I'm going to join the army this year, but I'm nearsighted. I don't want to see the laser yet.

The treatment of myopia can be divided into surgical treatment and non-surgical treatment.

(1) The best treatment for myopia-wearing a pair of appropriate glasses.

The hyperopia vision of myopia patients is reduced to varying degrees, and the scenery a few meters away is hazy. When you go to the mall, you can't see the displayed goods and price tags clearly. Walking on the road, you can't recognize the acquaintances coming across, don't say hello to people, and are considered to be putting on airs and ignoring people; The students misread the exercises on the blackboard and made mistakes in their homework. All these make people with myopia miserable. The only way out of this hazy world is to wear glasses. However, some patients with myopia would rather not see things clearly in the distance and squint their eyes to worry than wear glasses. The reason is that it is inconvenient for young people to wear glasses, and they are afraid of bumping and falling. Others think that wearing glasses is not good-looking and hinders beauty. I'm afraid the deeper I wear my glasses, the less I want to take them off. Put your glasses in your pocket and don't wear them until you are far away. In fact, this idea is not correct. Myopic people can't see distant objects clearly because the parallel light entering the eyes can't be focused on the retina. Although you can see things at close range, your eyes are too close to the book when you study, which is easy to cause eye fatigue. Children are nearsighted, inactive, inattentive in class, unclear in academic performance on the blackboard, and sometimes squint. If you put on a pair of suitable myopia glasses, you can move the image in front of the retina backward so that it falls right on the retina, so that you can see things immediately. This will bring great convenience to work or study, so why not? As for the inconvenience and ugliness of wearing glasses, these concerns should be dispelled. Wearing glasses is to correct vision defects and reduce eye fatigue. I got used to it after wearing it for a few days, and there was nothing wrong with it. Can myopia get deeper and deeper after wearing glasses? We said generally not. Whether myopia develops has nothing to do with wearing glasses. It is true that some people with myopia have deepened their myopia after wearing glasses for a period of time and have to re-optometry glasses. What is the reason? Some people feel that everything is fine after wearing glasses. When writing or reading, you are still close to each other, do not pay attention to eyesight hygiene, read for too long, or read while lying, walking or reading in a place with insufficient light. After a long time, it also leads to vision fatigue and myopia. Some young people think wearing glasses is a burden. They wear it for a while, don't wear it for a while, wear it when they are happy, don't wear it when they are unhappy, or only wear it when they are looking at the distance, so that their eyes are often in an unstable state of adjustment and gradually deepen myopia. Others don't have mydriasis optometry or the optometrist is inexperienced, which makes the glasses unsuitable. Some people just buy a pair of glasses in the store or wear them with other people's glasses. Even if you wear glasses, you can barely see it, but it won't last long. Over time, their eyes will feel sore and uncomfortable. Not only can vision not be improved, but it will deepen myopia. Therefore, people with myopia must go to the hospital for mydriasis optometry or ask an experienced optometrist for optometry. Besides sleeping and washing their faces, they should wear a pair of suitable glasses all day. Remember never to borrow someone else's glasses blindly.

How can I get a pair of accurate and comfortable glasses?

Teenagers with myopia must go to the hospital to check their eyesight and have mydriasis optometry. Mydriatic optometry, also known as objective optometry, is the application of drugs (such as 2% atropine, 1% atropine eye drops, etc.). ), the ciliary muscle is completely paralyzed, the pupil is dilated, and the adjustment function is lost. In this way, the interference caused by accommodation and pseudomyopia caused by it are eliminated, and the refractive state of the eyes is determined objectively and accurately. Then, grind the glasses according to the prescription determined by optometry, and match the ground glasses with the pre-selected glasses frame. Usually, at some time after mydriasis optometry, a re-examination is needed. Observe whether there is dizziness, nausea, blurred vision, distorted vision or unstable walking. Through re-examination, the objective mydriasis optometry results are organically combined with the subjective post-test results to ensure the high quality of glasses fitting to the greatest extent and achieve the best effect of correcting vision.

