青少年近視防治

早在 1982 年, 中國眼科專家已確認 -- " 近視眼主要由後天環境做成, 故防治工作應把改善環境作為重點 "
隨同科學進步, 電腦和精細的近作業增加, 幼童一雙 尚未完全發育成熟 眼球走進學校開始緊張繁忙的閱讀和書寫, 漢字繁體過多, 課本字體太小等, 都促使學生把書本拿近, 所以 視近 就是引起近視的根本原因.
視近過久必然引起調節過度緊張, 看遠反應就變慢, 這時表現為看遠糢糊或稱假近視, 此時如不防不治任其發展, 可向真性近視發展.
如能及早抓緊治療假性近視時機, 還能防治及減少真性近視的形成和發展, 所以防治重點在 治假 防真 防深. 主要措施是改良視覺環境, 輔以局部治療

防治近視重要性
中國以至華人聚居的近視發生率之高已是盡人皆知, 學生中多發的低度近視只要配上合適眼鏡, 就可提高視力水平, 但這只是 矯正的治標而非治本的防治, 最壞的是這副凹鏡會令人度數不斷增加, 若不防不治任其發展, 則可由低度到中度, 再由中度到高, 若有後期併發症發生就會導致視力大大降低.

有見及此, 祖國眼科教授 徐廣弟 提出應當把防治工作, 提高關乎全體華人根本視覺利益看待, 並提出治假防真防深口號,

近視不是病
人眼屈光系統由角膜,高度凸透鏡根據的水晶體屈折成像, 若外界物象恰好在視網膜上稱為正視眼, 則在視網膜前為近視, 配上適度凹鏡就可看清遠處物體, 完全是物理光學矯正,既非治療亦無預防作用, 但效果非常明顯. 因此單純性近視並不是病是有科學根據的, 只是單單以凹鏡這方法而不加以防治, 恐怕只會使近視更向高度發展而失控.

prevention before the onset of myopia

寄件者: "Lawson's optometrists"
收件者: "pamz"
主旨: Re: myopia prevention
日期: 2007年3月11日 PM 02:52

Hello,
Nice to hear from you again.
Of course I highly recommend you to have the base_in prism reading glasses to relieve the stress from convergence.
Just have a trial, I'm sure your daughter will appreciate the amazing relaxation effectiveness of the kind of glasses.

Thanks for your effort.
I hope more parents can band together to spell out the idea of prevention in order to overwhelming the traditional view on minus glasses for myope. Take care.

Steve Leung
prevention minded, HK

----- Original Message -----
From: pamz
To: lawson_s@pacific.net.hk
Sent: Saturday, March 10, 2007 9:05 AM
Subject: ref: myopia prevention


Dear Steve,
Thanks, thanks, and thanks again for all your precious advises you gave me one year ago.
It's now 1 year and my 8 years old daughter is using +3.50 glasses for all her close work at home, and +3.00 glasses for all her work at school. She doesn't use the +1 for the pc for the moment, but the time spent at school on it is yet very little and at home she doesn't use any pc for now). I test periodically her vision with a Snellen chart, that for now remains stable at 20/15.

I was mumbling if would be useful to put in the plus glasses also a base in prim correction to reduce convergence of the eyes. Do you think prisms could be useful?

I'm doing any effort to inform colleague and other parents about the plus prevention.

Best regards

Paolo Michela
ROME-ITALY


----- Original Message -----
From: Lawson's_optom_ltd
To: pamz
Sent: Wednesday, March 08, 2006 7:54 PM
Subject: Re: myopia prevention


Dear Paolo Michela,

Your daughter is of great fortune to have a parent like you willing to protect her vision before deterioration！

I prefer prevention (before onset of myopia) instead of cure (already negative focal state). And cure is very very difficult almost impossible！

Here is a brief recommendation of the strategy for your reference.

1. +1.00 for VDU at 75 to 95cm from screen.

2. +2.50 for reading at 30 to 40 cm from book.

3. +3.50 for writing at 25 to 30 cm.

