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甚麼是近視

甚麼是近視?

近視,通常被理解為不戴眼鏡或隱形眼鏡情況下看不清遠處景物。事實上,近視遠遠不止於此。1近視是一種慢性持續進展的眼睛健康問題,眼睛的持續生長不僅影響遠看視力,還會增加將來影響視力併發症的風險。1-4

甚麼是近視的成因?

近視加深的確實成因尚未得到證實。近視的形成及加深有許多風險因素,包括:
  • 孩子開始患上近視的年齡2
  • 極少的戶外活動時間(每天少於2小時)5
  • 長時間近距離使用眼睛或近距離使用眼睛6,7
  • 父母患有近視8

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我為什麼需要擔心

近視是一種越趨盛行的全球性眼睛疾病17:

您是否知道近視人口在過去 20 年中幾乎增加一倍?到2050年,全世界近一半的人口將會患有近視。9
據報道,年輕人的近視在許多亞洲地區比例高於80%10,年輕人的近視在美國和歐洲部分地區比例為50%並持續上升11,12

近視會增加影響視力併發症的風險14

到 2050 年,預計將有近1 億人患有深度近視(近視度數達到或高於-5.00D或500度)。9
近視(尤其是深度近視)源於眼球較長,會有導致損害視力的風險,亦會增加近視性黃斑病變的可能性。13,14(所示圖像模擬了黃斑病變導致的損傷視力)

應該監察兒童的眼睛發展

近視沒有安全線可言。1 研究顯示,兒童越早患上近視,近視加深2,15 和發展成深度近視的風險越高。16
參考文獻
1. Flitcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Prog Retin Eye Res.2012;31(6):622-660.
2. Donovan L, Sankaridurg P, Ho A et al Myopia progression rates in urban children wearing single-vision spectacles. OVS 2012;89(1):27-32.
3. Pärssinen O, Kauppinen M. Risk factors for high myopia: a 22-year follow-up study from childhood to adulthood. Acta Ophthalmologica.2019;97(5):510-518.
4. Flitcroft DI et al. IMI Defining and classifying myopia: a proposed set of standards for clinical and epidemiologic studies. Investigative ophthalmology and vision science 2019;60M20-30.
5. Wu PC et al. Increased Time Outdoors Is Followed by Reversal of the Long-Term Trend to Reduced Visual Acuity in Taiwan Primary School Students.Ophthalmology.2020 Feb 8:S0161-6420(20)30139-1.
6. Huang et al. The Association between Near Work Activities and Myopia in Children: A Systematic Review and Meta-Analysis. PLoS One 2015;10:e0140419.
7. Wen L et al. Objectively measured near work, outdoor exposure and myopia in children. British Journal of Ophthalmology Published Online First:19 February 2020. doi:10.1136/bjophthalmol-2019-315258.
8. Tedja MS et al. IMI - Myopia Genetics Report. Invest Ophthalmol Vis Sci 2019;60:M89-M105.
9. Holden BA Fricke TR Wilson DA Jong M Naidoo K et al Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 to 2050.Ophthalmol 2016,123(5):1036-1042.
10. Ding, Bo-Yuan, et al. "Myopia among schoolchildren in East Asia and Singapore. "Survey of ophthalmology 62.5 (2017):677-697.
11. Vitale S et al. Prevalence of refractive error in the United States, 1999-2004.Arch Ophthalmol.2008;126:1111-9.
12. Williams K et al. Increasing prevalence of myopia in Europe and the impact of education.Ophthalmology.2015 Jul 1;122(7):1489-97.
13. Tideman JW, Snabel MC, Tedja MS et al. Association of Axial Length With Risk of Uncorrectable Visual Impairment for Europeans With Myopia.JAMA.Ophthalmol.2016 Dec 1;134(12):1355-1363.
14. Haarman AEG, Enthoven CA, Tideman JWL, et al The Complications of Myopia: A Review and Meta-Analysis. Invest Ophthalmol Vis Sci.2020 Apr 9;61(4):49.
15. Chua SY et al. Age of Onset of Myopia Predicts Risk of High Myopia in Later Childhood in Myopic Singapore Children. Opthal Physiol Opt 2016;36:388-94.
16. Hu Y, Ding X, Guo X, et al. Association of Age at Myopia Onset with Risk of High Myopia In Adulthood In a 12-Year Follow-up of a Chinese Cohort. JAMA Opthalmol 2020.
17. Morgan IG, French AN, Ashby RS, Guo X, Ding X, He M, Rose KA. The epidemics of myopia: Aetiology and prevention. Prog Retin Eye Res.2018 Jan;62:134-149.

