Eye diseases. Treatment of myopia (the most important)

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Eye diseases. Treatment of myopia (the most important)

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43. Treatment of myopia

The beginning of the prevention of myopia or its development should occur with the clarification of heredity and the determination of clinical refraction in children under one year old, but not later than 12 years of age. At the same time, there should be a differentiated attitude to the upbringing of the child, taking into account the state of his heredity and refraction. To do this, divide the children into two groups:

1) children with heredity aggravated by myopia, regardless of the detected size and type of refraction, with congenital myopia, with emmetropia;

2) children with farsighted refraction without heredity burdened by myopia.

Treatment of myopia can be conservative and surgical. Conservative treatment begins with vision correction with glasses or contact lenses.

It is necessary to have the convenience of glasses and their compliance with the configuration and size of the face, ensuring visual acuity in both eyes within 0,91,0-2,03,0 and the presence of stable binocular vision. Glasses should be used constantly. In cases of moderate or high myopia, bifocal glasses can be used in such a way that the lower hemisphere of the lens is weaker than the upper one by an average of 3,0 diopters. With high myopia and anisometropia (more than XNUMX diopters), correction with hard or soft contact lenses is recommended.

Treatment of rapidly progressive and severe myopia is a serious and often difficult task. The development of changes in the area of the retinal spot, the appearance of recurrent hemorrhages in the retina and vitreous body require the cessation of visual work, the creation of rest for the eyes, protection from harsh light and vigorous treatment. Both local and general treatment with calcium chloride, cysteine, preparations of Chinese magnolia vine, ginseng, mezaton, ethylmorphine hydrochloride (dionine), as well as subconjunctival oxygen injections, reflex therapy are recommended. It is necessary to prescribe rutin with ascorbic acid, riboflavin, thiamine, vitamin E, intermedin, adenosine triphosphoric acid, taufon, etc.

If correction with glasses or contact lenses, conservative treatment methods, as well as reflexology do not stop or significantly reduce the rate of progression of the process, then surgical treatment is indicated. The decision on the timing and method of surgery is made depending on a number of factors. The younger the child, the faster the annual (over two to three years) progression of myopia (more than 1,0 diopters per year), the more significant the increase in the sagittal size of the eye, the greater the indications for strengthening the eye capsule with scleroplasty. The choice of scleroplasty technique is made in accordance with the stage of myopia, i.e., the location and magnitude of morphological changes. It is necessary to take into account that the less myopia, the more effective scleroplasty. Prevention of rapid progression of myopia through scleroplasty is effective in almost 90% of cases. Within two to three years after surgery, myopia often increases by 1,0 diopters. versus 3,04,0 diopters. with a conservative method of treatment.

Author: Shilnikov L.V.

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