Causes of sharp deterioration of vision in children. Deterioration of vision: causes of vision loss in children, age-related vision loss, treatment

Refractive errors are a group of disorders associated with a disproportion between the power of the optical system of the eye and its anteroposterior axis (roughly speaking, the length of the eye).

Refractive errors are divided into:

• myopia();
• farsightedness (hypermetropia);
• astigmatism.

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This is a type of refraction in which a characteristic feature is the location of the main focus directly in front of the retina, which, in turn, does not allow for a good view of objects located in the distance.

This all happens due to the discrepancy between the strength of the optical system of the eye and its length. As a result of this, axial (the size of the eyeball is increased) and refractive (the power of the refractive apparatus is increased) myopia is distinguished.

Also distinguished the following degrees:

• weak (up to 3 diopters);
• average (from 3.25 to 6.0 diopters);
• high (above 6 diopters).

Diagnostic methods

several diagnostic methods:

1. Determination of visual acuity (visiometry).

In young children, it is not possible to determine the real value of visual acuity. One can only indirectly judge it, based on ophthalmoscopy data when examining the fundus of the eye by a doctor, skiascopy data, if the child allows it, or refractometry data. At the age of 4-5 years, children's vision is checked using tables.

1. Determination of visual fields (perimetry).

The use of computer spheroperimetry in children is justified, since, according to research, not all children are able to understand the technique, and therefore the data obtained often have a false result.

1. Examination of the fundus (ophthalmoscopy).

Unlike adults, in children, fundus examination is always carried out with a wide pupil.

1. Skiascopy in conditions of complete cycloplegia.

This study gives a more objective picture after preliminary atropinization (the procedure of instilling Atropine drops into the eyes).

1. Refractometry.
2. Ultrasonography(A-scan and B-scan modes).
3. Fundus examination with a Goldmann lens.
4. Measuring intraocular pressure(tonometry) if necessary.

It is necessary to understand that, in fact, myopia, like hypermetropia, is not a disease, but a condition that requires the patient to adhere to a certain lifestyle.

A balanced diet, certain eye exercises, taking vitamins, massage of the cervical-collar area, work and rest schedule are important preventive methods.

Unfortunately, they are extremely rarely observed by patients.

The main conservative treatment method is spectacle or contact vision correction.

According to recent data, it has been established that the progression of myopia can only be stopped with complete vision correction. Partial correction causes a spasm of accommodation, thereby aggravating the condition, which, in turn, leads to progression of the disorder.

In the modern world, more and more people prefer contact vision correction, however, this type of correction is not always possible in young children and requires mandatory adult supervision.

Use of Paragon night orthokeratology lenses.

Has its advantages. The lens is inserted exclusively at night before bedtime. It's easy to use.

The main therapeutic effect lies in the structure of the lens: it gently affects the epithelial cells of the cornea, which in turn reduces the power of the refractive apparatus of the eye.

In cases of progressive myopia with pronounced changes in the fundus, it is necessary to carry out peripheral preventive laser coagulation, which limits the areas of the altered retina, and, in turn, is the prevention of such a formidable complication as retinal detachment.

Upon reaching the age of 18 years, doctors recommend surgical treatment: laser vision correction (PRK, LASIK, LASEK), refractive lens replacement or implantation of phakic lenses. The age of 18 was not chosen by chance; according to scientific research, it is up to this age that the growth of the eyeball occurs. Therefore, early surgical treatment will not be as effective.

This is a type of refraction in which the main focus is located behind the retina, which, in turn, makes it impossible to work at close range, and with a high degree of farsightedness, also at far distance.

Highlight the following degrees of farsightedness:

• weak (up to 2 diopters);
• average (from 2.25 to 5.0 diopters);
• high (above 5 diopters).

Diagnostic methods

Used to make a diagnosis 8 diagnostic methods:

• refractometry;

The doctor prescribes glasses for farsightedness only against the background of instillation of certain drugs (Atropine or its analogues). Often, children try to persuade adults either not to instill drops in them, or try to simply put on glasses, but it is important to remember that the doctor’s prescription is the main thing.

If you follow the child's lead, glasses will not be worn due to discomfort, and farsightedness will progress. Contact vision correction in this case is possible only after adequately selected spectacle correction.

2. Upon reaching the age of 18 years, doctors recommend surgical treatment: laser vision correction (PRK, LASIK, LASEK), refractive lens replacement or implantation of phakic lenses.

