Hypermetropia at a very early age. Hypermetropia - what is it with vision, what does congenital farsightedness mean in children Other examination methods

The eyeball of a newborn and during the first years of life is relatively large in relation to the entire body.
The most intensive growth of the eyeball is observed during the first year of a child’s life. By the age of two, the eyeball increases by approximately 40%, and by the age of 20-21 - 1.5 times compared to a newborn. In a newborn, the eye weighs 2.3 g, and in an adult it is more than 3 times heavier - 7.5 g. Thus, in a newborn, the weight of both eyes in relation to body weight is 0.24%, and in an adult only 0.02%.
Then the growth of the eyeball slows down somewhat; from approximately 12-14 years of age, its intensive growth occurs again until the age of 20-21.
The anterior chamber of the eye of a newborn is small and normally is no more than 2 mm, reaching a depth of 3 mm, as in an adult in the first months of life with the onset of active functioning of the choroid.

Dynamics of growth and development of the cornea

In newborns, the diameter of the cornea averages 9.4 mm, gradually increasing to 11-11.5 mm, i.e., to the size of an adult. By 1 year of life it reaches 11.25 mm. The formation of the thickness and curvature of the cornea ends in the second year of a child’s life. The refractive power of the cornea in a newborn is more than 50 diopters and decreases over the next 3-5 years. The change in the refractive power of the cornea is associated with its flattening and an increase in the radius of curvature. In a newborn, the curvature of the outer radius of the cornea is normally approximately 7-7.3 mm, and in an adult it is 7.8-8.0 mm. In adult emmetropes, the diameter of the cornea is on average 11.6-11.7 mm. The total area of the cornea over its surface is 1.3 cm2, which is 7% of the entire surface plane of the outer capsule of the eyeball. The total mass of the cornea is about 180 mg. The ratio of the area of the anterior surface of the cornea and the total surface of the outer capsule of the eyeball with a diameter of 24 mm corresponds to 1:15.6.
The average radius of curvature of the cornea reaches 8 mm, and in men it is 1.5% greater than in women. The thickness of the cornea, obtained on the basis of intravital studies, by the age of 55 in the central zone is 0.539 mm, and in the periphery - 0.676 mm. The thickness of the cornea between the center and periphery ranges from 0.1 to 0.3 mm. Optically, the cornea refracts light rays like a strong convex lens, exceeding the refractive power of the lens by more than 2.5 times. The refractive power of the cornea is more than 40 diopters, the lens - about 20 diopters in the resting state of accommodation.

Dynamics of growth and development of the lens

A newborn's lens is almost spherical in shape, very soft in consistency, transparent and colorless. Throughout life, new lens fibers grow and are added, enclosed in the enclosed space of the lens bag (capsule). This leads to a gradual increase in the relative density of the lens, its mass and volume. The relative density of the lens at 20 years of age is 1.034, at 50 years of age - 1.072, at 90 years of age - 1.113.
In adults, the equatorial diameter of the lens reaches 9-10 mm, the sagittal size - 3.7-5.0 mm. The thickness of the anterior capsule is 11-15 microns, the posterior one - 4-5 microns. The inner surface of the anterior capsule contains a single-layer, transparent cubic epithelium, the posterior capsule is devoid of epithelium. The intensity of the yellowish tint of the lens increases with age.
By the age of 40-45, the core of the lens becomes dense, it loses its elasticity. By this time, accommodation is significantly weakened and presbyopia occurs. By the age of 60, the ability to accommodate is lost almost completely due to severe sclerosis of the lens nucleus - phacosclerosis. During this period of life, thickening of the anterior lens capsule up to 17 microns is also noted, and in the paracentral zone - up to 25 microns. The equatorial (germental) zone does not undergo significant changes in its thickness due to age.

So, let's discuss the most necessary points that parents should know regarding the formation, development and development of the child's organ of vision.

The average size of the eyeball in the population is 24.22 mm. No matter how strange it may sound, the vast majority of healthy people, regardless of gender and race, have this length of the eyeball; the shape and size of the palpebral fissure is subjective and individual.

