孩子远视比近视更糟糕.doc

4 孩子远视比近视更糟糕快5岁的彬彬看画册时总是把画册拿到眼前来看，整本画册都快 要贴到小脸蛋了，妈妈看到后，叫他把画册放远一点看时，他却喊看不清，难道彬彬这是患了近视眼啦？妈妈把他带到医院眼科去看，谁知，医生却诊断为高度远 视。这可让彬彬的妈妈疑惑了，这明明就是高度近视的表现嘛，怎么医生却说是远视呢？这到底是怎么回事啊？儿童远视需要去治疗吗？如果要治疗的话，该如何治 疗呢？现代社会随着电子产品的出现，越来越多的青少 年患上了近视眼，因此，许多年轻的家长都知道要让自家的孩子预防近视，然而知道要让孩子预防远视的家长却不是很多，殊不知，远视眼比近视眼还要更糟糕。目 前，大多数人对远视眼的了解还比较少，甚至存在着种种对远视眼的错误认识，比如“配眼镜是近视眼的事”，“远视眼不影响学习和工作”，其实，这些观点都是 不科学的。如果将一个人的眼球看成是一个球体的话， 它有三个轴，即纵轴、横轴、矢状轴（即眼轴），一个正球体三个轴的长度是相等。婴儿出生后，由于眼球小、眼轴短而呈出一个扁球形，即远视型眼球，一直到 68岁的时候，才逐渐长成三轴长相等、约24mm左右的正球体，即正视型眼球，如果眼轴再继续增长，才成为近视眼。所以，一般来说，婴幼儿的近视眼仅约 1%1.5%，而90%以上的学龄前儿童其实都可能存在有远视，当然，这群有远视的学龄前儿童中绝大多数又都是生理性的，是眼睛正常发育的表现，然而， 也有20%25%的远视是异常的，或是病理性的，它是导致学龄前儿童视力低下及眼发育不良的主要原因，应引起年轻父母足够的重视。所谓远视眼，就是外界景物的反光进入眼内屈光系统后，焦点落在视网膜的后面，不能在视网膜上清晰成像，导致看远看近均不清楚的眼部疾患。不过因为儿童睫状肌 和晶状体的调节能力强，能使眼内屈光镜晶体变凸增加屈折光线力度，将视网膜后的焦点移在视网膜（底片）上，使轻度远视隐而不露，因而表现出了视力良好的假 象。但如果远视程度较深时，眼睛本身的调节力就很难弥补这种差异了，这个时候就会出现明显的视物不清。为了看清目标，只能缩短距离使影像目标放大，以此来 增加辨认能力，所以表现出貌似近视的姿态，我们称之为“远视型近视表现”，像这种情况时，我们应该要注意与近视眼相鉴别开来，切不可按近视去配眼镜，以免 加重了眼睛调节的负担。当远视眼患者眼睛的调节能力 被迫加强后，将会增加内直肌的兴奋性，如果其中一只眼睛的远视程度较严重时，为使该眼看清物景，这只眼睛就会继续增加调节力度，最后，导致这只眼睛成了内斜眼，许多斜视眼患者都习惯于用注视眼工作和学习，而将不使用的斜眼搁在一边，这样，时间一长，斜视眼又将会成为了弱视眼。另外又由于内直肌长期过度收 缩，致使肌肉长期处于疲劳症状而出现了眼球酸胀，眼眶疼痛，同时伴有头昏脑胀等，这个时候患儿可能会出现上课精神不集中，记忆力不佳，讨厌看书写字等，进 而影响了学习成绩。因此，如果家长发现自家的孩子看 电视距离近或歪头/眯眼，或诉说看书稍久就会感到字迹模糊、眼胀、头疼等时，建议立即带孩子去医院检查下，如果孩子被定为远视眼（含远视散光），则需要按 医生吩咐（包括配戴合适眼镜、弱视治疗等）进行适当的治疗，争取在7岁前将视力提升至正常，切不可拖延，以免形成斗鸡眼/对眼（内斜）和弱视，如已经患弱 视了，则更应该要及早治疗。对于儿童远视的治疗来说，年龄越大，治疗效果越差，想恢复正常就变得越困难，最终将可能会造成终身痛苦和遗憾。在治疗上，对于低度远视（即3个屈光度以下）的患儿来说，由于低度远视的小儿多为生理性远视，所以如果视力正常或接近正常，且无眼睛疲劳感，可不治疗（不配 眼镜）；有视力疲劳症状不伴弱视者，以消除不适症状为主要目的，可适量配镜，保留0.51个屈光度。对于中高度远视（即在3个屈光度以上）的患儿来说， 远近视力都会有不同程度的下降，大部分会伴随弱视甚至有视力疲劳症状，对这些患儿以治疗弱视和消除视力疲劳症状为主要目的，可分阶段配镜，但首次配镜以最 好视力的最高度数为原则，待适应3-6个月后再调整佩戴镜片度数。总之，对于儿童远视的问题，家长切莫等闲视之，也不能不经治疗就随意给孩子使用市面上的产品和药物，这些错误的观念和做法不但会贻误孩子的治疗，还会导致病 情变得更加复杂，家长们应该做的是，发现孩子眼睛有异常时，应尽快到正规医院进行系统检查并遵循医生的治疗方案，以免造成不必要的遗憾。Fast was the age of five when watching picture album always take picture album to the eyes to see, the whole album almost touched the small face, mother saw that, told him to put the books away, but he shouted couldnt see, dont was suffering from myopia is this? Eye to see the mother took him to hospital, but doctors diagnosed with highly far view. This allows mother was confused, and this is obviously the performance of high myopia, hyperopia is what the doctor said? How did this happen? Children hyperopia need to treat? If want to treat, how to cure cure?Modern society with the emergence of electronic products, more and more adolescents suffer from myopia, as a result, many young parents know should let their children to prevent myopia, know to let the child to prevent farsightedness of parents, however, not many, little imagine, far-sighted worse than myopia. Before, most people know about presbyopic is relatively less, even there are some wrong understanding of presbyopia, such as pair of glasses is myopia, far-sighted does not affect their study and work, actually, these views are not scientific.If a persons eye as a sphere, it has three axis, namely the longitudinal axis, transverse, sagittal axis (axis), a sphere is the length of the three axes are equal. After the baby was born, because of the small eye, eye axis short, is a spheroid, namely hyperopia type eyeball, until the age of 6 8, gradually become triaxial looks, about 24 mm is a sphere, such as the eye, in the face if eye axis and continue to grow, become near-sighted. So, in general, infants and young children myopia only about 1% 1.5%, and more than 90% of the preschool children are likely to have actually have