This is a type of refractive error, the characteristic feature of which is the presence of different refractive powers in different meridians of the cornea (more often) or the lens (less often), as a result of which the image has a distorted appearance.

Diagnostic methods

Used to make a diagnosis the following diagnostic methods:

• determination of visual acuity (visiometry);
• determination of visual fields (perimetry);
• examination of the fundus (ophthalmoscopy);
• skiascopy in conditions of complete cycloplegia (this study gives a more objective picture after preliminary atropinization);
• refractometry;
• ultrasound examination (A-scan and B-scan mode);
• fundus examination with a Goldmann lens;
• measurement of intraocular pressure (tonometry) if necessary.

Basic methods of treating farsightedness

1. The main conservative treatment method is spectacle or contact vision correction.

Glasses for, as well as for farsightedness, the doctor prescribes glasses only against the background of instillation of certain drugs (Atropine or its analogues). It is very important. If the child persists and refuses, he should explain everything in detail and insist on following the doctor’s recommendation.

Contact vision correction in this case is possible only after adequately selected spectacle correction. A feature of contact correction in this case will be the selection of so-called toric lenses, which allow taking into account the astigmatic component.

2. Upon reaching the age of 18 years, doctors recommend surgical treatment: laser vision correction (PRK, LASIK, LASEK), refractive lens replacement or implantation of phakic lenses with a toric component.

It is important to remember that a diagnosis of any refractive error can only be made by a doctor after a detailed clinical examination.

Many parents are faced with the problem of deteriorating vision in their child, who has just recently started school. So why does schoolchildren’s vision deteriorate? Let's figure it out.

8-9 years is a critical age for your child’s vision, since it is at this time that not only increased growth of the whole organism occurs, but also the beginning of school, which involves high loads. If in the first case, the eye muscles may simply not keep up with the increase in the growth of the eyeball and retina, which leads to deterioration of vision, then in the second, several factors begin to affect your child’s vision - this is a constant increased visual load on the eyes, incorrect posture during classes and etc.

Growth, of course, cannot be canceled, and it is not necessary, just like classes at school, but you can follow some recommendations that will help preserve your child’s vision for many years.

1. Monitor your child's vision from early childhood.

Myopia or myopia can begin to develop at a very early age, specifically from 3 years of age. Therefore, you should be wary if:
the baby often squints;
comes very close to the TV or tries to move the book as close to his eyes as possible.
If such alarming symptoms appear, you must immediately consult a doctor to make an accurate diagnosis and, if necessary, prescribe treatment. An eye doctor can write a prescription for glasses or even contact lenses. As a rule, the latter can be prescribed from the age of seven.

2. Remember about heredity

Parents who themselves suffer from any eye disease need to be doubly vigilant, since, for example, the same myopia can be inherited. This disease can manifest itself quite early (at 3-5 years old) or a little later, for example, at 7 years old, when the child starts school. It is also worth keeping in mind that myopia that appears at an early age can progress quickly. That is why it is very important to undergo regular examinations with an ophthalmologist for early detection of this disease.

3. Limit your use of gadgets and TV

It’s hard to imagine modern children without a smartphone in their hand, but you should always remember that their impact on your child’s health is detrimental. That is why you should limit the time your child spends on the computer and communicating on social networks. Try to distract him with active games, walks in the fresh air or playing sports.

If you follow all the above recommendations, you can be sure that your child’s eye health and high visual acuity will remain for many years!

Many children, with the permission of their parents, love to play computer games and spend hours on their phones. All this affects their well-being. Posture and general development suffer, but that’s not even the worst thing . The child's vision is deteriorating. What to do if a child has poor vision? How to prevent this, how to help children? Let's figure it out.

Eye diseases

Why does a child's vision deteriorate? There are various diseases that cause vision impairment, but in children it is most often myopia (minus) or farsightedness (plus). The reasons for their appearance are hereditary pathology or work in which objects are located close. Almost all newborns suffer from farsightedness, but over time their vision becomes normal.

Is it possible to correct a child's vision? A child suffering from farsightedness can be cured; for many, vision returns to normal by the age of 11.