A newborn is born with an eyeball size of about 20 mm. According to the laws of physics and optics of the eye, if the eyeball is larger than the required size, then the person is nearsighted - myopic, if less - farsighted - hypermetropic. From here we conclude that all children are normally hypermetropic until a certain age - 6-7 years old, by which time the eyeball has grown, and therefore this moment is almost fundamental when a child enters school - that is, at least 6 years old. A small note - there is no point in taking a child under 4-5 years old to the zoo, he simply will not be able to see the animals in the enclosures

The newborn’s eye is not adapted to daylight, the retina immediately after birth is not able to see 100%, and in the first months of life the baby can distinguish objects at a distance of about 30-40 cm, which is enough to properly look at the mother while in her arms or during feeding.

By the end of the first year of life, the baby has about 10% of the vision of an adult healthy person; this is only the first line of the ophthalmology office table. Every year the percentage of vision increases and by school age it normally develops to its maximum. If a child's eye grows faster, it becomes nearsighted; if it grows slower, it becomes farsighted. Since the development of vision function occurs until approximately 7 years of age, regular visits to an ophthalmologist are mandatory, because it is at this age that you can help the child as much as possible and try to correct existing changes. There is practically no prospect of developing visual functions in children over 10 years of age.

Let's talk about timing and frequency of visits to the ophthalmologist’s office.
I will not list the entire range of possible intrauterine changes that a child may already be born with. I’ll tell you about the main ones - congenital glaucoma, congenital cataracts, the consequences of intrauterine inflammation of the internal membranes - uveitis. These conditions are urgent and require emergency care. Therefore, at the moment, pediatric ophthalmologists have opened the question of a mandatory ophthalmological examination already in the maternity hospital. So far, this benefit is not available to us, and the first visit to an ophthalmologist is legally mandated at the age of 1 month, then at 6, 1 year, 1.5, then once a year. This is the frequency of clinical examinations of healthy children; existing problems are solved individually.

How he looks baby's doctor?
First of all, the condition of the lacrimal ducts is assessed; I have already devoted an article to this issue. Then possible strabismus is identified, the degree of refraction is assessed using skiascopy and, if necessary, the fundus is examined. In cases where a more detailed examination is necessary, the child is given medicated sleep. More or less objective answers according to visual acuity tables can be achieved in a 3-year-old child, and younger children can be seated at an autorefractometer, if there is one in the office.

And now about the most important thing - what parents should pay attention to.
1. Graefe's symptom - lag of the upper eyelid from the edge of the iris when looking down. Another name is the setting sun symptom. It is normal until 2 months of age; after that, a visit to a neurologist is required.
2. Nystagmus - small-scale synchronous movements of the eyeballs. It is considered physiological again at the age of up to 2 months, it is also called installation, as the child learns to fix his gaze. In other cases - again, your doctor is a neurologist.
3. Deviation of the eyeballs - strabismus. Up to 2-3 months is allowed, and after that you come to us. In most cases, the worse seeing eye is rejected, since the brain, to put it simply, does not need it, and the brain turns it off, the eye, as unnecessary, behaves as it pleases. There are a lot of reasons - the most common are, again, cataracts, glaucoma, high farsightedness, opacities in the vitreous body of various origins.
4. Different eye sizes. There are two sides to the issue here - microphthalmos, a smaller, lagging size, and buphthalmos - bull's eye. Children with congenital myopia and bilateral glaucoma are characterized by large, beautiful eyes. Dear parents, let’s not rejoice, but run to the doctor.
5. Different colors of the irises and the shape of the pupil are the consequences of previous uveitis. By the way, the final pigmentation of the iris of light-eyed children ends by the age of 2, while brown-eyed children already appear from the first months of life. The most alarming color is green.
6. The saddest moment is the lack of reaction of the pupil to light or the flip side is severe photophobia.

Premature babies deserve special attention. Retinopathy of prematurity- pathological processes in the retina due to its immaturity at the time of premature birth. The topic is extremely complex and individual. The risk group is gestational age less than 35 weeks and weight less than 1500g. Such babies should be examined 4 to 6 weeks after birth.

