What are the aspects of myopia control in children that need to be paid attention to? Smart eye protection tips you need to know

At present, children often use computers to take lessons, even if they do not have to attend class, they will still often look at mobile phones and tablets, and the machine will not leave their hands, so many children are prone to myopia from an early age. A survey has pointed out that more than half of children aged 4 to 12 with myopia have used e-learning during the pandemic, resulting in a deepening of myopia, which is likely to cause deep myopia and more serious eye diseases in the future. Therefore, as a parent, you should teach your children to protect their eyes as soon as possible, do a good job in controlling children's myopia, to avoid the deepening of myopia, the following nine tips to share with you, remember to pay attention to the following when using smart mobile phones, computers, surfing the Internet or reading:

Every 20 minutes, let the eyes rest for a while

Keep plenty of light when reading

Keep a minimum line of sight of 30 cm

Turn the screen light to comfort

Do not look in bed/in the car

Increase the time spent on your daily outdoor exercise

Go to bed early and get up early every day

Eat more foods rich in vitamin A
Carrots, for example

Get a comprehensive eye exam early and regularly

Cataract cannot be judged by its appearance in the early stage, and can only be determined by ophthalmic slit lamp examination. In the initial stage, the crystal will gradually turn yellow from transparent, and even produce a dark brown color, which is commonly known as "ripening". The formation of cataract is caused by the mutation of the protein of the crystal, which causes the cloudiness to be irreversible, so it is currently impossible to recover the cataract by taking medicine or taking a potion.

Therefore, cataract surgery with intraocular lens replacement is the only effective treatment method in clinical practice.

Cataract symptoms.

The most common symptom of cataract is gradual blurring of vision, in general, the symptoms of early cataract are not obvious, and when the condition progressively worsens, patients will notice:

• Blurred vision, blurred images: Blurred vision caused by cataracts can make it difficult for patients to see things in front of them, especially in dark environments, and the elderly may fall easily due to poor vision.
• Glare: In sunlight or strong light, patients may feel glare or flashes of light, greatly affecting visual comfort in bright environments.
• Double shadows: Cataracts can cause double vision, making objects appear to overlap or separate, in which case older people may lose their balance while walking, increasing the risk of falling.
• Worsening myopia and thinking presbyopia is lessening: Patients with presbyopia may notice that they see more clearly when they see near objects and mistakenly think that the symptoms of presbyopia have decreased, which may actually be a change in vision caused by cataracts.

The initial symptoms of cataracts may not interfere with daily life, but over time, the cloudy part of the lens may spread, leading to more pronounced cataract symptoms and even blindness.

If you have cataract symptoms or notice any changes in your vision, make an appointment with our ophthalmologist immediately.

Cataract self-exam

Although a cataract self-exam is not a substitute for a professional eye exam, there are some simple observations and precautions that can help you detect the presence of underlying cataract symptoms. If you notice that you have a cataract aura, you should consult an ophthalmologist as soon as possible.

Here are some guidelines for cataract self-exams:

1. Do you feel that things near and far are always blurry?
2. Do you feel a sudden improvement in presbyopia?
3. Are you afraid of light?
4. Does it feel like things are ghosting, glare/halos?
5. Do you feel like you're looking at things with yellowish/less vivid colors?
6. Do you notice that your myopia is getting worse?

If you meet some of the above criteria, it may also be a precursor of cataract, please make an appointment with our ophthalmologist as soon as possible for professional examination and diagnosis, early detection and treatment of cataract can help maintain good vision and quality of life.

The most common cause of cataracts

The main cause of cataract is lens aging, which is a common eye disease in the elderly, but it can also be caused by other causes. Here are some other common causes of cataracts:

Diabetes.

Cataracts are thought to be the main cause of vision problems in people with diabetes. This is because diabetics have high levels of sugar in their blood, and high blood sugar can cause the lenses to swell and cloud, eventually forming cataracts.

trauma

Trauma or trauma to the eye can also be a cause of cataracts. This can include eye surgery, accidents, or other injuries.

inflamed

Inflammation of the tissues of the eye can lead to the development of cataracts. This can be due to an eye infection, eye disease, or other inflammatory disease.

Genetic

Familial inheritance may also be one of the causes of cataracts. If someone in the family has cataracts, other members may be more susceptible to cataracts as well.