farsightedness, of course, the vast majority of this group of preschool children with hyperopia is physiology sex again, is usually the sign of the normal development of the eye, however, there are 20% 25% of farsightedness is abnormal, or pathological, it is result in preschool children of the main causes of low vision and eye dysplasia, should cause enough attention young parents.A far-sighted, is the scene of reflective after entering the intraocular refractive system, focus on the retina at the back of the, unable to clear image on the retina, causing far look nearly all not clear eye disorder. But because the childrens ability to the ciliary muscle and the adjustment of the lens, can make the intraocular diopters crystal convex increase inflectional light intensity, to shift the focus of the retina after on the retina (film), make a quiet mild hyperopia, thus showing the false like good eyesight. But if the degree of farsightedness is deep, ten-fold increase of the eye itself is difficult to make up the difference, this time will appear clear vision is not clear. To see goal, can shorten the distance makes image target amplification, to increase the recognition, so seemingly myopia posture, we call it farsightedness myopia type, like this happens, we should pay attention to and short-sighted phase identification, must not follow myopia glasses, so as not to aggravate the burden of his eyes to adjust.When the eyes of presbyopic patients after adjustment ability to strengthen, will increase the excitability of the medial rectus muscle, if one of the severe degree of farsightedness eyes, in order to make the see clear content, this eye will continue to increase the adjustment dynamics, finally, lead to this eye became esotropia, many cross-eye patients used to use fixational eye work and learning, and will not use squints aside, in this way, time grows, cross-eye again will be the eye. Another due to excessive medial rectus muscle contraction, the muscle fatigue and appear for a long time the eye acid bilges, the eye pain, at the same time companion has giddy, children may appear not concentrate in class at this time, poor memory, hate to read and write, etc., into which affects the grades.Therefore, if parents find their children watching TV or a little closer/squint, or reading about slightly long will feel blur, eye swelling, headache, and so on, suggest to take children to the hospital immediately to check, if the child is classified as far-sighted (including hyperopic astigmatism), you need to press a doctor ordered (including wear glasses, right amblyopia treatment, etc.) for the proper treatment, for will be up to the normal vision before 7 years old, must not delay, so as to avoid formation of cross-eyed/eyes (oblique) and amblyopia, is already suffering from weak, more should cure of as soon as possible. For the treatment of children hyperopia, age, treatment effect is poorer, want to return to normal becomes more difficult, will eventually may cause pain and regret for life.On treatment for low hyperopia (3 d) for children, because of the low hyperopia children living more rational hyperopia, so if normal or near normal vision, and no eye fatigue, not treatment (no glasses); Symptoms of eye fatigue is not associated with reduced vision, in order to eliminate symptoms as the main goal, appropriate glasses, keep 0.5 1 diopter. For the high hyperopia (above 3 d) children, far and near visual acuity can have varying degrees of decline, are most amblyopia have vision fatigue, even