The easiest way assess whether there are any reasons for concern using a camera. We photograph children both with and without red-eye reduction. The presence of eye deviation is determined by the symmetry of the light glare relative to the pupil. The transparency of optical media is assessed by the red eye effect - a normal pink reflex of a healthy retina. If there is no red-pink glow, this is an alarming sign of clouding in the optical media - lens, vitreous body, retina (especially alarming in relation to an extremely malignant tumor of the retina - retinoblastoma).

The main advice to mothers of schoolchildren is the key to success - compliance with the visual load regime and mandatory spectacle correction if necessary

Sincerely, your ophthalmologist

In modern times, various visual deviations are very common in children. And in many cases, a disease such as hyperopia manifests itself, which requires immediate correction. This disease is especially noticeable at the age of 5-7 years, when the child begins to study disciplines and reading. This is understandable, but read this article on how to cure farsightedness in children.

What it is?

Hyperopia is a refractive error of the eye, in which the image located at long distances is focused not in the center of the retina, but behind it.

Due to refractive error, the refractive power of the eye is impaired and poor visibility of nearby objects occurs.

Farsightedness in children is divided into three types:

weak (up to 3 diopters);
medium (up to 5 diopters);
high (more than 5 diopters).

After birth, children always exhibit an average degree of farsightedness (about 3 diopters). By the age of 3, the visual system of children becomes more developed and the degree of farsightedness decreases to 1-1.5 diopters.

However, some children are born with a high degree of farsightedness, which does not decrease as the child grows and develops.

As a rule, the first examination by an ophthalmologist in children is carried out 6 months after birth, the second examination – after 12. The norm at one year of age is farsightedness of no more than 2.5 diopters.

There are the following age norms for the manifestation of hypermetropia:

1 year – + 2.5 D;
2 years – + 2.0 D;
3 years – + 1-1.5 D.

Typically, deviations above or below these norms in children are considered a bad sign. If the deviation is above the age norm, then it is quite possible for it to occur; if the deviation is below the norm, myopia is likely to develop.

Parents need to especially pay attention to the presence of visual abnormalities in a child at 6-7 years of age, when the child enters school.

This is the maximum age when manifestations of farsightedness in children are not the norm, but a pathology that requires mandatory correction. If farsightedness is not treated at this age, there is a high risk of complications. In addition, a child’s education at school will place a heavy load on the child’s visual system, which is fraught with rapid progression of vision pathology.

Causes

In the vast majority of cases, the cause of hypermetropia is a decrease in the size of the eyeball in the anteroposterior axis.

In this case, the eye takes on a flattened shape, and as a result, light rays passing through the optical system of the eye are focused behind the retina, which ultimately leads to unclear, blurred vision of objects.

In children, farsightedness manifests itself early in life. The main cause of farsightedness in the vast majority of cases is an anomaly in the anatomy of the eye.

Typically, children have a very small eyeball in the first years of life. However, gradual elimination of this visual defect occurs due to the growth of the eyeball as the child develops. Some newborns exhibit congenital farsightedness. The occurrence of this disease occurs due to the congenital weak refractive power of the lens or cornea. Congenital farsightedness in children is usually of a high degree (more than 3 diopters).

In this case, there is a risk of developing concomitant eye diseases - strabismus and amblyopia.

Symptoms

Symptoms of hyperopia may vary depending on the degree of hyperopia:

With weak farsightedness, a child usually shows good results both at long and near distances, but at the same time he may complain of fatigue, dizziness and headache.
If a child has an average degree of hypermetropia, he can distinguish objects well at long distances, but visual acuity at close distances is quite reduced.
With high degrees of farsightedness, vision is quite difficult both at close and long distances. This is caused by the eye's inability to focus the image on the retina.

Diagnostics

Hypermetropia can usually be detected only in an ophthalmology office with the help of a special vision examination. This eye disease cannot be detected by a routine vision test. Children need to be diagnosed with hypermetropia regularly, at least once a year.

