“Is blue light from screens harmful? How to treat myopia? " 10 questions for an ophthalmologist and answers to them

2024 Author: Malcolm Clapton | [email protected]. Last modified: 2023-12-17 03:44

A qualified expert answers.

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Lifehacker has a “” section, within which we launched a thematic day. To do this, we invite a special guest to answer your questions.

This time you asked questions about ophthalmology. We chose the most interesting ones, and Lyudmila Panyushkina, an ophthalmologist, candidate of medical sciences and author of a blog about ophthalmology, answered them.

Can the progression of myopia in children be slowed down?

To slow down the progression of myopia and reduce the stress of accommodation (focusing apparatus of the eye), incomplete vision correction was used for a long time. For example, measurements showed that a child had -3 diopters, and a prescription for glasses was prescribed with a value of -2.75. But modern data on Effect of undercorrection on myopia progression in 12-year-old children / Graefe's Archive for Clinical and Experimental Ophthalmology speak inefficiency of this method:

• In children with incomplete vision correction, myopia may progress faster.
• Glasses with lower diopters do not provide good vision for a child. And this can negatively affect his academic performance, hobbies and social adaptation.

Therefore, parents should first of all take care of the selection of glasses or contact lenses with a complete correction of myopia. This will provide their children with myopia with the best visual acuity.

It is also worth remembering from The Association between Time Spent Outdoors and Myopia in Children and Adolescents / American Academy of Ophthalmology that every additional hour spent outdoors per week is associated with a 2% reduction in the risk of developing myopia. And 14 or more hours of outdoor walks per week reduce the likelihood of developing myopia by a third.

With pre-existing myopia, walking has less protective effect. But they still remain a simple and affordable way to distract the child from the computer and tablet. And this should be used.

If a child has significant risks of developing a high degree of myopia - for example, early onset, decreased vision by one or more diopters per year, the presence of myopia in parents - such strategies should be considered Update and guidance on management of myopia / European Society of Ophthalmology & International Myopia Institute slowing the rate of progression of myopia.

• The use of atropine in low concentrations and the use of orthokeratological (night) contact lenses. These methods have the largest evidence base and can slow vision loss by about 50%. That is, instead of one diopter per year, vision will drop by 0.5 diopters.
• Wearing multifocal contact lenses. There is less evidence of effectiveness, but it is also there.

In any case, all of these methods have their limitations, advantages and disadvantages. Therefore, you should discuss with your doctor which treatment is best for your child.

What treatments for myopia definitely don't work?

Visual gymnastics, apparatus treatment, massage, dietary supplements, injections and vitamin drops in the eyes definitely do not affect the rate of myopia progression. And they don't need to be used to treat myopia in children.

Also, in the modern Russian clinical guidelines Myopia / Clinical guidelines of the Ministry of Health of the Russian Federation for the treatment of myopia, drops for pupil dilation and surgery to strengthen the sclera are still present. But they do not have reliable evidence of effectiveness and in the international guidelines Update and guidance on management of myopia / European Society of Ophthalmology & International Myopia Institute are not even discussed as reliable methods of controlling myopia.

Why in adulthood can vision decline and how to deal with it?

There are a lot of reasons for a decrease in vision. And depending on the age, some problems may arise more likely, others less.

If you are 20-40 years old

Among patients of this age, the most common reasons for visiting an ophthalmologist are blurred vision due to myopia, hyperopia, or astigmatism. In these cases, the ophthalmologist may prescribe glasses and contact lenses. Possible laser vision correction is also discussed.

Another reason to visit an ophthalmologist is dryness of the ocular surface and associated discomfort, itching, lacrimation, redness of the eyes, blurred vision. Hygiene of the eyelids, the use of a humidifier and moisturizing eye drops solve the problem in more than 90% of cases. But there are other treatment strategies as well.

But floating flies, so frightening to many, most often turn out to be a symptom of harmless changes in the vitreous body. But in some cases, they can signal problems with the retina. If you notice a sudden increase in the number of floating flies, a change in their shape, the appearance of flashes, lightning in the eye, you should contact an ophthalmologist as soon as possible to exclude retinal detachment.

If you are 40-45 years old

After 40–45 years, all patients experience changes in near vision. This is called hyperopia. Initially, the person begins to push the reading materials aside at arm's length or lower their glasses to the tip of the nose.

When these tricks are not enough, he gives up and goes to the ophthalmologist. Reading glasses or multifocal lenses, which provide good vision at different distances, are a good solution to this problem.

If you are over 55 years old

The main causes of visual impairment in patients over 55 years of age are glaucoma, cataracts and retinal diseases.