Here's what Natalya Piotrovskaya, an ophthalmologist who works with children, says about this. Farsightedness is a structural feature of the eye in children. It's much shorter. Can it be made to grow? There is no definite answer; a lot depends on a person’s genetics. But, if you are constantly monitored by a doctor, the specialist will tell you whether there are changes for the better. Restoring vision in children is possible if we are talking about farsightedness. If a child’s eye is growing quickly and farsightedness is small, say +2, at 4 years old, then it is possible that by 1st or 2nd grade he will take off his glasses. If the situation is more serious, for example, a child has +6, then by the first grade there may not be 100% vision, but significant improvements are possible.

The situation with myopia is not so encouraging. A child cannot outgrow it. Myopia is an elongation of the anterior-posterior axis of the eyeball. The eye lengthens, this is noticeable, we are talking about extra mm. It is impossible to make him small again. It's like a parent trying to shrink a size 36 baby's leg down to a size 34. Is it possible to restore vision? Unfortunately, it is impossible, but this does not mean that the parent should give up and let everything take its course. If the doctor prescribed glasses for your child, you need to purchase them. In addition, parents can, if not cure the baby, then stop the deterioration at the very beginning, i.e. The child’s vision will remain, say, at level -1, and will not deteriorate to -2 or -3..

The most common vision defect - myopia - occurs today in every third school graduate. And every tenth child reaches the age of three with strabismus. The reasons for this are different, but most of them are completely preventable; the main thing is that parents know about this and do not make mistakes that could cost their child’s vision, experts say.

Early development helps to raise a genius

Fashion for the early development of a child is often detrimental to his health and can lead to eye disease. Unless, of course, parents adhere to basic safety rules. Thus, intensive classes with a child under three years old in drawing, reading, and spelling require frequent changes of activities. The fact is that neither the nervous nor the visual systems of the child, which are formed before 3-4 years of age, are ready for premature excessive loads. Therefore, the most optimal training scheme for children of this age is: 20 minutes of classes, 15 minutes of rest.

The second and, perhaps, the most important reason for the development of vision problems is that during long periods of study, the child’s eyes focus on one plane and at the same distance from the object. And this has a detrimental effect on vision, because the ciliary muscle must work both near and far. And here the advice is this: sculpt with the child - then count the birds outside the window, thus forcing the eyes to “work” at near and far distances.

Some modern mothers have nothing against their kids mastering a tablet - it's both modern technology and educational games. But introducing children to smartphones from a young age is very dangerous. The main danger of a tablet is that it is not fixed, it shakes all the time in the child’s hands, the eye is forced to constantly “reconfigure” and overexert itself. This provokes the early development of eye diseases. Let's face it: you can develop a child without a tablet - after all, you and I somehow grew up without gadgets!

“You won’t leave the table until you’ve done your homework!”

And this is a common mistake of parents of already grown children. Schoolchildren are no longer children and they need much more work. Parents teach them hard work, discipline, and at the same time spoil their eyesight. And then they blame poor lighting in the classroom, uncomfortable desks and a child who slouches too much and leans close to the notebook when writing. At the same time, few people realize that myopia does not develop at school, but at home while doing homework.

At school there are breaks every 40 minutes, plus during lessons the gaze switches first to the board and then to the notebook, so the ciliary muscle works at different distances. At home, the child sits with textbooks for an hour or two, and if he is interrupted, it is on a smartphone. The result is the same type of continuous load nearby. And if the child works not at the table, but on the bed or on the floor, then the visual system is strained even more, because the distance between the eye and the object is constantly changing.

Therefore, parents need to ensure that the child takes breaks every hour while doing homework.

And it’s better to load him with chores during these breaks - wash the dishes, clean his room. Let his eyes rest. Anti-glare glasses when working with a computer help preserve his vision. Another typical mistake of parents of teenage children. It has already been proven that modern monitors do not emit harmful radiation. This means there is no point in protecting your eyes from glare. Therefore, anti-glare glasses will do neither good nor harm. But provided that the child does not have developed vision problems. But if there are already problems, then such imaginary “protection” can become dangerous, because time for the necessary treatment will be lost. Therefore, the main assistant in matters of prevention and treatment of vision is an ophthalmologist.

“My child’s eyes are fine, why go to the ophthalmologist?”

A common reason for wasting valuable time is that the child does not complain about poor vision. And parents believe that going to an ophthalmologist is not necessary. But, unfortunately, the child himself cannot always understand that his vision is deteriorating. For example, if vision decreases in one eye, and the other continues to work with the same acuity, then the child will see as before and will not notice any changes.

