Pay attention to the treatment of myopia in summer vacation (July 8, 2002)
Professor Yan Xiaoming, doctoral supervisor, director of ophthalmology department of Peking University First Hospital, member of ophthalmology branch of Chinese Medical Association, specializes in the diagnosis and treatment of various corneal diseases, excimer laser for myopia, corneal transplantation for corneal blindness and phacoemulsification. (Left)
Associate Professor Li Haili and Deputy Chief Physician of Ophthalmology of Peking University First Hospital went to Hong Kong to study the new progress of refractive surgery and ophthalmic surgery, introduced excimer laser to treat myopia, hyperopia and astigmatism, and was good at corneal and ocular surface diseases, cataracts, corneal transplantation and refractive surgery. (right)
Hello, audience friends! This is CCTV's live program "The Road to Health". Today we will talk about the treatment of myopia.
Moderator: Ms. Zhang from Fengtai District, Beijing. My children are always used to reading and writing on their desks, and often play in front of the computer for 3-4 hours without listening. Will this cause myopia?
Yan Xiaoming: A very important reason for myopia is long-term close work. If you play computer for a long time and read and write incorrectly, it is easy to cause myopia. Usually, you should pay attention to not playing computer for more than an hour at a time, and pay attention to posture and light when reading and writing.
Moderator: Mr. Song from Zhengzhou, Henan, 23 years old. My eyes are all 900 degrees. Now I want to wear a new pair of glasses in the summer vacation, but there are many kinds of glasses on the market. I wonder which is better for the eyes, glass lens or resin lens? Which one should I choose in my case?
Li Haili: There are two kinds of glasses lenses in the market, namely, glass lenses and resin lenses. These two kinds of lenses have their own advantages and disadvantages. The disadvantage of glass lens is that it is hard and fragile, and the deeper the degree, the heavier it is. Its advantages are abrasion resistance and cheapness. Resin lenses are soft, light and not easy to break, but they are expensive and wear-resistant. Due to the deep myopia, it is recommended to match a pair of lightweight resin glasses.
Moderator: Mr. Zhang, Shunyi District, Beijing. My wife and I are both nearsighted. The child is 9 years old and nearsighted 1 year. Is this hereditary? Can buried ear beans be treated?
Yan Xiaoming: There are two reasons for myopia, one is heredity, and the other is environmental factors. Research shows that if both parents are nearsighted, children may be more likely to be nearsighted. The so-called environmental factor is that long-term close work is closely related to the occurrence of myopia. In addition, environmental pollution, unbalanced nutrition and careless eye hygiene are all related to the occurrence of myopia. Ear bean burying is a kind of traditional Chinese medicine therapy, which also includes eye exercises, magnetic therapy, massage and so on. These methods have a certain effect on pseudomyopia, but have no effect on true myopia with organic lesions. Attention should be paid to changing children's bad habits and learning environment.
Moderator: Usually people think that the degree of myopia is directly proportional to the depth of knowledge. Is this correct?
Yan Xiaoming: Due to the intensification of social competition, children's academic burden is getting heavier and heavier. Some surveys show that the incidence of myopia in China is gradually getting younger. The survey shows that the incidence of myopia in primary school students is 22%, that in middle school students is 55%, that in high school students is 70%, and that in college students is 86%. In addition, it also shows that the incidence of myopia in urban areas is higher than that in rural areas, and that key schools are higher than ordinary schools. All these situations indicate long-term close study and work.
Moderator: How can we find out that children have myopia at an early stage?
Li Haili: For those children who are too young to express themselves in words, parents should pay attention to whether they like to squint, rub their eyes often, look too close and so on. For older children, you can ask them if they can't see the blackboard clearly, or if they are tired from watching it for a long time. Once there is a problem, parents should pay enough attention and take their children to the hospital to check their eyesight. Generally speaking, children can check their eyesight at the age of 3-4. First of all, we should teach them to recognize visual targets, check their eyesight regularly, usually once every six months, and make full use of holidays to check their eyesight.
