近视眼要不要一直戴眼镜,配镜有何讲究

2017-04-25 王一心/上海中医药大学附属岳阳中西医结合医院眼科主任医师 澎湃新闻

人的一生中,或早或晚都要与眼镜打交道。有近视的要佩戴矫正近视的眼镜,有远视的要佩戴矫正远视的眼镜,有散光的要佩戴矫正散光的眼镜。就算你是正视眼,到了中老年,老视眼(即老花眼)就会找上门来,还非得配副老花眼镜。那么,近视眼应该配框架眼镜还是隐形眼镜?配镜之后,需要一直佩戴吗?这些问题都是近视患者的共同困惑,就让我们聊聊关于眼镜的那些事。配眼镜有何讲究不论是近视、远视、散光,在医学上都称为屈光不正。老

人的一生中,或早或晚都要与眼镜打交道。有近视的要佩戴矫正近视的眼镜,有远视的要佩戴矫正远视的眼镜,有散光的要佩戴矫正散光的眼镜。就算你是正视眼,到了中老年,老视眼(即老花眼)就会找上门来,还非得配副老花眼镜。

那么,近视眼应该配框架眼镜还是隐形眼镜?配镜之后,需要一直佩戴吗?这些问题都是近视患者的共同困惑,就让我们聊聊关于眼镜的那些事。

配眼镜有何讲究

不论是近视、远视、散光,在医学上都称为屈光不正。老视是由于年龄增长所致的眼睛生理性调节减弱所致,是每个人都会发生的。为了看得清楚、看得舒服、看得持久,获得最佳的视觉效果,我们就必须矫正上述屈光不正和老视。

怎么矫正呢?方法无非是三种类型:框架眼镜、角膜接触镜(俗称隐形眼镜)、屈光手术(包括激光和非激光角膜屈光手术、眼内屈光手术)。由于老年人手脚不太利索,角膜接触镜一般不适合老年人;另外由于角膜接触镜的镜片与角膜、结膜、泪膜等直接接触,容易影响眼表面的正常生理。屈光手术要改变眼组织结构,有一定的风险。所以隐形眼镜和屈光手术都是可能带来隐患的矫正视力方法。最安全、最方便、最廉价的,还是框架眼镜。

框架眼镜主要使用球镜、柱镜或球柱镜(现多为环曲面)来矫正屈光不正。球镜用于矫正单纯近视或远视,其中负球镜用于矫正单纯近视,正球镜用于矫正单纯远视和老视。柱镜和球柱镜用于矫正散光。

框架眼镜最主要的优点是安全、简便、经济。框架眼镜的镜片材料主要有玻璃和树脂。玻璃镜片耐磨性好、折射率较高,但较重、易碎。树脂镜片的特点是不易破碎、较轻、抗紫外线,但易磨损,现在镀膜工艺的发展逐步克服了树脂镜片的易磨损等问题。

如今框架镜片的设计已有突破性进展。非球面镜片使镜片更薄、更轻,并减少了像差,提高了像质。还有用于矫正老视的渐变多焦点镜片,通过同一镜片的不同区域看清远、中、近不同距离的物体。渐变多焦镜片上方为视远区,下方为视近区,之间为看中距离的渐变区,即度数逐渐变化的区域,两侧为变形(像差)区。多焦眼镜的价格偏高,佩戴的适应期较长。

当然,框架眼镜也有弊端,比如影响外观,特别是有一双漂亮眼睛的女孩;有时做事不方便,受环境气温的影响大,镜片起雾就看不清了;不适合在运动和演出等场合佩戴。

此外,对于度数较高的近视或远视,戴镜后物体有一定程度的变形(近视变小、远视变大)、视野变小;两眼屈光度数相差太大(一般超过250度以上)的人,就不好配镜了,勉强佩戴眼镜很容易疲劳,有时还会出现重影而难以适应。

正是框架眼镜的这些弊端,角膜接触镜和屈光手术才应运而生,但不管是采取哪种方法矫正视力,都要把眼睛的安全放在第一的位置。

眼镜要一直佩戴吗?