Please note the above figures of plus are approximation. You have to figure them out the best suitable power for her. And all young children tend to rest on surface of desk for their writing. You have to stop that otherwise the effectiveness of plus will be negated.

Don't miss the pictures and graphics at www.myopiafree.com as well as www.geocities.com.soonicansee for details.

Because the living environment at here, my kids also put on the +1.00 during TV watching.

Infact, very few of my motherland vision experts also advocate protection/prevention of vision. The key is to grasp as early as possible, as young as possible and insist the use of plus during the course of school years till maturity (age 18~20).

I suggest you to visit www.i-see.org and be a member to join the discussion group.

best regards,
Steve Leung (HK SAR, China)


----- Original Message -----

From: pamz
To: Lawson's_optom_ltd
Cc: fabio.angeloni@poste.it
Sent: Tuesday, March 07, 2006 3:50 AM

Subject: Re: myopia prevention

Dear Steve,
Thank for your reply. I read De Angelis' book ad before it Donald Rehm's, Otis Brown's, Brian Severson's, Frederick Deakins and prof. Francis Young books about defocus (fogging) tecnique.

Dr. De Luca (the first ophtalmologist I ever met in Italy who belevies in vision training) has already visited my daughter; he found her ok and preferred not to prescribe any plus lens for the moment (in his opinion these lenses have to be used only when the first myopia appears).

Anyway, I'm still a bit concerned and was wondering if would be better to start from now with the use of plus lenses, also because I read on your site that you're adopting this strategy with your children let them using plus lenses of different power for all their close tasks. Please, give me an advice from your professional point of view.

Best regards
Paolo Michela

child reading glasses prescription

寄件者: "Lawson's optometrists"
收件者:
主旨: Re: child reading glasses prescription
日期: 2007年1月15日 PM 07:16

Dear Sharon Fung
As a Chinese, you should search out who is Dr. XU Guang-di徐廣弟. Our motherland’s great eye doctor who advocates the protection of child's vision as well as the prevention of myopia development. I felt sorrow of nobody is willing to help you in the States, perhaps the standard professional ethnics restricts their willingness.

It is also unethnics for me to advise you in the net about the use of plus together with prism unless you are sitting in my office for consultation. I sincerely recommend you to join the discussion group in www.i-see.org to gain support from those zealous people. The site bases in the States.

Good luck for your kid!

Steve Leung
prevention-minded (HK)

----- Original Message -----
From: rschool0@yahoo.com
To: lawson_s@pacific.net.hk
Sent: Monday, January 15, 2007 11:56 AM
Subject: child reading glasses prescription

Dear Mr. Leung,

We are in Chicago of U.S. and I haven't found any doctor who is willing to provided the plus lenses prescription for my daughter thought I believe that reading glasses would prevent from increasing myopia and even better to correct the vision. My daughter's is eight year old and her distant glasses is: left eye -1.00-1.00 x 135, right eye -0.5-0.5 x 180. What diopters plus lenses will be fit her?

I am high motivate on using reading glasses for my daughter but I haven't found any optometrist and ophthalmologist to provide the prescription for her. Do you know any doctor in U.S. or H.K. can provide us the reading glasses prescription? Or, where can I get the child reading glasses without doctor's prescription?
Thank you very much in advance and I am looking forward to hearing from soon.

Sharon Fung

P.S. I can read and write in Chinese with my PC, too if that would be convenience for you.


寄件者: "Lawson's optometrists"
收件者:
主旨: Re: child reading glasses prescription
日期: 2007年1月20日 PM 06:38

Hello,
Reply in italics. Because subject to professional ethnics and holding anti-major opinion mind, I reluctant to give full detail explanation. Sorry for the short response.
Steve Leung

----- Original Message -----
From: rschool0@yahoo.com
To: Lawson's optometrists
Sent: Thursday, January 18, 2007 3:34 PM
Subject: Re: child reading glasses prescription

Dear Mr. Leung,
Thank you for your response!