Some young people don't want to mydriatic optometry, for fear that their eyes will be uncomfortable after mydriasis and they can't see things nearby clearly. In fact, this kind of worry is unnecessary. Pharmacologically, drugs used for mydriasis optometry (such as atropine, homatropine, etc. ) is an anticholinergic drug. Its function is to relax pupil dilators and ciliary muscles, showing pupil dilation and accommodation paralysis. The effect of this medicine is only temporary. As long as the drug is no longer used, the paralyzing effect of the drug will naturally disappear after a certain period of time. If mydriatic optometry is not used, excessive degree or pseudomyopia may be detected due to the adjustment of ciliary muscle and lens. Therefore, adolescents with myopia should have mydriasis optometry and choose appropriate myopia glasses. Only when the following conditions exist:

(1) Patients with shallow anterior chamber, high intraocular pressure or upper limit of normal value suspected of glaucoma should wait for detailed medical history and definite diagnosis before optometry. It is absolutely forbidden for glaucoma patients to use mydriatic optometry.

(2) Severe lens and vitreous opacity and corneal leukoplakia. Because the examination is difficult, mydriasis optometry is meaningless.

(3) The pupil adhesion is serious, and the pupil can not be dilated normally after using mydriatic drugs, so there is no need for mydriatic optometry.

(4) People over 40 years old generally do not use mydriatic optometry because the adjustment ability of ciliary muscles is weakened.

At present, the main material for making spectacle lenses is optical glass, also called optical spectacle lenses. There is also optical resin glass.

Optical glass has the following advantages.

(1) has high transmittance, and the transmittance can reach 92%. If one or more magnesium fluoride antireflection films are coated on the lens surface, the light transmittance of the lens can reach 99.2%.

(2) Absorb ultraviolet rays to avoid the harm of ultraviolet rays to eyes.

(3) Chemical stability and corrosion resistance of chemicals such as acid and alkali resistance.

(4) Constant refractive index The accurate refractive index is 1.523, which is constant and accurate, and the diopter after treatment is accurate.

Optical resin is characterized by light weight, hardness close to that of glass and refractive index of 1.490. The new high refractive index thermosetting resin has a refractive index of 1.600, and its surface is coated with superhard film and non-reflective multilayer film, which enhances the wear resistance, the light transmittance can reach 98%, and it can block ultraviolet rays. Glasses made of optical resin are not easy to break, not easy to damage the eyeball and have high safety, so they have been widely used at present. Crystal is hard, wear-resistant and heat-insulating, but its ultraviolet absorption performance is worse than that of optical glass, and its light transmittance is also poor. It is not an ideal material for making glasses, nor is it an eye-catching product.

The processing of lens luminosity must be accurate, the grinded lens should be consistent with the prescription, and the diopter error generally does not exceed the ministerial standard issued by the Ministry of Light Industry of China. The distance between the optical centers of the two glasses should also be consistent with the distance between the pupils of the two eyes.

What we see and wear every day are glasses that are placed on the bridge of the nose or clamped on the ears, which is very inconvenient. There are also some people who have high myopia in one eye and low myopia in the other; Or one eye had cataract surgery and the other eye was normal. Because the refractive error of both eyes is too large, one eye sees big things and the other eye sees small things, and the visual center can't fuse them together, so ordinary glasses can't be worn. In recent years, a kind of glasses, commonly known as contact lenses, has appeared. It is a lens directly worn on the surface of corneal tear layer, and there is a liquid mirror composed of tear between cornea and lens. In this way, a new refractive system consists of lens, liquid mirror, cornea and other refractive substrates of the eye. Medically called contact lenses.

Contact lenses can be divided into hard contact lenses and soft contact lenses according to different lens materials. Hard contact lenses are polymethylmethacrylate-based plexiglass, which is hard and difficult to deform. Suitable for correcting high astigmatism and keratoconus. Its disadvantage is that it has poor air permeability and cannot penetrate oxygen, carbon dioxide, water and metabolic substances, so it is uncomfortable to wear. Soft contact lenses are made of methacrylic acid or silicone rubber, which are soft, breathable and can absorb moisture. It can be used to treat corneal diseases, but it is easy to deform and not suitable for astigmatism eyes.

