The National Health and Health Commission recently released the latest findings on children and adolescents’ myopia. The survey shows that the overall incidence of myopia in children and adolescents in China is severe. The overall myopia rate is 53.6%, including 14.5% for 6-year-old children, 36% for primary school students, 71.6% for junior high school students, and 81% for high school students. The task of prevention and control of myopia is arduous.

Myopia has become a focus of society, especially for young people’s myopia, and has even become a hot event that the country attaches great importance to. Myopia not only affects the child’s vision, but also causes serious damage to the eyes. If not treated in time, it will not only cause amblyopia, strabismus and the degree will continue to deepen, eventually becoming high myopia. High myopia is easy to introduce a variety of complications, such as retinal detachment, vitreous lesions, macular degeneration, glaucoma and cataract, and even serious blindness. Therefore, it is imperative for parents to adopt scientific prevention and control methods to control children’s myopia.

At present, there are three evidence-based effective measures for prevention and control of myopia. The three proven effective measures were: outdoor activities for more than 2 hours a day, wearing a Ortho-K CL and 0.01% atropine eye drops.

For children who are not nearsighted, 2 hours of outdoor activities per day can effectively prevent myopia. Once it becomes true myopia, it will not be reversed.

For minors, Orthokeratology can be used to correct myopia, but not everyone is suitable. Because this Ortho-K lenses must be tailored to everyone, the wearer must undergo professional examination. . Therefore, it is necessary to go to a regular hospital for fitting. Need to be reminded that Orthokeratology can not cure myopia, can only delay the deepening of myopia.

Studies have shown that in Asia, Singapore, Japan, India, Hong Kong, China and Taiwan, the use of 0.01% atropine sulfate eye drops to prevent and control myopia has been applied for up to 20 years. The ATOM series of tests conducted by the National Eye Centre of Singapore (SNEC) and the Singapore Eye Institute (SERI) confirmed that 0.01% atropine sulfate eye drops are 60% effective in delaying the progression of myopia in children; atropine can significantly delay the progression of myopia in Asian children. It is more effective than white children. This effect has little to do with drug concentration differences. However, some studies have shown that 0.01% atropine eye drops due to low concentration, dilated effects are not obvious, generally do not cause close reading difficulties, and myopia prevention and control effects are equally effective and the rebound effect after stopping the drug is small, can achieve long-term The purpose of prevention and control of myopia is therefore widely accepted by most doctors for prevention and control of myopia. Moreover, the longest time used in clinical studies reached 5 years, and no significant side effects were reported.

01 Atropine eye drops are? (only from the perspective of optical optics application)

Atropine eye drops are a type of M choline receptor blocker that relaxes the pupil sphincter and ciliary muscles and forms a dilated pupil. Generally 1% gel single eye, the expansion effect lasts 7-10 days, and the regulation of paralysis lasts 7-12 days. In the examination of children’s refractive status, it is often used 2-3 times a day, three days in a row, four days, or one eye every day, seven days, and the eighth day. According to the results of the examination, the doctor will make further judgments on the combined eye position, refractive status, and visual acuity. Whether optical intervention is required, and the glasses should be reviewed on the same day or three weeks later. Eyes, mucous membrane dryness, fever, facial flushing, tachycardia, etc. may occur after administration of the eye. A small number of patients with allergic symptoms such as itching, redness, conjunctival congestion, etc. should be discontinued immediately.

02 Atropine eye drops prevent and control the mechanism of myopia

Atropine eye drops as a clinical diboring drug, the mechanism of action in clinical myopia prevention and control is unknown. However, the cause of paralysis of the ciliary muscle can be basically ruled out. If you want to ask why, other ciliary muscle paralysis agents do not seem to prevent and control the growth of myopia.

03 Clinical effects of different concentrations of atropine eye drops on myopia

The higher the concentration, the better the prevention and control effect of myopia, but the individual also has differences (such as the same application of drugs, relatively high-parent parents of both parents will be faster than myopia parents no longer myopia), but the corresponding side effects will also The bigger the time (going out of the light, writing homework can’t see clearly, local allergies), the rebound after stopping the drug will grow faster for a while. (We are clinically called the phenomenon of withdrawal and rebound: it refers to the long-term use of certain drugs to treat diseases, and the drug is suddenly stopped after the basic control of the symptoms, thus causing the phenomenon of disease reversal.) If the drug is discontinued, it should be gradually reduced. Step by step to stop.

