of the eyeball increases, that is, it stretches. However, if the outer shell of the eye ( sclera) tolerates this process relatively easily, the retina ( retina, which is made up of photosensitive nerve cells) is less extensible, and its regenerative ( restorative) functions are extremely limited. Average ( vascular) the shell of the eye is also difficult to stretch. As a result, with an increase in the eyeball and stretching of the sclera, the retina initially stretches, which leads to malnutrition of nerve cells and the development of dystrophic processes in them. With further progression of myopia, the size of the eyeball can increase so much that the retina simply comes off ( flake off) from the wall of the eye. This will cause irreversible changes in damaged photosensitive cells, causing them to die, resulting in poor vision.

It is also worth noting that with the progression of the pathological process, damage to the blood vessels of the membranes of the eye is possible, resulting in retinal hemorrhage, which can also lead to the death of photosensitive nerve cells and visual impairment ( until the development of blindness).

Is myopia dangerous during pregnancy?

In the middle and end of the last century, many studies were carried out, the purpose of which was to find out whether