And contrary to the prevailing view of myopic eyes in these people's eyes are small and with a small radius of curvature of the cornea. Often, such a refraction occurs in the immediate relatives of the patient, since most often transmitted through an autosomal dominant type. These children are characterized by a sufficiently high visual acuity in the distance without glasses, even with high-degree myopia. Details about this disease and its progression - in an article on the topic "How to stop the progression of myopia in children."
Most often, parents pay attention to the fact that the child looks at pictures or toys, very close to their eyes, and this is due to the approach of a further point of clear vision. On the fundus, as a rule, there are no characteristic symptoms of elongation of the anteroposterior axis of the eye - the myopic crescent, the cone from the temporal side of the optic nerve disk or even the staphyloma around it. There is no depletion of the membranes of the eye, when large choroidal vessels are seen through the stretched layer of the pigment epithelium. Moreover, there are no symptoms of a complicated course of myopia with changes in the macular area, thinning of the retina and dystrophy at the periphery. In children of school age, when there is progressive myopia, such changes, for example, around the optic nerve disc, may be, but they do not correspond sharply with the degree of myopia. Ophthalmometry will indicate a decrease in the radius of curvature of the cornea and an increase in its optical power compared with the age norm. Ultrasound examination will show that the size of the eye PZO corresponds to the age or even less. It is very important to carry out the biometrics of the eye in two planes: horizontal and sagittal. With myopia, the eye retains an ellipsoidal shape, typical of a healthy organ, as if with a flattened posterior pole of the eye. Therefore, in healthy eyes, the horizontal axis will be larger. The same relationship is typical for myopia. Rational optical correction of the eyes of such children promotes the stability of refraction and does not require any additional conservative or surgical treatment.
Of particular importance is the ultrasound examination for the second variant of myopia, due to the large size of the eyeball. It is typical for it as an increase in the length of the anteroposterior and horizontal axis of the eye. And because of the ellipsoidal shape, the size of the second is also somewhat larger. Unfortunately, with this variant of myopia, the disproportionate increase in the shape of the eyeball may be due not only to heredity, but also to intrauterine factors that lead to a disruption in the formation of the eyeball. In a number of cases, it can be a fetal intrauterine infection, intoxication of the fetus. Its symptoms are sometimes found in the form of old pigmented chorioretinal foci or barely noticeable white foci on the periphery of the retina. It is believed that it is in these cases that there may be a decrease in the maximum visual acuity with correction, called as "amblyopia" (often not amenable to treatment). In patients with disproportionately large eyes, an autosomal recessive type of inheritance is also often observed, often resulting in the development of complicated myopia. It is clear that the only way to manage such patients with myopia is rational correction with negative glasses or contact lenses (with myopia of high degree) for the prevention of amblyopia and the progression of myopia. It is important to emphasize that with myopia of more than 2 D, many physicians insist on the mandatory wearing of correction tools when performing work at close range. This helps to avoid the increased convergence associated with the close optical installation of such an eye, prevents the weakening of accommodation and the progression of myopia. Of course, in the stationary state of myopia, these children do not need any sclera-hardening surgeries. Unfortunately, ineffective correction of vision and intense visual load can provoke the progress of myopia. And the sooner it occurs, the more malignant it is and can lead to complicated myopia. In these cases it is necessary to carry out treatment aimed at stabilizing the process of eliminating progressive myopia.
After 5 years with stable myopia, questions of surgical correction of vision can be discussed. And the first variant of myopia is almost the only case of pathogenetic orientation of keratorefrakion operations. In particular, excimer laser correction, when a really "steep" cornea is really cut off in the development of myopia. Now we know how to stop the progress of myopia in children.