Long-term use of steroids

Long-term use of steroids or use of steroids in high doses can increase the risk of developing cataracts. This is because steroids may deteriorate the crystal, affecting the clarity and normal function of the crystal.

High myopia

People with high myopia (200~300 degrees) are a high-risk group for cataracts. This is because the structure of the eye in people with high myopia has changed, which may increase the burden on the lens, which in turn leads to accelerated aging of the lens, which ultimately promotes the formation of cataracts.

Understanding the causes of these cataracts can help to better prevent and detect the early symptoms of cataracts for the best treatment period. If you have symptoms or risk factors for cataracts, you should consult your ophthalmologist as soon as possible.

Types of cataracts

Although the final treatment plan for cataract is minimally invasive, ophthalmologists will analyze and understand the causes and symptoms of cataract before surgery to determine which type of cataract the patient belongs to, so as to avoid missing the golden period of best treatment. Clinically, we broadly divide cataracts into 6 categories:

Core cataracts

Core cataracts are the most common type of cataract and usually occur in people around the age of 40, although people with high myopia may develop earlier. Core cataract is the lens that "matures" from the middle, and because this type of cataract develops slowly, most people will not have vision problems in the early stage, and even some people with presbyopia will feel that their presbyopia has improved. However, as cataracts mature, vision deteriorates rapidly, and the ability to distinguish colors is weakened due to the angle at which light enters.

Cortical cataracts

Cortical cataracts occur in the peripheral cortical layer, and this type of cataract is more common in people with diabetes. Cortical cataract is caused by the deterioration of the lens cortex, which causes the lens to be blurred and difficult to see. This type of cataract may be subtle at first, but it will gradually spread to the core and blurred vision will begin to occur.

Posterior cystic cataract

Posterior capsular cataract is formed by a number of small spots, mainly in the center of the posterior lens capsule, which is associated with posterior capsule aging or epithelial cell overgrowth. These small spots can block the light so that the light cannot reach the retina completely, causing the patient to see things in bright light to become blurry and not brightly colored, and at night to see problems such as glare and halos. These cataracts usually develop more quickly than other types of cataracts, especially in patients who take steroids for a long time or in large quantities.

Congenital cataracts

Congenital cataracts are cataracts that are present at birth. This can be due to genetic factors, maternal infection, or other problems with fetal development.

Secondary cataracts

Secondary cataracts are caused by other eye problems or systemic diseases. For example, diabetes, eye inflammation or the use of certain medications that contain steroids can cause secondary cataracts.

Traumatic cataracts

Traumatic cataracts are caused by trauma to the eyeball, including eye injuries, complications after surgery, or other accidents. These traumas can cause the lens to become cloudy, which in turn can affect vision.

If you feel abnormal vision or have symptoms of cataract, it is recommended to seek medical attention as soon as possible to identify the cause of the disease so as not to delay diagnosis and treatment.

Overfamiliarity to do cataract surgery sequelae

In the era before ultrasound lens emulsification, cataract surgery had a large wound, long suture time and recovery period, so the surgery was performed only when the lens was ripe and hard. At present, due to the popularity of "ultrasound lens emulsification", the success rate of cataract surgery is very high, the wound is small, and the recovery is fast.

In addition, once the cataract is too mature, it may also be complicated by glaucoma, iriditis, and severe blindness, which also increases the difficulty of surgery. Therefore, the best time for surgery is to replace the lens whenever the cataract symptoms are obvious or the vision is affecting daily life. But if the surgery is delayed until now, it will be too late.

Learn more about how to take care of cataract surgery

Presbyopia is a natural age-related phenomenon that causes people to lose the ability to see close objects clearly. Presbyopia occurs in everyone's life. Even if a person has perfect vision for a lifetime, they will begin to have difficulty focusing near objects, especially when performing tasks such as threading needles.

There is currently no cure for presbyopia. However, there are several treatments that can correct your vision. Depending on your condition and lifestyle, you may have the option of corrective glasses, contact lenses, laser vision correction or surgery to correct your vision.

Choose to wear reading glasses that fit

The upper part of the progressive lens is set to long distance, while the lower part is set to work at close range. However, they have no visible lines and provide a more gradual transition between the far and near sides of the prescription. Because myopic presbyopia has different wearing needs than farsighted aging, we do not recommend buying reading glasses by yourself.

