如何控制兒童近視加深

香港兒童患有近視的問題嚴重,有大學研究指出,6歲兒童患有近視(50度或以上)的比率為18.3%,12歲兒童患有近視(50度或以上)的比率則為61.5%,這些數字已說明香港兒童近視比率是全球數一數二。

事實上,配戴凹透鏡便能矯正因近視導致的模糊視力,其問題是在於兒童近視是會因應眼球長長而不斷加深,深近視度數(600度或以上)已被證實會增加患不同眼疾(例如: 青光眼、白內障和視網膜)的風險,所以控制兒童近視不斷快速地加深是必需的,有科研支持而有效地減慢兒童近視加深速度的方法如下:

1. 角膜矯形術 (俗稱OK鏡)

什麼是角膜矯形術?

角膜矯形術是矯正近視的光學方法。原理是使用專門設計的硬性透氣性隱形眼鏡,令角膜形狀改變,從而達到矯正近視的目的。它是一種臨時措施,配戴者需每晚定期配戴鏡片,近視在白天便能矯正過來,但一旦停止配戴,矯正近視的效果便會消失。科研亦證實角膜矯形術是有效減緩兒童近視加深的速度,相比配戴單焦點近視鏡片,配戴角膜矯形鏡每年大概能減緩50%的近視升幅。

誰適合配戴角膜矯形鏡?

  • 年齡最少為7歲,8歲更佳
  • 近視度數為550度以下,散光度為150 度以下。若近視或散光度數超出上限,兒童在白天或需要配戴近視框架鏡片去矯正剩餘的度數。
  • 近視加深速度很快的兒童,每年加深75至100度或以上為之快。
  • 不適合進行邀光矯視手術的成年人。
  • 因配戴軟性隱形眼鐘而感到非常眼乾的成年人。

配戴任何類型的隱形眼鏡均會增加角膜感染的風險,所以配戴角膜矯形鏡的兒童及家長必須嚴格遵循眼科視光師的指導作定期覆診,以確保眼睛健康。

2. 低劑量阿托品(Atropine)眼藥水

有科研指出,每日使用低劑量阿托品的兒童,相比沒有使用的,每年大概能減50-60%的近視升幅。阿托品是一隻擴瞳藥,需要由眼科醫生處方,長期使用或會引起怕光、調節功能減弱、瞳孔變大和一些未知的眼睛健康問題。

3. 雙光或漸進多焦點框架鏡片

使用多焦點鏡片去緩減近視增長的科研結果參差 (由15% 到40%不等)。原因可能是兒童較低的遵從性去使用多焦點鏡片底部較為淺的近視區域去閱讀,以至成效不一。

4. 特製日拋軟性隱形眼鏡

有科研指出,透過配戴一種名為”周邊離焦技術”設計的日拋軟性隱形眼鏡,相比配戴單焦點近視鏡片,每年大概能減緩30%的近視升幅。缺點是它不能矯正度散光度數和增加角膜感染的風險。

5. 保持良好的視覺衛生

除以上描述的光學和藥物方法外,有不少文獻已指出每天多做戶外活動和接觸適量的陽光能紓緩近視增長。

要是功課繁重令到無暇作戶外活動,家長亦應緊記20-20-20 法則,就是觀看近距離事物20 分鐘後,應觀看20尺以外的事物最少20秒鐘。兒童過份地用眼觀看近距離事物只會令近視度數不合理地快速增長,家長應多加注意。

註冊眼科視光師(第一部份) 陳家豪


以上護眼資訊由瑞士寶視光中心提供

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