04 points a 0.01% atropine eye drops do not wear glasses?

Innocent! Obviously not. Atropine eye drops only slow down the growth of myopia, increase the degree of myopia, and reduce the degree of myopia. Therefore, atropine eye drops as an auxiliary drug, can not replace the conventional refractive correction methods such as frame glasses, contact lenses! If myopia only hopes to use 0.01% atropine eye drops without optical correction, and does not say that it is not clear, the delay may not be as good as wearing glasses. (People who have recently encountered a lot of 300-degree myopia have seen many places without glasses)

05 preventive use

Q: Our children have no nearsightedness. It doesn’t matter if you first point it up. Have the effect of controlling the progress of myopia, and point to this “magic medicine”, our children can not be nearsighted, and then can be less myopia.

A: Emmm, once I felt that the canteen was not clean. I ate an antibiotic every day after eating. Later, I was infected with bacteria, and the resistance was very bad. Perhaps this metaphor is not appropriate, but for the moment, I have not seen the team doing research in this area (maybe I have missed it), I don’t think it is necessary, I think there is no prevention and control in myopia. It is to bring children out of the house, to swim in the mountains, to pay attention to the usual behavior habits, to control the habits of writing homework for a long time, to play mobile phones, to maintain a good sitting posture, etc., and not to hope for drugs.

06 already taking medicine, go to the hospital to check what?

1. Basic consultation (you should tell the doctor honestly, are you applying 0.01% atropine eye drops, including clinical first doctors and optometry doctors or optometrists), are there any systemic or local reactions?
2. Regular slit lamp inspection, pay attention to fundus examination when the degree is high
3. Tear secretion test (does there be dry eye phenomenon, etc.)
4. Adjustment range
5. Adjust the sensitivity
6. Regulate the reaction (hysteresis?)
7. Intraocular pressure
8. Eye axis
9. Corneal topography (as appropriate)
10. Diaphragm diameter in bright and dark environments (if there is photophobia)
11. Other
The above check is only for the time being, I only think so much, welcome to add. Of course, it is possible that all checks will not be done because some checks are recordable. For example, when measuring the pupillary diameter, the pupil diameter can only be evaluated objectively. If you want to solve it, stop the medicine or wear color-changing tablets or sunglasses. Will not affect the processing? It doesn’t matter, but you can see how the potion has a big impact on you. Therefore, parents are advised not to take the examinations listed in this article to the doctor to go online, saying that you did not give me this, I believe your first doctor can.

07 What should I do if I have a side effect?

1. Systemic allergic reactions, etc.
The drug should be discontinued immediately.

2. Dry eye syndrome
Reduce eye frequency as appropriate or give artificial tears regular monitoring.

3. When the adjustment amplitude drops below the corresponding age group
Perform the appropriate adjustment training. Such as negative lens reading sorting.

4. When the adjustment sensitivity drops below the corresponding age group
Perform the corresponding adjustment sensitivity training.

5. Intraocular pressure
Ophthalmology clinic to investigate the cause.

6. Photophobia
Stop taking or wearing a color film or sunglasses.

7. Other
Follow the doctor’s advice.

08 Where can I buy it?

At present, China’s Food and Drug Administration has not approved low-concentration atropine as a control for the development of children’s myopia, so it can only be purchased in Singapore or Taiwan, or it can be self-configured. However, there is no way to ensure the sterility of the self-configured eye drops, and there is no way to ensure the content. Accurate, the patient may cause unintended harm such as infection of the eye after use, so it is not recommended to prepare it by yourself. At present, 0.01% concentration of atropine eye drops has been listed in Macao and is represented by Macao Wuzhou Pharmaceutical International Trading Co., Ltd., and is currently registering with CFDA registration in China.

It is currently available for purchase in Macau or by the CFDA.