(Laser Blended Vision) LBV presbyopia laser correction

It can make up for the shortcomings of monovision technology and create a "Blend Zone" for patients at the same time, so as to provide good near, medium and distance vision, without affecting the original chromatic aberration and stereoscopic acuity.

Cataract surgery

If the elderly have cataracts, they can choose one eye (main eye) to 0 degrees to facilitate viewing distant objects, while the other eye (non-main eye) can achieve 50 to 150 degrees of myopia (monocular vision correction). However, this method is not suitable for everyone. Some people find it impossible to adapt at all. Ophthalmologists often recommend trying a DSLR vision correction test with contact lenses before undergoing surgery. In addition, the placement of multifocal IOLs can also be considered to regulate the degree of presbyopia. However, the doctor needs to discuss possible side effects with the patient, such as the appearance of visual symptoms such as halos, glare, and low contrast sensitivity.

Presbyopia is a normal physiological phenomenon. In this case, your eyes gradually lose their ability to focus on close objects. When the human eye is about 40 years old, the function of the ciliary muscle and lens begins to deteriorate, so the focus slows down. This is because the ciliary muscle function deteriorates. At this time, there is about 100 degrees of presbyopia, and then it increases by an average of ten degrees every year, about 200 degrees of presbyopia at the age of 50, about 300 degrees at the age of 60, and after the age of 60, the degree will not deepen significantly.

Common symptoms of presbyopia are:

• When you are reading a newspaper or a book, you have to look a little further away to see clearly
• When looking at distant objects and then at close objects, you feel that focus slows down
• Reading is easy to get tired and your eyes feel sore 
• Difficulty reading small print
• Fatigue from tight work Brighter lights are needed when reading or working in close proximity 

Although this is a disease that affects everyone in the natural aging process, it has recently been found that there is a trend towards rejuvenation, especially in recent years, the use of tablets and mobile phones has increased, causing the ciliary muscle to tighten for a long time, resulting in poor lens regulation. According to statistics, the average increase in presbyopia patients under the age of 40 is two to three percent, and the situation is worth paying attention to.

How to prevent presbyopia 

There are currently no mature techniques for preventing presbyopia. However, you can help protect your eyesight by following these steps: 

• Check your eyes regularly. 
• Control chronic health conditions that can lead to vision loss, such as diabetes or high blood pressure. 
• When participating in strenuous exercise, wear protective glasses. 
• Eat foods that contain antioxidants, vitamin A, and β-carotene and eat a healthy diet. 
• Make sure you are using glasses of the correct prescription. 
• Use good lighting when reading.

Early intervention and treatment can benefit many eye diseases and conditions, so professional ophthalmologist consultation and examination should be sought.

High myopia is a relatively severe level of myopia. Myopia of 600 degrees or more is medically defined as high myopia. Its formation is related to changes in eye length. The normal length range of an eyeball in adults is 22-27mm. If the length is greater than 27mm, it will cause high myopia. In almost all cases, genetics is linked to the development of high myopia. If both parents are short-sighted, their children also have a greater chance of developing high myopia.  High myopia by itself usually does not lead to vision loss. However, people with this condition are more likely to develop several other vision-threatening conditions, including:  

• Retinal detachment 
• Glaucoma 
• Cataract 
• Retinal perforation or even detachment
• Macular lesions and bleeding

Even if laser vision correction surgery reduces the degree of high myopia, complications cannot be avoided

In recent years, some patients with high myopia have undergone laser vision correction surgery, and the degree of myopia has decreased, so they have forgotten to continue to pay attention to the problems that may be caused by the original high myopia. But in fact, laser correction only changes the curvature of the cornea, not the length of the eyeball. Therefore, all complications arising from long eyeballs will not be reduced by laser correction!

High myopia causes cataracts to deepen rapidly

In a recent study of cataract and cataract surgery outcomes for high myopia, researchers found that cataracts in highly myopic eyes occur more quickly than in normal eyes. In addition, highly myopic eyes have a higher prevalence of comorbid diseases and complications such as retinal detachment.

Therefore, people with high myopia must have a routine eye exam so that their ophthalmologist can monitor the health of their eyes and look for these symptoms as well as signs of other complications of severe myopia.

Does myopia deepen without glasses?

There is a misconception that parents advise their children to delay the start of glasses to minimize the time they spend wearing glasses, or to wear glasses with a lighter prescription to avoid the progression of myopia.