In some cases, in children, mild farsightedness can be compensated by the accommodative apparatus of the eye, so a false statement may be created that the child has good vision that does not require correction. Ophthalmologists call this latent farsightedness. As a result, a hidden vision problem can subsequently lead to a gradual decrease in vision, as well as a general deterioration in the child’s condition in the form of rapid eye fatigue and frequent headaches. As a rule, untimely detected farsightedness can only be corrected later. Therefore, examination of the visual system should always be thorough and regular to avoid such problems.

Detection of hypermetropia in children is carried out by the method of drug dilation of the pupil, with the help of which the lens of the eye relaxes and the real refraction of the eye becomes obvious.

Treatment

In modern times, ophthalmology has in its arsenal about 20 effective methods for treating hypermetropia.

The most common methods for correcting hypermetropia are spectacle and contact lenses. However, these vision correction methods are temporary, as they are not able to permanently rid a child of farsightedness.

Before the age of 3, children do not undergo farsightedness correction. Before this age, wearing contact lenses or glasses is contraindicated for children, as they can pose a significant danger to them. Microsurgical operations on the eyes, as a rule, are not performed until the end of the period of active growth of the organ of vision.

At older ages, spectacle correction of farsightedness is permitted. The selection of glasses and control of the treatment is carried out by an ophthalmologist. To treat myopia, as a rule, spherical or spherocylindrical converging (“plus”) lenses are selected, with the help of which the focus shifts to the surface of the retina.
Wearing contact lenses is usually only allowed for high school teenagers, since this category of children treats such vision correction responsibly. It will be quite difficult for young children to get used to contact lenses; in addition, lenses require strict adherence to wearing rules, hygiene, and careless use of lenses can lead to infectious diseases.

Spectacle or contact vision correction in children can be combined with hardware or physiotherapeutic treatment. It is used to stimulate visual function, relieve spasm and train the eye muscles.

You can read about conjunctivitis in infants in this article.

There are the following physiotherapeutic procedures for the treatment of farsightedness:

Transcutaneous electrical stimulation. It is carried out to improve blood supply to the ciliary muscle and retina.
Electrical stimulation using low-intensity infrared laser. The procedure is performed to stimulate fluid circulation in the eye and restore blood circulation. Also produces an anti-inflammatory effect.
Color pulse stimulation.
Vacuum massage.
Ultrasound therapy.
Electrocoagulation.

To avoid progression of the disease, additional drug treatment is carried out. To eliminate complications and symptoms of farsightedness and improve metabolic processes in the tissues of the eye, ophthalmologists prescribe special medications.

When treating hypermetropia in children, laser correction is also possible. As a rule, it is performed on children over 18 years of age who have a stable form of hypermetropia. This is a highly accurate, painless method for correcting hypermetropia and other types of refractive error. Laser correction allows you to completely restore vision with hypermetropia up to + 6 diopters. However, there are certain contraindications for this procedure. It is also important to be aware that laser eye surgery can cause significant complications.
With a high degree of hypermetropia (more than + 6 diopters), microsurgical refractive surgery is performed. During the operation, the clear lens is removed and an artificial intraocular lens is implanted in its place. With the help of an artificial lens, you can clearly see objects both at close and far distances.

The child’s diet is of great importance in the treatment of hypermetropia. The child should eat foods rich in vitamins, microelements and antioxidants.

The following have a beneficial effect on the eyes:

blueberry;
cherries;
carrot;
cowberry.

greens (dill, green onions);
citrus fruits (orange, lemon);
black and red currants;
rose hip;
kiwi;
cranberry;
Rowan.

To strengthen the blood vessels of the eyes, children suffering from farsightedness are recommended to consume foods rich in polyunsaturated acids:

vegetable oils (especially corn and olive);
sea fish;
seafood;
nuts.

Complications

If you ignore treatment for high degree of farsightedness in children, there is a high risk of complications. If a child’s refractive error is not detected and corrected in a timely manner, complications such as convergent strabismus and amblyopia may develop.