Moderator: What is pseudomyopia? Some people say that pseudomyopia will get better after a period of rest. Is this correct?
Yan Xiaoming: Simply put, pseudomyopia means that it may be blurred to see the distance, but it is normal to see the near distance. To judge whether it is pseudomyopia, you should go to the hospital for mydriasis optometry. If myopia disappears or becomes hyperopia after mydriasis, it is pseudomyopia.
Li Haili: The purpose of mydriatic optometry is to paralyze the ciliary muscle, relieve the eye accommodation function, and make optometry accurate and reliable. Children under 12 have strong accommodation ability, so they need to choose a slow and strong atropine mydriasis. They should take medicine three days before optometry, and their eyesight can only be restored 2-3 weeks after mydriasis optometry. It is best to use holidays for mydriatic optometry. 12. If it is the second optometry, that is, when changing glasses, if the vision changes little and the astigmatism is not obvious, you can choose rapid mydriasis optometry. Vision can be restored 5-6 hours after mydriasis optometry on the same day. People over the age of 40 can optometry without mydriasis because of their decreased accommodation ability.
Compere: Can computer optometry replace mydriatic optometry? How accurate is it?
Yan Xiaoming: Computer optometry cannot replace mydriatic optometry. Children often have a higher degree of optometry because of their strong eye adjustment ability. The younger the child, the greater the deviation of myopia. So it is not suitable for children to do computer optometry. When people reach middle age, the degree measured by computer optometry is close to that measured by manual optometry due to the decline of adjustment ability. Usually going to the hospital for optometry is generally a combination of computer optometry and manual optometry.
Moderator: Ms. Wang from Haidian District, Beijing, aged 26. I am a primary school Chinese teacher. I have been wearing contact lenses for 8 years, and I feel much better. I often feel dry eyes, and sometimes it is not convenient to go out for a few days. Can you tell me the operation to treat myopia?
Li Haili: Corneal refractive surgery is usually used for surgical treatment. Corneal refractive surgery can be divided into three different methods, as shown in figure: 1. RK surgery is a radioactive keratotomy, which cuts the cornea radially and symmetrically with a knife to reduce the refractive index of the central cornea and change the diopter of the eye. 2.PRK surgery is excimer laser keratectomy. First, the corneal epithelium is cut off at the center of the cornea, and then the laser beam is aimed at the center of the cornea for cutting. According to the degree of each person, the corneal epithelium can heal 3-5 days after operation, thus changing the diopter. 3, LASIK surgery, the principle is the same as PRK surgery, but the method is different. LASIK surgery is to make a corneal flap on the corneal surface with a special V-shaped keratome, then cut the corneal surface with laser, and then put the corneal cover back in place after cutting. LASIK is the safest surgical method commonly used at present.
Moderator: Which operation is better, PRK or LASIK?
Yan Xiaoming: Comparison between PRK and LASIK.
PRK laser surgery
The adaptation range is mild to moderate myopia, myopia within 1500 degrees, hyperopia within 600 degrees and astigmatism.
There was no obvious pain 3-5 days after operation.
Vision recovered slowly and quickly (the next day)
The medication time was 4 months 1 month.
Moderator: Why do women have LASIK surgery? Is it for aesthetic reasons?
Li Haili: According to the data at home and abroad, most of these operations were performed by young women, accounting for more than 1/3. In addition, some people are unwilling to wear contact lenses because of the big refractive difference between their eyes, and some patients usually choose surgery because they join the army or choose some special majors.
Yan Xiaoming: Any operation has certain risks. The safety of LASIK surgery is FDA-certified and very safe. In order to ensure safety, a detailed examination should be done before the operation. For example, people with thin corneas or dry corneas are not suitable for surgery. In addition, it is required that the laser used for surgery must be very precise. And the skill of the surgeon is also the key to success.