Glaucoma - disease of the optic nerve, often (but not always) associated with increased intraocular pressure. The insidiousness of glaucoma lies in its asymptomatic course in the early stages. For a long time, the patient does not notice either an increase in pressure or a narrowing of the visual fields. Left untreated, glaucoma can lead to permanent blindness. Therefore, it is so important to screen it in all people over 55 years old - even in the absence of complaints.

To diagnose glaucoma, the doctor will check the intraocular pressure, assess the condition of the optic nerve behind the slit lamp, and, if necessary, perform visual field examination and tomography of the optic nerve. Treatment may include the use of eye drops to lower intraocular pressure, laser or surgery.

Cataract - This is a clouding of the lens (the lens inside the eye). It does not allow light to freely penetrate into the eye, and because of this, vision decreases or appears foggy. Glasses stop helping as the disease progresses.

Cataract treatment is only surgical. The doctor removes the cloudy lens and replaces it with an artificial lens, thereby restoring good vision if the eye is otherwise healthy. This is one of the most common and safest operations performed around the world.

Retinal diseases are common causes of decreased vision in elderly patients. This is the inner lining of the eye, which is involved in the perception of the image and its transmission to the brain.

Age-related macular degeneration (AMD) - characterized by cell death in the central area of the retina, which leads to blurring or distortion of the image or the appearance of a spot in front of the eye. For the prevention of AMD, eye protection from ultraviolet radiation, a Mediterranean diet, and control of cardiovascular risk factors are recommended. In the later stages, nutritional supplements and injections of a special solution inside the eye may be helpful.

Diabetic retinopathy (DR) - a complication of diabetes, which manifests itself in the form of damage to the retina. Most people do not notice until the development of advanced stages of DR and the onset of complications. Therefore, the most important preventive measures for DR are blood glucose control and regular screening (examination of the fundus with a wide pupil). And with the already manifested diabetic retinopathy, laser treatment and injections into the eye help successfully fight.

If we talk about the general principles of preventing eye disease, it is important to remember these things: protect your eyes from ultraviolet radiation, control cardiovascular diseases, quit smoking, eat a variety of foods, exercise, maintain optimal body weight, and get regular check-ups with an ophthalmologist.

Is blue light from screens harmful to the eyes and are special computer glasses protect them?

There is no reliable evidence that blue light from digital screens is harmful to the eyes. Therefore, recommendations to defend against it with the help of special computer glasses look more like a marketing ploy.

For example, the American Academy of Ophthalmology discourages the use of Blue Light / American Academy of Ophthalmology blue-blocker glasses due to lack of evidence of their effectiveness. And the main complaints associated with discomfort when using gadgets are explained by eye strain and / or dryness of the ocular surface. Special glasses will not solve this problem.

There is also concern that the use of such glasses may interfere with our circadian rhythms. This is because blue light plays an important role in regulating the natural sleep-wake cycle.

The main source of blue light is solar. And from computer screens we get negligible, in comparison with the sun, the amount of blue light. During the day, he keeps us awake. And when its supply decreases as the sun goes down, melatonin, the sleep hormone that allows us to fall asleep, begins to be produced.

If there is no sharp drop in the concentration of blue light in the evening, melatonin will not begin to be produced in sufficient quantities and insomnia may appear. This is possible if we constantly block blue light during the day or use gadgets just before bed.

Is it possible to lift heavy objects or endure labor without a cesarean section if there is a high degree of myopia?

The degree of myopia should not influence the choice of the type of childbirth and limit the person in physical activity. This myth comes from Soviet decrees, when knowledge about the risk factors for retinal detachment was very different from modern ideas.

Retinal detachment is a severe but rare pathology. Indeed, patients with a high degree of myopia are more likely to experience this disease due to the fact that their retinas are thinner and stretched. To minimize these risks, they need to have regular check-ups by an ophthalmologist and avoid head and eye injuries.

But if on examination the doctor does not reveal dangerous changes in the retina, then there is no need to limit physical activity. We usually recommend refraining from contact sports or using special safety glasses.

Women can give birth naturally with any degree of myopia. If doctors find dangerous thinning, retinal tears, then they should carry out prophylactic laser treatment. Then the woman will be able to give birth without risk to eye health.

Only in very rare cases can there be indications from an ophthalmologist for a cesarean section with high myopia - these are changes in the central zone of the retina, when newly formed vessels grow under it, capable of hemorrhaging during the laboring period of labor.

What to do if after working at the computer there is redness in the eyes, as well as dryness and burning sensation?

Most likely, you have dry eye syndrome - this is a frequent companion of long-term work at the computer and other gadgets. When you focus on the screen, you blink less often. As a result, the eyes remain open for a long time and the tear film does not have time to renew itself.

Because of this, we begin to experience visual discomfort, pain, burning sensation, dryness and complain of redness of the eyes. And air conditioners or heaters make the situation worse. Here's what can help in this case.

