Nearsightedness (myopia)

Myopia (myopia) is a kind of ametropia in which parallel rays coming from distant objects are connected in front of the retina.

Etiology, pathogenesis. Myopia is most often caused by lengthening of the anteroposterior axis of the eye, less often by the excessive refractive force of its optical media. The development of myopia is facilitated by intense visual work at close range with a weakened accommodation and a hereditary predisposition. With weakness of the sclera, a progressive stretching of the eyeball occurs, which leads to changes in the vascular and reticular membranes. The weakening of accommodation and stretching of the sclera can occur under the influence of common infections and intoxications, endocrine disruptions and metabolic disorders.

Symptoms, course. Reduction of visual acuity, especially in the distance. Vision improves from attaching negative lenses to the eyes. When working at close range, there may be pain in the eyes, in the forehead and temples. Usually short-sightedness begins to develop in primary school classes. The degree of it in the future often increases gradually to 18-20 years of age. In some cases, the lengthening of the eyeball can take a pathological character, causing degeneration and repeated hemorrhages in the area of ​​the yellow spot, rupture of the mesh shell and its detachment, turbidity of the vitreous. With timely not corrected myopia glasses due to excessive work of internal rectus muscles and lack of impulse to accommodation binocular vision can be upset and appear divergent strabismus.

The diagnosis is based on the definition of refraction after instilling in the conjunctival bag of 0.5-1% solution of atropine sulfate 2 times a day (morning and evening) for 3 days.

Treatment. At a weak and moderate degree of myopia, as a rule, a full or almost complete optical correction for distances and weaker (for 1 2 diopters) lenses for working at close range. At a high degree of myopia - a constant correction, the value of which is for distance and for near is determined by portability. If the glasses do not increase the visual acuity, contact correction is recommended. Exercises for ciliary muscle in order to improve accommodative ability. Careful observance of visual hygiene in the school and at home (adequate lighting of the workplace, correct landing when reading and writing, etc.), systematic physical training and sports (as prescribed by a doctor!), Correct day regimen, frequent alternation of visual load with rest for the eyes (Every 30 to 40 minutes of exercise 10-15 minutes of rest, better in the fresh air). With the progression of myopia, drug treatment is prescribed: calcium gluconate 0.5 g 3-6 times a day for 10 days, ascorbic acid 0.05-0.1 g 2-3 times a day for 3-4 weeks, nicotinic acid 0,005-0,05 g 3 times a day for 20 days, a 0.05-0.1 gm halide for 2 times a day for 2-3 weeks. In case of chorioretinal complications, nihexin is 0.125-0.25 g 3 times a day for a month, the trend is 0.05-0.1 g three times a day after a meal for a month, riboflavin 0,002-0,005 g of 2- 3 times a day for 1-1.5 months, subconjunctival injection of 0.2% ATP solution at 0.2 ml daily or every other day, 10-12 injections; Theophylline by 0,05-0,1 g with nicotinic acid to 0,02-0,1 g 2-3 times a day 2-3 days in a row with a break for 2-3 days, only for 10-15 days; Tissue preparations, it is better to suspend the placenta by 1 ml of SC every 1 to 7-10 days, for a course of 3-4 injections (tissue preparations should not be administered during puberty).

For the prevention and treatment of hemorrhage - rutin to 0,02 g with ascorbic acid to 0,05-0,1 g 2-3 times a day or ascorutin 0,05 g 2-3 times a day for 3-4 weeks; Aminocaproic acid 0.5 g 2-3 times a day for 3-5 days, vikasol 0.01-0.02 g 2 times a day for 3-4 days. When the opacities appear in the vitreous body, intravenous infusions of 20 ml of 40% glucose solution with 2 ml of a 5% solution of ascorbic acid (20 infusions), then sodium iodide at 0.3-1 g 3-4 times a day for 10-15 days . With the rapid progression of myopia, sclerotherapy or ISU (sclerosing injection). With myopic astigmatism, anisometropia (when optical correction is not tolerated) refractive surgeries on the cornea are possible.

Forecast. With stationary uncomplicated myopia, eyesight is well adjusted. The visual prognosis worsens with the progression of myopia and the occurrence of complications.

Prevention. General strengthening of the body. Limitation of visual work at close range. Compliance with all requirements of visual hygiene. Training of the ciliary muscle with a weakened accommodation. Elimination of pseudomyopia.