According to the way of wearing, there are long-term wear and daily wear. Those who wear contact lenses overnight for more than two consecutive days are long-term wearers, including weekly wearers, monthly wearers and even those who don't take them off. Long-term wear of lenses should be worn for several days before taking them off and cleaning them once. Protein and other substances in tears are deposited on the lens, and eventually permanent turbid spots appear, which affects the clarity of the lens. What is more serious is bacterial growth, which is prone to infectious keratitis. In view of this, the long wearing method is no longer advocated at present. The daily wear type can be worn continuously for no more than 14 hours, and must be removed every night for necessary cleaning, disinfection and safekeeping, and then worn on the same day. Because of the daily wearing method, the lens will be removed for cleaning every night, and there will be no permanent turbidity spots on the lens. Daily cleaning and disinfection greatly reduces the possibility of infectious keratitis. Therefore, we must adhere to the daily wear mode, and it is not advisable to wear it for a long time. Contact lenses have advantages that ordinary glasses don't have, and solve problems that ordinary glasses can't solve. Because the contact lens is closely attached to the cornea and can rotate with the rotation of the eyeball, no matter the eyeball rotates in any direction, the light always enters the eye through the center of the lens, eliminating the defects of prism effect and oblique astigmatism caused by the edge of ordinary glasses. Contact lenses are ground according to the curvature and diopter of the patient's corneal surface, which clings to the cornea, making the lens, tear layer and cornea form a new refractive stroma and participate in the formation of a complete optical unit. The curvature of the lens surface can be polished at will according to the refractive requirements. It replaces the irregular curvature of the corneal surface, effectively eliminates the irregular astigmatism of the cornea and narrows the size gap between the eyes. Because the contact lens is close to the cornea, the distance from the center of the eyeball is shortened. After the light passes through, the image formed on the retina is similar to that without the lens, and things will not be enlarged or reduced. It avoids the shortcomings of ordinary glasses and is most suitable for people with large anisometropia or aphakia in one eye. Contact lenses are thin and light, and stick to the surface of cornea, which is much more convenient than thick and heavy lenses of high myopia glasses. In addition, it also brings great convenience to people with special needs (such as actors and athletes). It is precisely because contact lenses have so many advantages that ordinary glasses do not have, so their scope of application is much wider than ordinary glasses. Contact lenses are more suitable for the following situations:

(1) High myopia, anisometropia over 3.00D, mixed astigmatism or irregular astigmatism of cornea. In particular, some literary or sports workers can choose to use contact lenses because of their professional needs and wearing ordinary glasses will affect their work or competition results.

(2) Some people have undergone monocular cataract surgery. Because of anisometropia, they can't wear ordinary glasses, but only contact lenses.

(3) Soft contact lenses can be used to treat corneal edema, exposed keratitis and keratoconjunctivitis sicca. Painting the periphery of the lens with the same color as the iris and keeping the central part transparent can eliminate the photophobia symptoms of albinos and patients with iris defect. In recent years, there are also contact lenses specially made for therapeutic purposes. Some drugs are soaked in contact lenses and can be released into conjunctival sac regularly. This not only reduces the number of drug spots and saves the dose, but also keeps the dose in the conjunctival sac at a high concentration all the time, thus achieving better therapeutic effects, such as treating glaucoma and corneal ulcer.

Although contact lenses have many advantages, they also have certain limitations, and not everyone is suitable to wear them. There are three taboos in wearing contact lenses.

* Self-condition eyelid entropion, incomplete closure, dacryocystitis, dry eye, severe trachoma and chronic conjunctivitis, keratitis, diabetes, hypertension, sinusitis, etc.

Environmental conditions: sandstorm, dust, volatile chemicals and seriously polluted environment.

* Those with poor personal hygiene habits and poor self-care ability, such as primary and secondary school students, who cannot insist on serious care.

Although contact lenses are improving, their chemical properties, comfort and safety have reached an ideal level, and they have been widely used. With the popularization of application and long-term clinical observation, some complications have appeared in different degrees. Such as corneal injury, conjunctival inflammation and corneal infection.

Over the years, curing myopia and taking off glasses have become the urgent desire of people who wear glasses because of myopia, expecting the arrival of the nemesis and gospel of myopia and realizing the dream of taking off glasses. It is in this situation that some therapeutic instruments and drugs have appeared to cater to parents and teenagers' eagerness to take off their glasses, which are said to be more than 95% effective.

The methods used to treat myopia include acupuncture, plum blossom needle, ear acupuncture, electroacupuncture, low-frequency current, ultrasound, acupoint laser irradiation and so on. These therapies have a certain effect on the prevention of myopia and the treatment of pseudomyopia, but they have no definite effect on true myopia. In recent years, countless medical personnel and pharmaceutical experts engaged in ophthalmology have made beneficial research on the treatment of myopia, and formulated some drugs for the treatment of myopia, such as Xiatianwu Eye Drops, 1% Dibazole Eye Drops, Danshen Eye Drops, Safflower Eye Drops, Myopia 1 Eye Drops, No.2 Eye Drops and so on. These eye drops can relieve ciliary muscle spasm to a certain extent, and have a certain effect on mild myopia, especially juvenile myopia and pseudomyopia. The vision of some patients can be improved, but the curative effect is not consolidated. In a word, the effect of drugs on myopia is not ideal at present. As for the therapeutic instruments for myopia, such as magnetic therapy glasses, vision care instrument, vision care instrument, vision correction instrument, physiotherapy mirror, eye mask, magic mirror, etc. There are many kinds of advertisements, which frequently appear in various propaganda media, and their advertising words are extremely exaggerated. What's more, some of them have won national patents, which is really attractive. Many people with a try-and-see attitude have to spend money and time, and finally have to wear glasses.