Where and how can I contact Dr. Xu Guang-di?
He lives in Beijing at age 90. He reminds every eye professional has the obligation to slow down the development of myopia for the own good of all Chinese in getting literacy. He wrote several books about protection and prevention of child's vision 青少年近視防治指南.

I could not find his information online in U.S. I used Snellen chart from i-see to check my daughter's vision. The result were left eye 20/50 and right eye 20/40. She could read some letters on 20/30 with both eyes. I respect your ethnics on your professional. However, I wonder if you would like to explain some questions about my daughter's case.

1. Why did she see better with both eye? Summation of L & R visaul signals. Is this normal or abnormal? Absolute normal.

2. She has astigmatic based on the doctor's prescription. Does her plus lens need to include the figure of CYL and AXIS? No need.

3. Both of her eyes have different based on the prescription and Snellen chart. So, would her plus lens be one eye using higher +D than another (let's say left eye +1.00 D and right eye +1.50 D)? Not necessary, natural eyes would level off in natural environment.

She found lazy-eye on her left eye when she was five. Then, she started to ware glasses for the last three years. With the prescription that I put on my first email, both her eyes could read 20/20 but the right eye was easier than the left eye.

4. When I searched information online in Chinese web sites, I found a term called "wai yin xie ???"? Can you tell me what it is called in English? Heterophoria.

I am frustration of the American doctors here. However, I still want to give my daughter a try on the plus lens. Being a mother, I am strong feeling to do my best for my daughter's vision. I am going to order a plus lens reading glasses for my daughter based on "my own prescription". I realize the risk of this way but I don't have other option now. I hope that you don't mind giving me a hand to clear up my above questions before I give the order. Or, if you have any ideas regard to order plus lens, please just say so. Follow the advice from Otis as he is free to speak out.

I would prefer to communicate in Chinese but I only know to write simplified characters in my PC. I am not sure if you can read simplified Chinese in H.K. I can read both simplified and traditional though. Therefore, I still write to you in English.

I appreciate you help and hope to hear from you soon again.

Sharon Fung



Hello,
Here is my reply.
Work-hard and take your own responsibility to protect your kid's vision.
It is boring, not easy and long long haul till her reaching maturity and even headache.....

best wishes
Steve Leung


----- Original Message -----
From: rschool0@yahoo.com
To: Lawson's optometrists
Sent: Tuesday, January 23, 2007 3:56 AM
Subject: Re: child reading glasses prescription


Dear Mr. Leung,

Thank you very much for your answers! They are valuable information for me. I am going to order the reading glasses in a web site since the optical centers don't take the order without doctor's prescription. Well, I do not have any other option....

I didn't know until today that there are different PD (pupillary distance) for distant and reading glasses. My daughter doesn't cooperate well, plus, I haven't have experience to measure the PD. Her distant glasses of 2006 had PD 56mm, 2005 was 55mm. Based on the average kids, how many mm PD of a reading glasses needs to be shorter than the distant glasses?
Because convergence (turning inwards) of both eyes in reading, deduct the PD by 2 to 4mm will be fine.
Or, should I just use the same PD as her distant glasses?

I am going to order a reading glasses with +2.00 D in both eyes. Would the diopter be appropriate for my daughter?
If she could read at 30~35 cm, I would say the diopter is OK. And you have to figure out what is her habitual reading distance and don't forget PUSH the reading materials OUT otherwise no point in using plus. The idea of plus is to deliberate blur out her print. WHY? -- optically to move near objects out into INFINITY}

I understand your situation under the professional ethnics and other issue. I will take all the responsible for my own decision no matter what you respond. I appreciate your consideration and time.

I am looking forward to hearing from you soon.