许多人虽然是近视眼,也配了眼镜,但出于各种原因,如戴镜的习惯、对戴镜外观的考虑、工作和运动的需要等等,并不是一直佩戴。那么到底近视眼镜是应该经常佩戴呢,还是需要时再佩戴?

对于有明显散光和需要矫正的远视眼,一般认为应该经常佩戴眼镜。对于轻中度的近视来说,如果是成年人,可以根据个人习惯、生活及工作需要而决定是否经常佩戴。

我观察到,有的人即使近视度数并不高,也离不开眼镜,因为平时习惯了佩戴眼镜,一旦不戴眼镜便找不到北,看什么都模糊。而有的人,虽然是中高度近视,如非必要,如上课,观看电影、电视,一般情况下不愿意佩戴眼镜,对生活和工作也影响不大。

另外,有的人虽然是高度近视,但没有配足度数,因为如果配足了度数,虽然看东西会清晰一些,但很不适应,感到头昏,走路也不习惯。

观察和研究表明,近视的发生、发展与长时间的近距离用眼有密切关系。许多做了近视眼激光手术的患者,如果还是从事大量近距离用眼的工作和学习,很可能会再出现近视。许多配镜后视力达到1.0的青少年,如果成天戴着眼镜学习、看书、写作业,近视还是会继续加深。

这是为什么呢?因为不论是近视激光手术,还是佩戴近视眼镜,都只是治标不治本。现在有的公司研发出多焦的青少年眼镜,这是根据我们的眼睛,在看不同距离的物体时,是需要不同屈光度的原理。

对于儿童和青少年来说,究竟要不要一直佩戴眼镜?我的建议是,如果是轻度近视,看书学习时,完全可以不佩戴眼镜。即使是中高度近视,在近距离的学习工作时,也可佩戴比看远时的度数低一些的眼镜。但是切记,不论是佩戴还是不佩戴眼镜,尤其是青少年,切忌长时间近距离的大量用眼,否则近视的度数一定是越来越深。

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    2017-05-06 萧寒

    是的

    0

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    2017-04-26 138****8908

    很好的文章,学习了!涨了见识了!

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=194481, encodeId=59f4194481e8, content=是的, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161218/IMG58562C7F3188D3554.jpg, createdBy=67f21996849, createdName=萧寒, createdTime=Sat May 06 09:30:57 CST 2017, time=2017-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1560393, encodeId=dc7015603933f, content=<a href='/topic/show?id=4ff1e294238' target=_blank style='color:#2F92EE;'>#眼镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72942, encryptionId=4ff1e294238, topicName=眼镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=508115130308, createdName=zhangfenasdf, createdTime=Thu Apr 27 12:05:00 CST 2017, time=2017-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1566402, encodeId=a58b15664022d, content=<a href='/topic/show?id=4ff1e294238' target=_blank style='color:#2F92EE;'>#眼镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72942, encryptionId=4ff1e294238, topicName=眼镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=508115130308, createdName=zhangfenasdf, createdTime=Thu Apr 27 12:05:00 CST 2017, time=2017-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190596, encodeId=8fe519059684, content=很好的文章,学习了!涨了见识了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nen7zrXWiaG4hrGCwNshovyBgXNj5Q0vjMlbsaoXPqiaCRuibSpicXNzObwSj4ocZc1a0h2KKS4VNX50h0oN5TW3ibYP/0, createdBy=07662052030, createdName=138****8908, createdTime=Wed Apr 26 02:11:25 CST 2017, time=2017-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190590, encodeId=247219059078, content=学习了很有用, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Wed Apr 26 01:29:03 CST 2017, time=2017-04-26, status=1, ipAttribution=)]
    2017-04-26 飛歌

    学习了很有用

    0

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