• Try to improve the ergonomics of your workplace. Place the computer at arm's length and place the monitor below eye level (about 10 °). There should also be no big difference between ambient light and screen brightness. Also, remove light sources that create glare on the display.
• Remember the 20-20-20 rule: every 20 minutes, take your eyes off the screen for 20 seconds and look at objects 20 feet (6 meters) away from you.
• Rest for at least 15 minutes after every 2 hours of use in front of the screen.
• To relieve dryness symptoms, follow these guidelines: use a humidifier, blink frequently, apply warm compresses to the eyelids, and use moisturizing eye drops.

If that doesn't work, be sure to visit an ophthalmologist.

Also, similar symptoms can be caused by refractive errors ("imperfect" optics of the eye). For example, a person with astigmatism or high farsightedness who does not have special glasses or lenses may experience constant eye strain when working close.

Another possible cause of eye redness and increased visual fatigue is inconsistency in the work of two eyes, that is, binocular disorders (strabismus, lack of alignment of the visual axes).

The solution to these problems is to correct the causes of their occurrence. If you suspect that this is due to refractive errors or binocular abnormalities, see your doctor. He will ask the necessary questions, conduct research and, if suspicions are confirmed, select glasses or contact lenses.

What if I feel sick and have a headache when I wear glasses?

Fitting glasses is not a five-minute procedure. Trust this process to your ophthalmologist or experienced optometrist. Be sure to go around with a trial correction, share with the doctor your impressions, doubts or complaints, so that you can adjust the prescription before sending the glasses to production.

Good tolerance is a condition that must be taken into account when choosing glasses. If the ready-made glasses hurt and dizzy, first of all, they should be double-checked in the optics for compliance with the prescription. It is extremely rare, but there are mistakes during their manufacture. If everything is good there, then check the recipe itself. To do this, it is better to contact another specialist to get a second opinion.

There can be many reasons for discomfort: incomplete or excessive correction, lack of correction of astigmatism, incorrect center-to-center distance, double vision, poor choice of frames, absence or incorrect markings in complex glasses.

It should also be remembered that a significant difference from the previous prescription (for example, due to the fact that vision has decreased) and different lens designs may take longer to adapt to new glasses.

Also, don't be afraid of a complete correction. Often the addition of astigmatic correction or prisms in the presence of double vision solves the problem of dizziness and headache.

What negative effects can contact lenses cause and how can they be avoided?

The contact lens fits snugly against the cornea - the outer shell of the eye. If it is selected or used incorrectly, then the risk of injury or infectious inflammation of the cornea increases.

Oversized lens, prolonged sleep in it can aggravate dryness of the ocular surface or lead to insufficient oxygen supply to the cornea. In this case, vessels will begin to grow into it, and over time, the cornea may become cloudy.

Therefore, today the best choice is one-day contact lenses, since the risks of infectious complications in them are minimized. They do not require any special care, solutions or lens containers. And you can always carry spare blisters with them to replace them with new ones if necessary.

If you are using routine replacement lenses, it is very important to follow these guidelines.

• Strictly adhere to deadlines. If you are wearing lenses that are intended to be used for one month, then exactly one month after opening the blister, you must replace the lens with a new one. No matter how many times in a month you put it on.
• Wash your hands thoroughly with soap and water before handling the lens. And do not forget that the contact lens should never come into contact with ordinary water. This rule also applies to those who wear daily lenses.
• Power the lens surface daily. This is done with a finger and a multifunctional solution.
• Visit your ophthalmologist regularly, because in the early stages, complications of contact correction may remain invisible to the patient.

And if redness and pain in the eyes or blurred vision appear, you need to remove the lenses and consult a doctor as soon as possible.

Should you worry about your eyesight if your close relatives had eye diseases?

At the ophthalmologist's appointment, it is imperative to discuss a family history of eye diseases. If your next of kin has, for example, myopia, glaucoma or age-related macular degeneration, then this increases your chances of facing the same problems. But not necessarily.

Therefore, if there were eye diseases in the family, just notify the doctor about this in order to develop an individual examination plan with him and discuss the necessary observation intervals and possible prevention.

Can hyperopia be prevented or cured?

Age-related hyperopia (presbyopia) is a natural process that is associated with a decrease in the eye's ability to focus at different distances. This is due to the compaction of the lens (intraocular lens). Therefore, neither gymnastics nor vitamins can solve this problem.

Glasses for working close or glasses or lenses with different focal lengths (multifocal) will help to restore good vision and overcome difficulties when working with texts or gadgets.

If presbyopia is combined with cataract, then replacing the lens with a multifocal artificial lens can be a good method of treating two problems at once.