Sharon Fung

未病先防，既病早治

蔡太，您好！
預防近視理念是依据我國故藉---黃帝內經所提倡的未病先防，既病早治的防治思維所推行。
事實上近視無理想治療法，我國眼科老教授 徐廣弟在其著作青少年近視防治指南一書已清楚指出對付近視只可從預防著手，治療早期假近視，進而阻止真近視發生和再發展。筆者對此深表認同，
既已發生了的近視若不及早通過光學應用加以制止，只有一直深下去直至穩定下來。
意見是及早給予你女兒正確使用正視鏡及其霧視法。

梁彥康 視光師


From: hon yuk fung
To: steveleung@chinamyopia.org
Subject: 正視鏡
Date: Fri, 13 Apr 2007 12:53:07 +0800 (CST)

梁先生：
您好！
我從網站和書中了解了預防近視的方法，很想讓女兒試試，女兒亦看了您出版的書，但我心中一直下不了決定。

我女兒今年12歲，11/06年健康檢查時，左右眼視力為：-0.2 / -0.3；上月由於我要配眼鏡，故要求她再檢眼，左右眼視力為：-0.75 / -1.00。我一直要求她保護好眼睛，但還是出現近視了，我是過來人，知道配了眼鏡後，度數只會越來越深，很想有辦法幫她。
您可有什麼意見給我呢，請指教！

蔡太

An insightful parent

From: Steve Leung
To: KW Leung
Sent: Tuesday, September 07, 2006 10:14 AM
Subject: Leung Wing Yee

Dear Mr. Leung ,
Thank you so much for your update.
With your persistent hard-working and Wing Yee's self motivation, I think she will be paid off in the coming future.

Sorry for you have encountered such a shallow view teacher. But truely she reflects a great masses of us lack of the insight .

For simplicity, just encourage her to use the prismatic plus whenever using her eyes for near work to avoid strange looking from teacher or classmates.

For maximum effectiveness of the plus, you have chosen the right answer. In addition to your proposal, I may suggest her to tolerate +0.25 in the upper portion if feasible.

Few of my myopic patients have already been given the kind of bifocal with upper portion negative and lower portion either positive or reduced negative for those lack of discipline in changing glasses.

sincerely,
Steve Leung

----- Original Message -----
From: KW Leung
To: Lawson's optometrists
Sent: Tuesday, September 05, 2006 10:14 AM
Subject: Leung Wing Yee

Hi Steve
After staying away from books for two months, Wing Yee shows some progress in myopia improvement. Her left eye, which was -1.0D before, can now read the 20/30 line naked eyes

My daughter just started school year.
She wears the plus lens to school and see over the top of the glasses to read the blackboard.
But the teacher states that this is rude and will not allow her to do so. Further explanation to the teacher would make us become troublesome parents. I do not want her vision to become worse again.

Can I get a bifocal, with the same power/prism at the lower portion and no correction at the upper portion, from you for her to go to school? Can a bifocal fabricated in such a way that the boundary is high such that a smaller gap is left for distance vision?.

If so, I will make a booking soon. Or you have better idea.

Many thanks

Mr Leung


From: "Steve Leung"
To:
Subject: Leung Wing Yee and Wing Hong
Date: Tue, 15 Jun 2006 11:15:02 +0800

Dear Mr. leung,
I am so glad you own the insight as Dr. Stirling Colgate and take great care of your children!
I reply in the following in parenthesis after your questions.

Attached is an excellent article written by Dr Stirling Colgate 30 years ago which had not been published, I obtained his permission to translate it for the benefit of all Chinese. Please feel free to open it and spread out where applicable. You can view the English version at http://geocities.com/otisbrown17268/aboutus.txt

Best regard,
Steve Leung
optomertist (prevention minded)


From: "KW Leung"
To:
Subject: Leung Wing Yee and Wing Hong
Date: Tue, 13 Jun 2006 11:15:02 +0800
Dear Steve

I have discussed the plus lens idea among my friends. Only friends with high school physics experience understand what I said without serious explanation for up to an hour.
{That is the core of the difficult situation, very few of us possess the insight of plus lens application.}

One of my friends, Mr Au Yeung, who is a teacher bought his kid to you on last Sat (10/6) at Tsuen Wan.?
{Yes, all I can do is to prevent him getting into deeper nearsightedness. He has been wearing the first minus glasses for several months. Recovery is almost impossible. Sucess depends on his own willingness.}

Mrs Au Yeung said you asked the progress of Wing Yee and I report as follows:-
She wears the plus lens all the time except during sleeping and cycling. When she needs to see things far away, she dips her head and looks over the glass.
{Wonderful to have she put on the glasses all the time! My kids do the same thing for they can see much clearer over the top.}

She said she noted some slight improvement (she is a kid anyway). Go ahead to reinforce her commiment.