Dr. Tong points out that the opposite is true, a pair of glasses of the right prescription can help easily identify things that are far away.

Conversely, using an inappropriate lens prescription can lead to amblyopia, which may worsen your myopia.

If you experience headaches or eye strain while using your glasses, it could mean that your glasses are too high or too low.

Of course, many people question: "I almost always wear glasses, but the prescription is really getting deeper?"

If this happens, it may be due to the continuous development and elongation of the child's eyeball, and the natural increase in degree.

In addition, if you have poor eye habits and stare at the screen for a long time, it will induce myopia.

Therefore, when using a mobile phone or tablet to read, remember to do it under sufficient light source, reduce the luminosity of electronic products, adjust the font size and line spacing to moderate to reduce eye fatigue;

How not to make myopia worse?

Dr. Tong recommends that you rest for 20 seconds every 20 minutes of reading, looking at something 20 feet away, so that the ciliary muscle can rest and relax.

There is no evidence that exercises such as massaging the area around the eyes can help delay the progression of myopia in children.

On the contrary, pressing too much on the muscles around the eyes will cause the intraocular pressure to rise.

In addition, people with high myopia are at risk of retinal detachment if they turn their eyes quickly.

Parents misunderstand that laser vision correction surgery reverses myopia.

In fact, increased myopia means longer eyes, which is no way to retract the eyeball back to the length when your child's vision is intact.

Laser vision correction changes the curvature of the cornea, allowing light to focus on the retina without the help of glasses or contact lenses.

The eyeball can still continue to grow.

So it's better for parents to let them participate in outdoor activities.

Studies in Australia have found that children who are outdoors for up to 14 hours a week can help promote dopamine secretion and slow down the formation of myopia.

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What is pseudomyopia? Fake myopia eye drops can tell the difference between real and fake myopia — Sometimes it's not really myopia, but it occurs suddenly after overusing the eyes

高度近視威脅視力, 白內障症狀不可忽視 — 高度近視本身通常不會導致視力下降。 However, people with this condition are more likely to develop several other vision-threatening diseases

Myopia rate among children in Hong Kong

The myopia rate among Hong Kong children increased with age, from 6.3% of pre-school children to 18.3% at age 6 and 61.5% at age 12, while the prevalence of myopia among adults aged 21-30 was 84.7%.

If you develop deep myopia, the risk of developing different eye diseases, such as retinal detachment, cataracts, glaucoma, and yellow class disease, will be greatly increased when you grow up.

The purpose of childhood vision correction is not to stop the progression of myopia completely, but to slow down the progression of myopia.

Myopia prevention

If a child increases myopia by 100 degrees per year, it is considered to be treated for treatment, and the ideal rate of myopia progression for children is within 50 degrees per year.

Low-dose atropine eye drops are commonly used by ophthalmologists in recent years as the first line to slow myopia in children.

Research by CUHK has shown that this method can effectively slow the progression of myopia in children by up to 60%, and side effects are rare.

IN ADDITION, A MULTI-ZONE FORWARD OPTICAL DEFOCUS (DIMS) SPECTACLE LENS DESIGNED BY THE HONG KONG POLYTECHNIC UNIVERSITY WAS SHOWN TO SLOW THE PROGRESSION OF MYOPIA IN THE PARTICIPATING CHILDREN BY UP TO 60%.

Spectacle lenses consist of a "central optical zone" to correct refractive errors and a "multi-zone continuous myopia defocus" that extends around the central area to the perimeter of the lens.

WHEN THE WEARER IS VIEWING OBJECTS AT DIFFERENT DISTANCES, DIMS SPECTACLE LENSES PROVIDE CLEAR VISION AND MYOPIA DEFOCUS TO CORRECT VISION AND HELP SLOW THE PROGRESSION OF MYOPIA.

FINALLY, CHILDREN CAN CHOOSE TO WEAR ORTHOKERATOLOGY LENSES (OK LENSES).

It uses special rigid orthopedic contact lenses and tear tension to change the curvature and shape of the cornea.

Children who receive orthopedic vision correction only need to wear orthopedic lenses at night to sleep, but the advantage is that they do not need to wear glasses in the morning.

The only concern is that children unconsciously pinch their eyes during sleep and cause corneal damage or infection, so this method is only suitable for children over 8 years old who have good self-care ability.