Myopia


Does nearsightedness surgery involve holding the eyelid open?
Eye surgery, apart from eyelid surgery, requires the use of a speculum to hold the eyelids open to fully expose the field of vision for surgeries involving the eyeball and the inside of the eye. Myopia surgery, which involves the surface of the eyeball, also necessitates holding the eyelids open. The surgery can then be performed with the aid of a laser.


How to treat high myopia?
High myopia refers to a degree of nearsightedness above 1000 degrees. High myopia brings great troubles to people, even affecting their diet and preventing them from participating in high-intensity physical exercise. It may also lead to complications such as retinal detachment, cataracts, macular hemorrhage, macular degeneration, vitreous liquefaction degeneration, and glaucoma. The treatment of high myopia has always been a major challenge in ophthalmology. With the advent of refractive lens exchange surgery, after extensive clinical practice, it has now become a better option for correcting vision in patients with extremely high myopia. The refractive state of the eyeball is mainly determined by the refractive power of the eyeball and the length of the eye axis. In cases of nearsightedness, the lengthening of the eye axis causes the light to focus in front of the retina, making it difficult for patients to see distant objects clearly. During refractive lens exchange surgery, a concave lens specifically tailored to the patient is implanted into the eyeball to change the focal point of the light so that it accurately focuses on the retina, achieving the purpose of correcting nearsightedness. Refractive lens exchange surgery maintains the integrity and accommodative function of the eye's physiological structure, has a larger optical zone, eliminates aberrations, and has a wider range of adaptability compared to corneal refractive surgery. Post-surgery, patients experience less discomfort, faster vision recovery, stable refraction, and no regression phenomenon.


Will nearsightedness be inherited?
Myopia has a certain hereditary aspect, but it is mainly caused by improper use of the eyes. Myopia is characterized by clear near vision and blurred distant vision, primarily due to changes in the eye's axial length. After the onset of myopia, it is crucial to properly dilate the pupils and conduct an optometric examination to rule out false myopia and amblyopia. Currently, the main treatments for myopia are still corrective glasses or orthokeratology lenses. Surgical treatment can also be considered for individuals aged 20 to 45. Once myopia develops, proper eye usage should be practiced, reducing close-range activities to avoid eye strain, and regular follow-ups are advised.


Can people with trichiasis undergo myopia surgery?
Generally, people with trichiasis should not undergo myopia surgery, as trichiasis primarily affects the eyeball. It causes abrasion to the cornea, affects the corneal epithelium, and can lead to neovascularization of the cornea and corneal pathology. Following the occurrence of trichiasis, surgical treatment should be considered. If there are only a few ingrown lashes, electrolysis of the eyelashes might be performed. After active treatment and once the condition has stabilized, the possibility of undergoing myopia surgery can be considered. Current options for myopia surgery include corneal laser reshaping surgery and ICL (Implantable Collamer Lens) surgery.


How can children with myopia recover their eyesight?
Children with myopia should go to a formal optometric center for eye examinations and to get properly prescribed glasses. After wearing glasses, it is important in daily life to not read or write in dim environments and to maintain a correct posture while reading or writing. Abide by the "rule of three": the distance between the eyes and the book should be about one foot; the distance between the body and the desk should be about one fist; and the distance from the tip of the pen to the holding point should be about one inch. This can help prevent the deepening of myopia in children. Additionally, after using the eyes for forty minutes, it is recommended to gaze into the distance or perform eye exercises to relieve eye fatigue. Children should engage in outdoor activities for more than two hours per day, and more than fourteen hours per week, and they should have regular check-ups, generally every six months, to ensure the prescription of the glasses matches the degree of myopia. Currently, there are also options like orthokeratology lenses that can be worn at night to effectively control the progression of myopia.


The main cause of myopia formation
Myopia is primarily caused by the focusing system of the eyeball focusing parallel light rays in front of the retina when our eyes are in a relaxed adjustment state. The far point of a myopic eye is at a certain point in front of the eye. The occurrence of myopia is influenced by a combination of factors including genetics and environment, and the incidence is still being explored. Based on the refractive components, myopia can be classified into refractive myopia and axial myopia. According to the degree of myopia, it can be classified into mild myopia (below 300 degrees), moderate myopia (300 to 600 degrees), and high myopia (above 600 degrees). The clinical manifestations of myopia include blurry distance vision but good near vision, often with fluctuating distance vision where squinting is needed to see clearly at a distance.


Which is more serious, amblyopia or myopia?
Amblyopia and myopia are two different concepts; there is no comparative severity between them. Amblyopia refers to a condition where, despite correction, vision still does not reach 0.8, which is defined as amblyopia and generally occurs before the age of eight. Myopia, on the other hand, is a type of refractive error. This condition can be corrected by wearing eyeglasses, contact lenses, or through myopia surgery after reaching adulthood.


What should I do if nearsightedness is inherited by my child?
Not all myopia is hereditary, but high myopia does have a genetic component. The occurrence of myopia is mainly related to genetic and environmental factors. If there are children in the family with a history of high myopia, they should develop good eye habits from a young age, or undergo genetic testing for high myopia. If myopia occurs, it can be corrected by wearing glasses, or by refractive surgery after reaching adulthood.


Does myopia correction rebound?
Will there be a rebound after myopia correction surgery? Generally, it relates to two aspects. The first is associated with your pre-surgery degree of myopia; the second relates to your habits in using your eyes after the surgery. Generally speaking, the higher the degree of myopia before the surgery, the more likely a rebound will occur. Roughly speaking, if your degree of myopia was above 700 degrees before the surgery, there's about a 20% to 30% chance of rebounding. However, a rebound does not mean it will return to the previous degree of over 700; typically, it might rebound by around 100 to 200 degrees. The second aspect is significantly related to your post-surgery visual habits. If, after the surgery, you frequently use computers, read documents, or use your phone, there’s a higher chance of experiencing some degree of rebound. Conversely, if your screen time is less, the proportion of myopia rebound tends to be smaller.


Can eye fatigue cause nearsightedness?
Eye fatigue can exacerbate myopia, and it is an important factor in worsening nearsightedness. When the eyes look into the distance, they are in a completely relaxed state, which does not cause or worsen myopia. Myopia occurs due to near-distance eye activities. Prolonged close-distance eye activities and working too closely can lead to chronic fatigue in the external eye muscles. When this happens, the eye axis is stretched and, over time, cannot fully return to its original state, resulting in the onset or worsening of myopia. Therefore, during daily eye use, it is essential to avoid excessive duration and too close distances to prevent fatigue and thus avoid worsening myopia.