Moreover, you cannot draw conclusions about diseases such as astigmatism, amblyopia, anisometropia by appearance - only an ophthalmologist can see this. Therefore, preventive examinations by an ophthalmologist should be performed annually, even if it seems to you that everything is fine. For a preschooler, there is a regular schedule for visiting an ophthalmologist: at 1 month, 3 months, 6 months, 1 year, 2 years, 3 years. If no deviations are identified, then you can come to the next appointment before school at the age of 6.

Why go to the ophthalmologist so often?

Firstly, so as not to miss deviations from the norm. And, secondly, most eye pathologies are inherited, even myopia. For example, according to statistics, if one of the parents has reduced vision, then 50% will be the same for the child. And if both parents are myopic, then the probability that the child will develop myopia reaches 80%. A competent ophthalmologist must not only diagnose myopia, but also stabilize it and stop the loss of vision.

Dietary supplements with blueberries improve vision

This is the most common misconception among parents. Dietary supplements with blueberries, tablets with lutein, carrots - all this has no effect on the visual system. Of course, the child’s diet should be enriched with vitamins, but this does not help with eye diseases. Let’s say that an eye pathology is inherited by a child, but hereditary diseases, unfortunately, cannot be cured with dietary supplements and carrots.

Unsystematic hardware treatment

If necessary, the ophthalmologist prescribes outpatient, conservative treatment for the child, which is popularly called “hardware”. This treatment is indicated for pathologies such as amblyopia, myopia, farsightedness, strabismus, and astigmatism. Many parents believe in hardware treatment as a panacea for vision loss. But it’s not enough to just bring your child to sit at the machines. The main thing is to receive adequate and effective therapy that will help stop the growth of myopia. The equipment costs the same everywhere, the treatment regimens are standard, but the children are all different. Therefore, each specific case requires an individual approach. Otherwise, the child can be “healed” in such a way that it will only get worse.

Before starting treatment, all visual functions of the child should be diagnosed. Additional examinations will not hurt either. For example, encephalography. The fact is that an apparently healthy child may have functional changes in the brain that do not manifest themselves in ordinary life. And it is very important to see these lesions before starting treatment. Because among the devices there are also those that emit light or flash different lights. These lights, like catalysts that stimulate the brain, can trigger seizures in a child. In addition, hardware treatment is effective only in combination with medication. Modern ophthalmologists use electrophoresis - with its help, medicine can be delivered to the desired area of ​​the eye. This increases the effectiveness of the procedure.

If parents start working on their mistakes and gradually abandon harmful stereotypes, then perhaps very soon we will see a decrease in the myopia epidemic. How to understand that a child’s vision has begun to decline

Parents should be alert to several characteristic signs:

• The handwriting has changed for the worse - it has become larger, “clumsier”
• the child leans too low towards the notebook
• when watching TV, the child does not sit on the sofa, but goes straight to the screen itself
• a child squints when trying to see something in the distance

You need to clearly understand the sequence of actions. First, together with your doctor, you should stop myopia, and then try to take off your glasses. Modern ophthalmology can do this with the help of hardware and drug treatment, as well as laser vision correction.

When parents find out that their child’s vision has become worse, they often, instead of going to the doctor, begin to dig into the reasons. Some blame heredity, they say, nothing can be done about it, some criticize school - you have to read a lot, others simply take away the tablet and think that the problem will be solved by itself. By doing this, parents lose precious time when they can not only preserve their vision, but also save their child from having to wear glasses in the future.

Igor Erikovich Aznauryan, Doctor of Medical Sciences, Academician of the Academy of Medical Sciences of the Russian Federation, pediatric ophthalmologist, ophthalmic surgeon, head of the Yasny Vzor association of children's eye clinics, told Letidor about what mistakes should be avoided and how to preserve a child's vision.

What should vision be like and deviations from the norm?

All children are born farsighted. Farsightedness at birth is about +3.5–+3.0 diopters. As the child grows, the degree of farsightedness decreases. And at 1 year, its value should, as a rule, be + 1.25–+1.0 diopters, and at 3 years - +0.5–+0.25 diopters.

Serious deviations from the norm indicate a predisposition to the development of one or another eye pathology.

A competent ophthalmologist can accurately identify these deviations in a child as early as 6-8 months and immediately give all the necessary recommendations.