Convergent strabismus occurs due to overstrain of the extraocular muscles. Overexertion usually occurs due to the fact that the baby is constantly trying to bring his eyes to his nose in order to see more clearly. Due to prolonged overstrain of the eye muscles, it can also develop. This disease, as it develops, leads to a loss of the ability to respond to changes in focal length, as a result of which visual acuity rapidly decreases.
As strabismus progresses, a complication associated with strabismus occurs – amblyopia. Amblyopia in most cases develops in children with advanced farsightedness. This visual deviation manifests itself in decreased visual acuity in one of the eyes. Very often, amblyopia develops as a concomitant disease with strabismus.

Progressive farsightedness can cause significant complications. If this disease is not treated, the outflow of intraocular fluid in the eye may be impaired and glaucoma may eventually develop. This complication manifests itself in a constant or periodic increase in intraocular pressure above the permissible level. Glaucoma usually leads to blindness.

Prevention

Hypermetropia in children is quite difficult to treat. Therefore, this disease is easier to prevent than to cure. Preventive measures are especially necessary for children with a hereditary predisposition to farsightedness.

To avoid the development of farsightedness, you must adhere to the following rules:

Visual stress should always be alternated with active recreation.
The workplace must be well lit.
Playing sports and spending long periods of time outdoors are advisable.
The child should have a balanced nutritional diet, rich in vitamins and microelements.
Regular eye exercises are recommended.
Examinations by an ophthalmologist should be regular (at least once a year), even if farsightedness does not manifest itself.

Video

conclusions

Hypermetropia () is a fairly serious but treatable disease in children. To avoid the negative consequences of this disease, parents need to regularly examine their children with an ophthalmologist. Moreover, it is best at a young age.

At birth eye A normal full-term baby is 65% the size of an adult eye. In the postnatal period, maximum eye growth occurs during the first year of life, then growth continues at a high but gradually decreasing rate until 3 years, after which slow growth occurs until puberty, and the eye remains almost unchanged throughout subsequent life. It can be said that the anterior structures of the eye are relatively large at birth and subsequently grow proportionately less than the posterior ones.
The result is a progressive change in the shape of the eyeball, which becomes more spherical.

Sclera baby is thin and transparent, with a bluish tint. The cornea of a newborn's eye is relatively large (on average 10 mm), and by the age of 2 years or earlier it reaches the size of an adult (about 12 mm). Its curvature decreases with age with a progressive change in the refractive properties of the eye. A normal cornea is perfectly transparent. Premature infants may have opalescent corneal opacity that disappears over time.

The anterior chamber appears shallow in the newborn, and the angle structures that maintain normal intraocular pressure (IOP) must undergo further differentiation after birth. The iris, which is light blue or gray at birth in white-skinned individuals, progressively changes color as the stromal pigmentation increases over the first 6 months. life. The pupils of a newborn baby are small and difficult to dilate. Ophthalmoscopic examination often reveals remnants of the pupillary membrane (anterior vascular membrane) in the form of arachnoid filaments crossing the pupillary aperture, especially noticeable in premature infants.

Newborn lens baby has a more spherical shape than the adult lens; its higher refractive power compensates for the relatively short axis of the young eye. The lens grows throughout life; new fibers appearing at the periphery push older fibers toward the center of the eye. With age, the lens becomes denser and more resistant to changes in shape during accommodation.

Ocular fundus the newborn eye is less pigmented than the adult eye; The choroidal vascular pattern is clearly visible, the pigment pattern of the retina has a small dotted or spotted structure. Some darkly pigmented (black-skinned) babies have a gray or opalescent film (plaque) in the fundus of their eyes. In newborns, some macular indicators, especially the foveal light reflex, are less pronounced and not so easily determined. The peripheral retina appears pale or grayish, and the peripheral retinal vessels are underdeveloped, especially in premature infants.