Immediately after visiting you (about 2-3 weeks ago), I measured her far clear point (according to your book) at 92 cm. Now the far clear point is about 120-140 cm (it greatly depends on how much school work she've done on that day). But she can only read up to the 20/40 line on a Snellen Chart 20 feet away without significant guessing. The 20/30 line can only be "guessed" 80% correct.
{The best VA is 20/20 without any correction. It seems her vsion is largely improved.}

I also found that she can read a book with the plus lens more than 50 cm away and this is not convenient and she may need a stronger lens.
{The principle of plus is to move any close object out into infinity optically. Both you and she are very smart and intelligent to grasp the whole process！ }

What is your opinion? I am willing to buy extra pair of lenses if it helps.
{Fogging technique means to deliberate blur out viewing object, you have to consider either blurring out far vision as I suggested last time or at closer range such reading and writing. Yes, it is worth to have an extra pair of stronger plus if she is willing to use it and I would like her to try.}

For My Son, Wing Hong:

Due to curiosity, I bought 2 uncut lense (+0.5D and +1.0D) to test my son's vision. When he sees through the +0.5D lens, he can read up to the 20/40 line only. Does it mean that he lost his farsightness and action need to be taken? Or vision test cannot be done this way.
{It might be the case as you thought, anyway he should be at <+0.50 farsightedness but > 0.00D. What is his feeling with the +0.50 and +1.00. Should he replies be better, worse or about the same ?}

If so, would it be appropriate to let him wear plus lense all time during TVgame, homework, etc.?
{I rather suggest the use of plus for all close work to prevent the onset of any negative focal status (nearsightedness) for his long term visual welfare}

If yes, I will make appointment immediately An ounce of prevention is outweigh a ton of cure.

Best Regards

Mr Leung

push print for vision improvement

寄件者: "Alex Eulenberg"
主旨: "Pushing print" technique for better distance vision
日期: Friday, 13 July, 2007 9:58

Has anyone tried "pushing print" for clearing distant vision? I have,
and I have found the effects to be dramatic.

To do it right, you need to be looking at a very high contrast,
finely detailed image held at the farthest point possible that is for
you absolutely clear and distinct. In practice this is usually black
text on white paper under a bright light, sunlight if possible. If
you are a low myope (2 diopters or less), plus lenses (drugstore
reading glasses) can help you achieve this more easily by bringing
the "far point" closer, something you can hold in your hand.
Otherwise, you may practice with a piece of paper on the wall. If you
normally wear glasses for distant vision, you may simply take them off.

Scan over those black lines, corners, edges that you see; don't stare
at any one point, and keep the image perfectly clear, black, sharp,
and distinct. Blink when you feel the need -- or don't blink if you
don't. If you can make it look blacker or sharper by pulling the
paper or book in, then you know you have exceeded your far point.
Bring it in until you get your "best" vision.

Spend some time running your eyes on that print. Then slowly push the
print back a hair (or step back if you're looking at something on the
wall). Has it gotten a little bit gray? A little bit smudged? Now
just run your eyes over the print as you did before until it gets
black and distinct as before. If you can't get it black again, don't
strain, but bring the print closer until it is as good as it gets,
the push back again.

Can you do it?

Try it with one eye, then the other, then both at the same time.

How far can you extend your furthest point of best vision?

How do your eyes feel?

Do you feel anyting in any other part of your body as you do this?

Now Take a look around. How do things look after you're done?

--Alex

(for details, you are invited to visit www.i-see.org )

不知不信----更迷信

彥康你好!

