RU2543037C1 - Method for prevention of myopia - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: parasympathetic chain of the vegetative nervous system is activated by developing diaphragm pattern of breathing with preset inspiration-expiration ratio 1:4 by means of voice commands. The inspiration and expiration length is controlled under the control of cardiac rhythm. The total length of a training session makes from 5 to 7 minutes daily.

EFFECT: method enables reducing a risk of myopia that is ensured by stabilising the vegetative balance.

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Description

The invention relates to medicine, specifically to ophthalmology and can be used in the prevention of myopia.

The issue of the prevention of myopia is today relevant and socially significant. Myopia is the most common cause of vision loss. According to the results of the All-Russian clinical examination, the incidence of children and adolescents with myopia over the past 10 years has increased by 1.5 times (V.V. Neroev, 2003). The main reason for the development of myopia is a violation of the functions of accommodation.

According to the 3-component theory of Avetisov, when a myopia occurs, the leading role is played by:

- hereditary predisposition;

- increased load at close range;

- weak accommodation.

Therefore, in these cases, the issue of preventing the development of myopia plays an important role.

Currently, there are various drug and non-drug methods for stabilizing the progression of myopia.

In medicine, two views are known, two relationships to the prevention and treatment of myopia:

- accommodation training by increasing the tone of the ciliary muscle (Beletskaya L.V., 1986; Dashevsky A.I., Avetisov E.S., 1971; Rosenblum Yu.Z., 1975 etc.);

- accommodation training by reducing the load from the ciliary muscle, incl. medical (Utekhin Yu.A., 1988; Remizov M.S., Gildina B.I., 1971; Vyazovsky I.A., Ponomarenko S.F., 1980; Gimbel N.V., 1973, Gruber E., 1978).

A number of authors (Akimova T.F., Zolotareva A.I., 1984; Cancer V.I., 1987 and others) suggest a combination of these methods.

The disadvantage of these methods is the isolated effect on the ciliary muscle without taking into account the general vegetative status of the patient. Do not use the natural internal capabilities of the body itself.

In the prevention of myopia today, methods involving the use of various lenses are widely used. Some of them are protected by patents such as EP 2499535, WO 2011/031948, EP 2149069, WO 2008/144497, RU No. 2449765, RU No. 2423956.

Known methods of training the ciliary muscle specified in patents RU No. 2351305, RU No. 2148982, including by changing the color of the screen RU No. 2077292.

Patent WO 2012/073077 protects the use of folic acid as an element of the composition in ophthalmology, specifically for the prevention of myopia.

There is a method of preventing the progression of myopia (patent No. 2444338, according to the application 2010140164, priority date 09/30/2010, publication date 03/10/2012, class A61E 9/00). The method includes spectacle adjustment, accommodation training, instillation of a 2.5% solution of irifrin in both eyes at night for 4 weeks. Additionally, the type of autonomic regulation of the nervous system is determined according to the method of Wayne A.M.

The use of the drug allows in some cases to improve the indicators of accommodation response in patients with myopia of varying degrees.

As a prototype, a well-known method for the prevention of myopia is considered taking into account the general vegetative status of the patient (Gerentiev V.A. Myopia as a valeological problem. All-Russian scientific and practical conference. Problems and ways to improve the efficiency of education of students and students. Barnaul, 2000.) Published article 06/18/2008 and found on the Internet www.uni-altai.ru/Jornal/vestnik/ARHIW/№2_2000/list/list147.html. In this work, it was shown that the main direction in the prevention of myopia is to increase the parasympathetic tone of autonomic regulation and the formation of cholinergic homeostasis in the patient. The method involves a mechanism for enhancing the tone of the parasympathetic department through a decrease in the natural rhythm of respiration and heart rate. It is about eliminating the lag of children in physiological development by increasing the tone of the parasympathetic department of the autonomic nervous system. It is supposed to carry out intense physical exercises, especially endurance. In addition, the prototype provides for the implementation of visual work close to the sphere-prismatic glasses of Yu.A. A comfort that moves away from the eyes the rest zone of accommodation and thereby forces children to keep a book or notebook at a farther distance. The prototype author does not provide evidence that physical education and increased tone of the parasympathetic department are prevailing. An impression is made of their secondary, auxiliary character. There is no evidence of a direct relationship between physical education and increased eye accommodation. In addition, not all children may be shown physical activity, especially endurance. For example, if a child suffers from myopia and at the same time has problems in the cardiovascular region, excessive exercise in endurance can only do harm. Therefore, the method proposed in the known prototype can not be used by all children, but only by a specific group. At the same time, monitoring the state of the cardiovascular system is necessary. It is known that the average degree of myopia (3.0D-6.0D) is a contraindication for physical education at school in the main group. Not all methods of increasing the tone of the parasympathetic division of the autonomic nervous system are acceptable for all categories of patients suffering from myopia or predisposed to its development.

What had a greater impact on improving the condition of children: the use of sphere-prismatic glasses or physical exercises with a reduction in the natural rhythm of breathing from the text of the prototype is not clear.

The present invention relates to the prevention of myopia. The basis of the present invention is the prevention of myopia by stabilizing the autonomic balance and increasing accommodation of the eye through respiratory training.