Color optic nerve heads varies from pink to pale, sometimes grayish. Within 4-6 months. the fundus takes on the appearance of a mature eye.
For many newborns In infants, superficial retinal hemorrhages are observed. They usually dissolve quickly and rarely leave lasting marks. At birth, conjunctival hemorrhage may occur, which resolves spontaneously without any consequences. Remnants of the primitive hypoploid vitreous vasculature are sometimes visible as small fascicle- or vermiform structures radiating from the disc (Bergmeiger's nipple) or as a thin filament passing through the vitreous; in some cases, only a small point (Mittendorff's point) remains on the posterior side of the lens capsule.

baby eye is to some extent farsighted. Farsightedness tends to progress from birth to 7 years of age. After this, the level of farsightedness decreases rapidly until age 14. During this time, farsightedness may disappear. If this process continues, myopia (nearsightedness) develops. A slower decline in farsightedness, or progression of myopia, continues into the third decade of life. The refractive power of the eye at any period of life is determined by the cumulative effect of many factors: the size of the eye, the condition of the lens, the curvature of the cornea.

U newborn babies eyes closed most of the time, but normal infants can see, respond to changes in light, and fix points of contrast. Visual acuity in newborns is determined in the range of 20/400. One of the earliest reactions to a formed visual stimulus is looking at the mother's face, especially during feeding. By the 2nd week of life, the baby's gaze is fixed on large objects, and by the 8th to 10th week, a normal infant can follow an object within 180°. Visual acuity improves quickly and by 2-3 years can reach 20/30-20/20.

U many normal babies There may be imperfect coordination and consistency of eye movements during the first days and weeks, but by 3-6 months. (usually sooner) coordination becomes normal. Persistent eye deviation in an infant requires consultation.

Tears usually absent when a child cries before 1-3 months of age. In premature infants, the reflex and basal secretion of tears are reduced, which causes an increase in the concentration of locally applied agents and rapid drying of the cornea.

The structure of our visual system is such that it has a number of functional features. To obtain a clear and unblurred image, light rays must pass through refractive media.

Collecting at the main focus located on the retina, light rays stimulate receptor cells to generate a nerve impulse, which, when converted in the brain, produces an image. In other, not entirely correct, words, the resulting image should be displayed on the retina.

In the case of farsightedness (hyperopia), the main focus lies behind the retina. Everything that is at a distance gets onto the retina and, therefore, is displayed. This means that images of objects located close do not reach the retina, and therefore their contours appear blurry.

All this occurs due to the discrepancy between the power of the refractive media (cornea and lens) and the length of the eyeball. In farsighted people it is usually a little less.

Farsightedness in 1-year-old children is explained by the small size of the eyeball and the imperfection of the visual analyzer, which is actively developing. All newborns, infants, and infants suffer from hypermetropia. But after a year, with a gradual increase in the size of the eyeball and the development of visual functions, farsightedness usually becomes less, and by the age of 3-4 years it gradually disappears.

However, there is also congenital farsightedness in children. In this case, the child’s visual acuity tends not to increase with age, but, on the contrary, to decrease. Congenital hypermetropia can also be caused by weak refractive power of the optical system.

Farsighted astigmatism in children, which is also called hypermetropic, is a certain congenital feature due to the fact that the refractive power of the cornea or lens in different areas (and often in meridians) is different. As a result of this, in addition to the fact that objects are better visible from a distance, they also appear curved, twisted or broken.

Factors predisposing to farsightedness

Farsightedness in a child can be caused by one or several factors, which, in combination with the individual characteristics of the structure and functioning of the visual analyzer, lead to this disorder.

If at least one of the parents has a so-called refractive error (farsightedness, nearsightedness, astigmatism), then most likely the child has all the prerequisites for its development.

Presbyopia (age-related farsightedness), which appears after 45 years, cannot be considered a hereditary factor, since its appearance is associated with age-related weakening of the muscles that change the shape and position of the lens, and initial changes in the structure - clouding, changes in density, and the appearance of a vacuole.

Ecology and medications used during pregnancy

Any chemical compounds directly or indirectly affect the development of a child in the prenatal period. This does not mean that you should stop taking your medications to maintain your health or immediately move to another place.

It’s just that in some cases we don’t always know what kind of water flows from our tap and what kind of air we breathe. Therefore, we cannot predict how this will affect the child.

High visual load

In cases of mild farsightedness, the body is able to try to cope on its own by changing the position of the main lens of the eye - the crystalline lens. However, increased visual stress causes muscle fatigue and leads to the progression of hypermetropia.