(2) Surgical treatment of myopia

Indications for surgical treatment of myopia: 18 years old or older; Myopia diopter is more than 2.50D; Wear glasses to correct normal vision; There is a need to take off glasses; No active keratopathy or keratoconus; No history of diabetes or collagen disease.

As mentioned above, myopia can be treated by acupuncture, drugs and other methods, but the more reliable treatment is to wear myopia glasses. However, whether wearing glasses or contact lenses, there are some insurmountable shortcomings. Can you correct your vision through surgery? In the 1980s, some advanced countries in the world successively carried out operations to treat myopia-radial keratotomy, or PRK for short. This surgical method originated in Japan. After that, ophthalmologists in the former Soviet Union and the United States improved and perfected the surgical methods and equipment, greatly improved the accuracy of radial keratotomy, accumulated a lot of clinical experience, and achieved good therapeutic effects. Especially for young adults over 20 years old, the success rate of surgery is over 95%. For high myopia of 6.00D- 10.00D, most of them can take off their glasses, and for high myopia above 10.00D, the degree of myopia can also be reduced. It also has a certain effect on myopia astigmatism. Radial keratotomy has opened up a new way to treat myopia. Myopia surgery was carried out late in China. After radial keratotomy spread to China in the mid-1980s, it became popular all over the country, and hospitals of all sizes went into battle, including foreigners from Russia. Due to the lack of surgical instruments and clinical experience, postoperative corrected vision is not ideal and there are many complications. In recent years, some large hospitals in China have purchased advanced surgical instruments-gold diamond knives from abroad. This kind of knife is not only sharp, but also thin (only 0. 1 nm), with scale display, and the depth of incision can be adjusted at will. Postoperative corneal scar is thin and uniform in width, which has less chance of irregular astigmatism. Therefore, it is very popular with myopia patients, especially those with high myopia.

In addition to radial keratotomy, there are many new surgical treatments for myopia abroad, and some large hospitals in China have also carried out these operations one after another.

(1) Topkeratology: Use allogenic cornea, grind different diopters on a special machine tool after freezing treatment, then stratify the central part of the patient's cornea, embed the special corneal lens into the corneal lamina, and sew around to achieve the purpose of correcting myopia.

(2) Corneal grinding: using your own cornea, do lamellar resection from the center, treat the excised corneal tissue at low temperature to make it hard, then grind it on a finishing lathe as needed to achieve the required diopter, and then sew it back to its original position.

(3) Laser keratectomy: excimer laser (wavelength 193 nm) radial keratectomy. The incision is more precise and accurate, the correction effect is better, and the surgical complications are greatly reduced.

(4) Posterior scleral reinforcement: This operation uses medical silicone sponge, allogenic sclera or fascia lata as protective reinforcement material to reinforce the fused sclera, support the posterior pole of eyeball, and prevent the posterior pole from progressive expansion and axial length extension.

To a certain extent, the degree of myopia is reduced. At the same time, the formation of new blood vessels after operation can enhance the blood circulation of choroid and retina, excite visual cells, activate bioelectricity and improve vision. This operation is suitable for controlling the progressive extension of the axial length of high myopia, especially for teenagers with high myopia whose axial length is more than 26 mm and their myopia diopter is deepened and developed by more than 1.00D every year.

Surgical complications Myopia surgery has solved the problem of glasses fitting for high myopia to a certain extent, and also met the needs of people engaged in special occupations, which has been welcomed by myopia patients. However, no matter how simple and safe the operation is, it is by no means foolproof. Moreover, myopia surgery is not a very mature surgery, and many aspects need to be improved. At present, the main surgical complications are:

(1) Intraoperative corneal perforation complicated with cataract and bacterial endophthalmitis;

(2) Corneal ulcer, delayed wound healing and corneal endothelial injury;

(3) Irregular astigmatism caused by postoperative scar and epithelial cyst seriously affects vision;

(4) Residual myopia, anisometropia, astigmatism or overcorrection.

References:

China Ophthalmologist Network