The technical result of the claimed invention is to reduce the risk of myopia and increase the accommodative ability of the eyes by a non-invasive method.

An important role is played by methods of non-pharmacological treatment, which include biofeedback of the body's reserve capabilities with biological feedback (BFB). The issues of prevention and prevention of the development of myopia across the country, especially in early childhood, are relevant.

A method for the prevention of myopia is proposed, including activation of the parasympathetic component of the autonomic nervous system at a general level, increasing the accommodation capacity of the eye.

The difference is that the accommodating ability of the eye is improved by developing a diaphragmatic type of breathing in the patient with a given ratio of inspirations and exhalations using voice commands, and the duration of inspiration and exhalation is regulated with a certain frequency under the control of the heart rhythm with a total duration of the training session from 5 to 7 minutes daily.

The above technical result is achieved by the fact that during the patient’s sessions they teach the diaphragmatic-relaxation type of breathing, which ensures synchronization of the respiratory and heart rhythms. The effects obtained make it possible to increase the reserve capabilities of the whole organism and optimize autonomic regulation at the general and local (ciliary muscle) levels, while simultaneously (as shown in the description of the experiment) increasing the accommodation capacity of the eye without additional involvement of medications and devices. During the session, patients are in a comfortable, convenient environment and are not physically overloaded. A series of experiments established a causal relationship between the formation of the diaphragmatic type of respiration in compliance with certain rules for its conduct with improved accommodation capacity of the eyes.

The diaphragmatic type of breathing in medicine is usually associated with the restoration and beneficial effects on the cardiovascular system, pulmonary diseases, and simply as general strengthening procedures. The causal relationship between respiratory procedures and accommodative abilities of the eye has not been studied. The optimal regimen for conducting respiratory training for these purposes was not developed. The filing of the application materials was preceded by painstaking work over four years to develop methods for conducting respiratory training, the effect of diaphragmatic breathing on the results of eye accommodation, confirmed by ophthalmological examinations, was studied. The technical progressiveness of the method lies in the fact that the previously unknown effect of respiratory training on the increase in the accommodation capacity of the eye was revealed. Rules have been developed for conducting training on diaphragmatic breathing, which is acceptable for conducting under normal conditions, for example, in a classroom. A previously unknown approach to the prevention of precisely myopia is proposed. The inventive step of the proposed method lies in the fact that it offers a simple, affordable and inexpensive way to prevent myopia, which can simultaneously improve the general condition of the body of a teenager. Thanks to the simple methods of diaphragmatic breathing, it is possible to stop the development of myopia, and in many cases to improve the accommodation of the eye. Conducting daily classes at the school with teenagers on the use of the method specified in the application will allow to obtain positive results to improve their vision, without interrupting children from classes. It can be especially relevant for first-grade students, when the load on the eyes increases significantly in children. This is the advantage of the proposed method compared to the prototype. The method is easily practicable during training sessions in the presence of a school paramedic, in contrast to the known and including medical methods of treatment and prevention of myopia.

The results of the effect obtained are experimentally verified.

The inventive method for the prevention of myopia is as follows.

1. Necessary conditions for the training: comfortable atmosphere, silence. The room must be pre-ventilated.

2. The child is explained how to breathe “tummy”.

3. Teaching the patient the technique of diaphragmatic breathing: with a quick inspiration, the anterior abdominal wall protrudes outward, with a slow exhalation it returns to its original position, inspiratory: expiratory ratio = 1: 4. Exhalation is used in several stages. It’s easier for children to use a voice command: “Inhale. You-dy-ha-em ”, holding your breath slightly while exhaling while regulating the duration of inspiration and expiration.

4. Conducting breathing exercises begin with 3 cycles and bring to 5 or more. The total duration of respiratory training is from 5 to 7 minutes. When conducting experimental studies, the diagnosis of the value of respiratory arrhythmia of the heart (DAS) for comparison and identification of differences in children with good vision and myopia was carried out using the computer program “Breath 2.12” (CJSC Biosvyaz, St. Petersburg, with the participation of St. Petersburg State Medical University named after Akademik IP Pavlova. Method of biofeedback according to heart rate. Certificate No. 1717116. 08/18/1989).

Necessary equipment: PC, biofeedback device (converter and cardiosignal amplifier), two heart rate sensors with a strap for fastening.

1. Cardiac sensors are superimposed along the mid-clavicular line in the 5th intercostal space.

2. Checking the quality of the sensors and their connection to the system. Control - a persistent and clear ECG signal.

3. Record of background indicators - heart rate (HR) on inspiration and expiration, respiratory rate (RR), respiratory arrhythmia of the heart (DAS = HR max-HR min).

4. Recording of the same indicators during diaphragmatic respiration using biological feedback signals. On the screen, the patient sees an image of a column with a varying level of staining, which demonstrates an increase in heart rate. The task of the subject is to align his breathing so that the maximum heart rate is noted at the height of the inspiration.

4. The duration of 1 session is 7 minutes. At the end - a lesson report is issued with a graphical representation of the pulsogram, average heart rates for inspiration and expiration, BH, DAS - per minute.