PP2021OTH6122

如何減緩近視的加深?

強烈建議兒童應從小便接受眼睛健康全面檢查和監控。兒童近視的近視度數每減少一百度,他們患視網膜疾病的機率就會降低 40%。1 要最大限度地減緩兒童近視的發展,務必盡早採取行動。強烈建議您的孩子在 18 歲之前應每年定期接受全面的眼科檢查。2

用於近視控制的角膜塑形鏡

角膜塑形術,也稱為 Ortho-K、OK 鏡片或過夜鏡片,是一種夜間配戴的特殊隱形眼鏡,可暫時改變角膜形狀,使得配戴者在日間無需配戴眼鏡,也可擁有清晰的視力。Ortho-K 對於積極參加體育和水上活動的孩子來說是一個很好的選擇,與有框眼鏡相比,它甚至能幫助配戴者在主觀上改善對外表和社交的自我認知。4 因為這種鏡片是在家裡夜間使用,父母們可為孩子戴上及移除鏡片。這使它成為成為小朋友控制近視的一個良好選擇。

用於近視管理的軟性隱形眼鏡*

這些特殊的隱形眼鏡在日間配戴,可控制近視的發展,同時提供清晰的視力。近視控制軟性隱形眼鏡對於積極參加體育運動的孩子來說也是一個很好的選擇,與有框眼鏡相比,也能幫助在主觀上改善對外表和社交的自我認知。5

用於近視控制的眼鏡鏡片

這些眼鏡具有專門設計用來減緩近視加深的光學系統。光學設計與近視控制效果差異很大。

戶外生活方式

除了治療外,戶外活動已被證明能延緩兒童近視的出現,並有可能減緩近視的發展。8,9 又一個多參加戶外活動的好理由!


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Young boy of mixed race smiling with excitement.
參考文獻
1. Bullimore MA, Brennan NA. Myopia Control: Why Each Diopter Matters. Optom Vis Sci 2019;96:463-5.
2. American Optometric Association. Evidence-Based Clinical Practice Guideline: Comprehensive Pediatric Eye and Vision Examination. Optometric Clinical Practice. 2020; 2(2). doi:10. 37685/uiwlibraries. 2575-7717. 2. 2. 1007. https://doi.org/10.37685/uiwlibraries.2575-7717.2.2.1007
3. Brennan, N. , Toubouti, Y. , Cheng, X. , & Bullimore, M. (2020). Efficacy in myopia control. Progress in Retinal and Eye Research, 100923.
4. Santodomingo-Rubido, Jacinto, et al. Myopia control with orthokeratology contact lenses in Spain: a comparison of vision-related quality-of-life measures between orthokeratology contact lenses and single-vision spectacles. Eye & Contact Lens 39. 2 (2013):153-157.
5. Rah, Marjorie J et al. Vision specific quality of life of pediatric contact lens wearers. Optometry and Vision Science 87. 8 (2010):560-566.
6. Yam, Jason C. , et al. Two-year clinical trial of the low-concentration atropine for myopia progression (lamp) study: phase 2 report. Ophthalmology 127. 7 (2020): 910-919.
7. Kinoshita, Nozomi et al. efficacy of combined orthokeratology and 0. 01% atropine solution for slowing axial elongation in children with myopia: a 2-year randomised trial. Scientific Reports 10. 1 (2020):1-11.
8. He M et al. Effect of time spent outdoors at school on the development of myopia among children in China: a randomized clinical trial. JAMA. 2015;314:1142-8.
9. Wu PC et al. Myopia prevention and outdoor light intensity in a school-based cluster randomized trial. Ophthalmol. 2018;125:1239-50.