感謝你來到club O 給我們這次分享, 可惜當天我有要事忙著, 來不了聽你講話, 稍後待該次講座的錄音放上網了, 一定會細聽的!

其實很多年前在學醫的過程中, 已經十分關注西醫的問題, 在許多疾病中, 西醫是沒有根治方法的, 只是壓制, 對抗的暫時解決問題. 因為表面的問題好像很快解決了, 不會醫學的 大眾, 很容易就以為病情好轉了.

在眾多問題中, 眼睛的問題是比較少人討論的, 而我一直也認為近視配戴眼鏡的方法也是按照西醫的主流思路, 就是對抗的, 治標的, 沒有解決根本問題, 我認為患者需要配戴一輩子的 眼鏡, 那是不應該的. 難道自古以來沒有近視嗎? 古代的人有近視怎麼處理? 而現代的人為什麼多了這麼多近視? 這些都是我關注的問題. 幸運地能夠看到你的書, 解決了我不少疑惑, 的 確, 現在這麼人有近視的原因, 是眼鏡(凹透鏡)造成的.

這問題其實真的很複雜, 就像西醫上的問題那樣, 如果那種治療的藥物非常有效, 那就一定賺不到錢(因為很快就治好病, 病人不用長期吃藥). 如果那種是慢性病, 例如血壓高, 糖尿, 膽固醇等的藥物, 需要服用一輩子, 那樣藥廠當然喜歡. 同理, 如果近視是可以治好的, 那許多眼鏡生產商, 還有視光師的 "飯碗" 會很大影響, 所以你所提出的真確信息, 很難會被主流所接受, 更甚會遭到非議.

正因為這樣, 我們更是十分欣賞你的勇氣, 甘願冒險逆流而說出真相, 這是相當難得的! 我想, 別人不相信不要緊, 最重要是我們明白自己所知道的. 我們相信, 紙不能包起火, 真實的事情一定會彰顯出來的, 有一天大眾會接納你所推廣的.

好的, 以後有機會的話, 一定要來拜訪你呢!
祝生活安康, 工作愉快.

後輩
宇銘





----- Original Message -----
From: "Lawson's optometrists"
To: "Vincent Lee"
Sent: Monday, December 11, 2006 4:57 PM
Subject: 綠色茶座


> 李大夫, (Dear Vincent)
> 12 月 2 日的綠色茶座已完滿講述個人對近視的觀點和處理手法，可惜未能與你一見，
>
> 在此感謝你、周先生和 Club-O 給予這次分享的機緣。
>
> 拜讀你的著作 " 中醫學神 "和翻聽你的中醫為甚麼？察覺你是位有理想和實幹的年輕
> 中醫師，體會你所提出的：
> 1. 不知就信----是為迷信
> 2. 不知不信----更迷信 有感而發：
>
> 上述反映大多數港人對中西醫療、對陌生 (非主流) 治療法的執信程度，以至近視了的
> 採用順其道的凸透鏡合併稜鏡的防治法，不是不相信就是充滿懷疑。
>
> 相反對近視了的便配凹透鏡卻深信不已，並單一認定遺傳決定一切，和你所說第一點不謀而合。
>
> 最無奈是絕大多數眼科醫生和視光同業也只採用簡單的凹鏡法 (表面快速解決問題)， 並拒絕認
> 同凸鏡的長遠療效。
>
> 個人雖對中醫中葯不甚了解，隱約也覺得凸鏡好比眼的視覺調理 (順其看近要求)，效果當然
> 遲緩並需堅持使用。
>
> 不知你對時下大眾有病即看西醫並對中醫不認識、不信任有何觀感？這使我想起你的第二點。
>
> 相信因中醫可簽發病假紙，你盡可發揚中華醫學以做福普羅大眾。
>
> 個人有感對修過理科，認識光學特性的成年父母卻否定它的應用，延誤近視防治
> 以至孩子錯失機會而終生成為近視患者深感可惜。在這裡只可以說...
>
> 知而理解卻不信------執迷不悟。
>
> 祝 愉快
>
> 梁彥康 (Steve Leung)
>
>
>