Li Haili: LASIK requires patients to be over 1, under 18 and under 55. 2. Strongly ask to take off your glasses. 3. In recent two years, the degree of myopia is relatively stable, and the annual development degree is within 50 degrees. 4. Corrected vision is greater than or equal to 0.5. 5. The correction range of myopia is 100 degrees to 1500 degrees, and the correction range of hyperopia is 100 degrees to 600 degrees, and astigmatism within 600 degrees can be corrected at the same time. 6. Patients with different diopters.
Moderator: What preparations do patients need to make before operation?
Yan Xiaoming: The following preparations should be made before the operation: 1. People who wear contact lenses should take them off at least two weeks before surgery. 2. Drop anti-inflammatory eye drops regularly three days before operation, 6-8 times a day. 3, surgery should be chosen during the period of good health, avoiding surgery when you have a cold or fever. 4. Don't wear makeup on the day of operation, and don't use skin care products and hair care products with pungent smell, so as not to affect the operation effect. 5. Don't wear a pullover on the day of operation.
Moderator: Is it possible to have vision deterioration after operation?
Li Haili: After LASIK, some people will suffer from vision deterioration. The so-called regression means that the refractive power decreased after LASIK for a period of time compared with the last review. This will not happen to everyone who has an operation. Related to personal factors, such as 800 degrees or higher intraocular pressure, people are prone to regression. You can order some hormones after surgery to prevent vision deterioration.
Moderator: What problems should I pay attention to after the operation?
Yan Xiaoming: Don't use your eyes too much the day after the operation and in the short term. General patients will not have symptoms such as fear of light and tears after operation. If something accidentally gets into your eyes, don't rub your eyes yourself. You must go to the hospital for treatment.
Moderator: Mr. Liu from Jinzhou, Liaoning, my child 15 years old, has been nearsighted for 6 years. His eyes have the same degree, both of which are 550 degrees, and his left eye has astigmatism of 200 degrees. He wore a pair of OK glasses last year, and now his eyesight has improved to 1.0. I heard that someone has a problem wearing OK glasses. I'm afraid to keep wearing them, okay?
Yan Xiaoming: OK lens is a kind of hard contact lens, which corrects myopia by flattening the middle of cornea. There are some defects in this processing method, including 1. Because patients usually wear it at night, the cornea is prone to hypoxia. 2. If the patient wears it improperly, it is easy to cause corneal epithelial abrasion and infection. 3, correct vision instability, must be worn for a long time. The patient's specific situation is not suitable for wearing OK glasses. Even if it is suitable, you should wear it after a comprehensive examination in the hospital. In 200 1 year, China's drug administration issued a document to restrict the production and operation of OK glasses.
Moderator: Ms. Dang, from Jiangxi, is 35 years old. I used to be 800 degrees nearsighted. After myopia surgery, myopia disappeared, but hyperopia of 150 degrees reappeared. What's going on here?
Li Haili: The phenomenon that myopia becomes hyperopia is called overcorrection. If this phenomenon occurs in a short time after operation, it is called temporary overcorrection. Don't worry about this situation. After the wound healed, tissue hyperplasia and edema subsided, and normal vision could be restored. If hyperopia is still greater than 100 degrees after one year of operation, this situation is called actual overcorrection and can be solved by secondary operation.
Moderator: Mr. Liu from Shanxi Province is 25 years old. I have a high myopia of 2800 degrees. I want to take off my glasses. The doctor said that the degree of myopia is too high, so I can't correct my eyesight. Can I have an operation? What is the approximate cost of the operation?
Yan Xiaoming: This patient is not suitable for LASIK surgery, because LASIK surgery thins the cornea by laser. The higher the degree, the more tissues need to be cut, and the remaining corneal thickness may not be enough, which is unsafe for patients. In addition, the patient's corrected vision is not very good. As mentioned above, the corrected vision of the surgical object should be above 0.5. If the patient has no problem in examining the fundus, he can choose another surgical method, such as putting contact lenses in his eyes. At present, this kind of surgery is rarely carried out in China and needs to be customized abroad. The cost of monocular surgery is about 1 ten thousand yuan, and the cost of LASIK binocular surgery is about 8000 yuan.
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