In recent years, the age of myopia in children and adolescents has not only moved forward, but also the incidence has increased year by year, which has become a major public health problem affecting the national health in China.
It is particularly important to take appropriate measures to control the progress of myopia. Corneal plastic lens is one of the most recognized methods to prevent and control myopia in clinical practice.
The back surface of the corneal shaping lens is designed with inverse geometry. The lens changes the curvature of the cornea through the mechanical compression on the cornea, the negative pressure of tears and the compression of the eyelids, so that the refractive state in the middle and periphery of the retina tends to be normal, thus temporarily reducing the myopic diopter, and ultimately improving the naked eye vision.
What is the fitting process of the corneal shaping lens? The initial diagnosis and time division of the wearer can be divided into: inspection before initial fitting, inspection on the day of taking the mirror, recheck on the first day of wearing the mirror, and recheck after fitting.
The initial pre matching examination process includes medical history, specialized examination, diagnostic trial wear, fitness evaluation and parameter adjustment, nursing guidance and education.
Only after the wearer and (or) the guardian fully informed and agreed on the benefits and risks of the corneal plastic lens and the prevention and control mechanism of the corneal plastic lens on the progress of myopia, can a complete and standardized special examination be carried out to ensure that the corneal plastic surgery is safe, non-invasive and effective in reshaping the corneal morphology.
In clinical practice, in addition to the necessary examinations emphasized by consensus, more in-depth ophthalmology and optometry examinations are usually carried out for the wearer, including fundus examination, intraocular pressure, ocular ultrasound, eye position, tear film quality, corneal diameter, pupil diameter, corneal endothelial cells, etc. In addition, contrast sensitivity, glare contrast vision, wavefront aberration, etc. can be checked.
In the process of diagnostic trial wearing of lenses, Chinese doctors should show the wearer and/or guardian the steps of washing hands, removing and wearing lenses and cleaning lenses in a standardized way, so that they can gradually establish the concept of standard wearing and correct nursing. At the same time, through the comparison and adjustment of static and dynamic evaluation, the final prescription can be obtained.
The inspection process of mirror removal day is divided into wearing glasses and removing glasses, and the relevant inspection is combined in a subjective and objective way.
During the process, the doctor must check the lens information and confirm that the patient goes to take the lens for examination when the patient's eye and body health are good; In order to avoid corneal epithelial damage caused by lens removal and wearing and evaluation errors caused by other eye irritation, the doctor should carry out the process of lens removal and wearing and nursing education for the new wearer at the end to ensure that the wearer can complete the complete procedure of lens removal, lens wearing and nursing by himself or with the help of the guardian.
The first day recheck of wearing glasses clearly stipulates the recheck contents and the wearing time of the wearer.
① The night before the follow-up should be no less than 8h of sleep time with glasses on, and within 2h after getting up in the morning, the patient should return to the hospital in a timely manner with glasses on and consolidate the learning curve of removing, wearing and nursing.
② Scratches and precipitates on the lens appearance should be checked as routine items in the ophthalmologist's review process.
The complications of corneal shaping lenses often affect their effectiveness and safety. Therefore, the process of re examination after wearing the glasses is mainly reflected in preventing the occurrence of potential risks to eye health. While tracking the progress of myopia and the length of the eye axis, doctors should pay close attention to whether corneal shaping also causes pathological changes to eye physiology.
During the daily follow-up, it is necessary to combine the ocular surface condition, corneal topography, lens fitting and lens condition. If the naked eye vision is found to be poor, it is necessary to wear glasses to check according to the situation and combine the eye parameters and lens fitting to determine whether the lens parameters need to be adjusted or wear compensation glasses.