In case of serious impairments (farsightedness, astigmatism and high myopia, strabismus), already at this age the child can be given the first glasses, which will allow him to clearly see the faces of his parents and freely navigate in space.

If refractive error is detected at an older age - as a rule, this happens when the child is sent to kindergarten - then either the parents missed preventive examinations with a pediatric ophthalmologist, or the diagnosis was carried out poorly.

What is inherited

Heredity is one of the main reasons for the development of eye diseases in children.

According to statistics, myopia is inherited in 80% of cases if both parents are myopic, and in 50% if one of them is, astigmatism in 66% of cases, and farsightedness in 50%.

If there are relatives in the family with eye pathology, visits to a pediatric ophthalmologist should be taken seriously and routine examinations should not be missed.

In the first year of life, a pediatric ophthalmologist should examine the child at 3, 6, and 9–12 months.

If no pathology is detected, show the child to the doctor once a year with a mandatory examination for a narrow and dilated pupil. In the case when the doctor diagnoses the problem, he will determine an individual schedule of visits and tactics of observation and treatment.

If vision loss is caught in time and immediate action is taken, your child can be spared the need to wear glasses!

Such technologies have been developed and successfully applied.

Three reasons that prevent children from preserving their vision

1. Connivance and half measures

Even knowing about the eye disease, some parents either do nothing or limit themselves to half measures - they put glasses on the child, and that’s it. But practically any eye pathology can now be successfully treated! And many unpleasant moments associated with complications can be avoided with proper and timely treatment.

What is the danger

Did they start treatment at the wrong time, did they not pay attention to the discrepancy between visual acuity and age norm? Then be prepared for the fact that amblyopia, partial atrophy of the optic nerve, nystagmus and strabismus may be added to congenital myopia, farsightedness and/or astigmatism. These diseases, in addition to serious impairments of the visual system and difficulty in orientation in space, will create psychological problems and restrictions in choosing a profession in the future. And acquired myopia can lead to a sharp drop in vision and serious complications, including retinal detachment.

2. Belief in myths and following prejudices

This is the most common reason that prevents you from maintaining excellent vision or restoring it.

“It will go away on its own, it will outgrow it, treat it when it grows up.” This misconception is perhaps popular not only among parents, but also, paradoxically, among specialists.

What do we hear most often? Myopia cannot be cured, which means there is no need to treat it. Fundamentally wrong! You really can’t get rid of the existing disadvantage without laser correction. Treatment for myopia is carried out solely to prevent this disadvantage from increasing.

The most insidious myopia is that which develops as a result of uncontrolled visual stress.

This myopia progresses very quickly. The eyeball grows, this is fraught with stretches and tears of the retina - the most common complications of myopia. And therapeutic treatment allows us to successfully avoid all these troubles.

“Therapeutic treatment is ineffective and will go away on its own.” With farsightedness and astigmatism, thanks to proper therapy, doctors achieve fantastic results, even getting rid of glasses.

And in case of such complex pathologies that were previously considered incurable, such as amblyopia, strabismus or nystagmus, with the help of therapy, not only visual acuity increases and the poorly seeing (lazy) eye is included in the work, but also binocular and stereoscopic vision is restored - the child’s ability to perceive 3D format , which is absent in 90% of children with these pathologies.

Can such serious disturbances in the functioning of the visual system go away on their own?

What is the danger

Following myths is a waste of time. If you are familiar with eye pathology firsthand, you need to be aware that treatment will require time and effort. Courses of treatment should be carried out several times a year, usually 3-4 times. And in the case of myopia, perhaps more often.

The visual load of modern children is so great that the reserve of accommodation (eye focusing - ed.) that can be achieved is barely enough for two months, and treatment has to be carried out more often (a few years ago, treatment once every 4-6 months was sufficient).

But there is no need to be afraid. The issue is always resolved individually. Between courses of treatment, the doctor may recommend medicinal procedures at home to consolidate the achieved result.

All these efforts, both of children and parents, pay off with interest when results are visible every day thanks to treatment.

Waiting for the start of treatment when the child reaches a certain age (by the way, we came across different numbers - 7, 10, 18 years) or puberty is the height of frivolity.

Vitamins are definitely useful. Summer has come, include seasonal vegetables and fruits in your diet, and spend more time outdoors. This is beneficial not only for the eyes, but also for the body as a whole. But if there is an eye pathology, it needs to be treated by a pediatric ophthalmologist.