Symptoms to suspect farsightedness

Childhood farsightedness has a number of indirect symptoms that allow attentive parents suspect this refractive error and promptly consult an ophthalmologist:

low visual acuity or its decrease. A 2-3 year old child examines fairly large objects at close or very far distances.
Watch your child carefully to see if he always does this or just plays. If your baby has a sufficient vocabulary, you can try to test his visual acuity by placing his toys at different distances. And ask to show where each one is. For a 4-5 year old child, you can try showing pictures, circles, letters at a distance;
It is difficult for a child to concentrate his attention on activities that involve the development of fine motor skills and books. In this case, try to determine whether the baby likes what he is doing. Perhaps he is simply tired of fixing his gaze up close, or he does not like this activity;
after creative reading activities, the child complains of a headache;
the appearance of a progressive Children under 1.5 years old may squint their eyes while trying to look at an object. This is explained by the imperfection of gaze fixation mechanisms. If strabismus does not decrease, but intensifies, you should immediately consult a doctor.

There are 3 degrees of farsightedness

Weak degree (up to 2 diopters). Very often the body is able to cope with it on its own. However, the child may complain of a headache that appears after working with objects at close range. Distance vision is high.
Medium degree (from 2.25 to 5.0 diopters). both at close and far distances.
High degree (above 5 diopters). Poor vision both near and far.

Determination of visual acuity(visiometry). There are special children's tables for determining vision; they show pictures. Children who know the alphabet are shown letters. If the level of vision is low, then they show cards with sticks or fingers drawn on them that need to be counted. Determining visual acuity is always considered a subjective method that allows one to judge the performance of the visual analyzer. After determining visual acuity, the maximum vision correction with spectacle lenses is determined. This correction is not final; glasses and lenses cannot be prescribed for it, since true farsightedness can only be determined by achieving complete cycloplegia. Cycloplegia is a condition in which the ability to accommodate oneself is blocked with the help of special eye drops.
Fundus examination(ophthalmoscopy). Allows you to identify the initial stages of organic diseases, one of the manifestations of which is progressive farsightedness.
Skiascopy in conditions of complete cycloplegia. Allows you to objectively determine the magnitude and, accordingly, the degree of hyperopia and hyperopia.
Refractometry. A hardware method that allows you to measure the power of the refractive system of the eye and identify the astigmatic component.
Ultrasonography(A-scan and B-scan modes). Allows you to determine the anterior-posterior size of the eye (eye length), as well as visualize a number of intraocular pathologies.

There are conservative and surgical methods for treating farsightedness in children.

The main non-operative method is the selection of spectacle or contact correction.

An ophthalmologist can prescribe glasses for farsightedness only after achieving complete cycloplegia. They begin to wear them while the effect of the drug has not yet worn off, and the pupil is still wide. Very often, children do not want these drugs to be dropped into their eyes, as it makes it worse to see.

It must be remembered that the effect of the drug is temporary, and non-compliance with the doctor’s recommendations leads to the fact that due to a certain discomfort that occurs when wearing without achieving persistent cycloplegia, the child will take off his glasses. In this case, farsightedness will either progress or vision will be significantly reduced, which can lead to amblyopia - “lazy eye” syndrome.

If spectacle vision correction is adequately selected and the child is old enough to wear lenses, contact vision correction can be used. In the case of hypermetropic astigmatism, it is possible to select lenses with an astigmatic component.

To avoid unwanted diseases, you should follow the rules for wearing and caring for lenses, which will be explained in detail by your ophthalmologist.

Surgical treatment Can only be carried out by those over 18 years of age. It consists of one type of laser vision correction, implantation of special phakic lenses, or planned removal of the lens with implantation of an intraocular lens. This age was not chosen by chance, since it is believed that it is before this age that the anatomical and functional development of the organ of vision occurs. For patients with astigmatism, there are toric lenses that take into account the astigmatic component.

Surgical treatment is selected taking into account all the individual characteristics of the patient. It is possible to carry out combined surgical interventions in order to obtain the highest visual acuity.