According to the proposed method, a survey of 92 children (girls - 34, boys - 58) aged 10 years, students of two schools of different types (lyceum, comprehensive school) in Kemerovo was conducted.

The subjects were divided into 2 groups according to clinical refraction:

Group 1 (57 people), patients with emmetropia (visual acuity is 1.0);

Group 2 (35 people), patients with mild myopia, which arose for the first time during training in elementary school.

Ophthalmologic examination of children included:

- visometry;

- determination of refraction by scioscopy against cycloplegia (1% tropicamide solution fractionally) and in vivo.

A statistical analysis of the results of a study of respiratory arrhythmias of the heart revealed no statistically significant difference in the DAS value at rest: the initial DAS in people with myopia was 12 beats / min (25 percentile - 9 beats / min, 75 percentile - 15 beats / min) , in subjects with emmetropia - 13 beats / min (25 percentile - 9 beats / min, 75 percentile - 16 beats / min; p> 0.1; Kolmogorov-Smirnov test). The initial sinus arrhythmia is regarded as moderate in both groups of patients (according to the classification of M.K. Oskolkova, 2003).

When performing breathing exercises, the DAS value increases significantly (p = 0.000001, Wilcoxon's test), which is associated with an increase in the reflex activity of the parasympathetic part of the autonomic nervous system with slow diaphragmatic breathing. To a greater extent, an increase in the magnitude of respiratory arrhythmia was observed in subjects with emmetropia - 22 beats / min (17.5 beats / min - 26 beats / min), in patients with myopia - 20.5 beats / min (16.5 bpm - 22.75 bpm), p <0.05; Kolmogorov-Smirnov test. Therefore, in schoolchildren of the 1st group, parasympathetic influences on the heart rhythm are more pronounced. This variant of the regulation of the heart rhythm is optimal for the body and helps to increase its adaptive capabilities, the effective use of the functional reserves of the cardiovascular system (Baevsky R.M., 1979). Thus, in patients with myopic refraction, there is insufficient vegetative support from the parasympathetic nervous system at the organism level.

Our studies, the results of which are presented in the tables below, reliably confirm the achievement of the claimed technical effect.

Table number 1 Reserves of absolute accommodation for distance in schoolchildren (n = 27) before and after respiratory training RA before breathing exercises RA after breathing exercises P Wilcoxon test Me 2,0D 4.0D P≤0.001

Table number 2 The degree of severity of respiratory cardiac arrhythmia in schoolchildren (n = 27) before and after respiratory training DAS max. wednesday prior to breathing exercises DAS max. wednesday after breathing exercises P Wilcoxon test Me 15.5 bpm 23.5 bpm P≤0.001

The essence of the method is further illustrated by individual examples.

Example 1: Patient A., 10 years old.

September 2010 (beginning of the school year):

visual acuity of the right eye 1,0 visual acuity of the left eye 1,0

clinical refraction: emmetropia

Reserves of absolute accommodation for the distance:

right eye 2.0 Diopters left eye 2.0 Diopters The severity of respiratory arrhythmias of the heart 9 beats per minute.

May 2011 (at the end of the school year):

visual acuity of the right eye 1,0 visual acuity of the left eye 1,0

clinical refraction: emmetropia

Reserves of absolute accommodation for the distance:

right eye 4.0 Diopters left eye 4.0 Diopters The severity of respiratory arrhythmias of the heart 17 beats per minute.

Example 2: Patient B., 10 years old.

September 2010 (beginning of the school year):

visual acuity of the right eye 1,0 visual acuity of the left eye 1,0

clinical refraction: emmetropia

Reserves of absolute accommodation for the distance:

right eye 2.0 Diopters left eye 2.0 Diopters The severity of respiratory arrhythmias of the heart 15 beats per minute.

May 2011 (at the end of the school year):

visual acuity of the right eye 1,0 visual acuity of the left eye 1,0

clinical refraction: emmetropia

Reserves of absolute accommodation for the distance:

right eye 5.0 diopter left eye 5.0 diopter The severity of respiratory arrhythmias of the heart 26 beats per minute.

Example 3: Patient B., 10 years old.

September 2010 (beginning of the school year):

visual acuity of the right eye 1,0 visual acuity of the left eye 1,0

clinical refraction: emmetropia

Reserves of absolute accommodation for the distance:

right eye 2.0 Diopters left eye 2.0 Diopters The severity of respiratory arrhythmias of the heart 17.5 beats per minute.

May 2011 (at the end of the school year):

visual acuity of the right eye 1,0 visual acuity of the left eye 1,0

clinical refraction: emmetropia

Reserves of absolute accommodation for the distance:

right eye 7.0 Diopter left eye 7.0 Diopter The severity of respiratory arrhythmias of the heart 26.5 beats per minute.

Long-term results were checked in 27 patients after a year performing respiratory gymnastics according to the proposed method daily for 5 minutes. No cases of visual impairment were noted in this group of patients.

As follows from the materials of the application for the invention, the method of preventing myopia allows you to get a positive effect and can be claimed for the prevention of myopia in schoolchildren. At the same time, it is affordable and easily applicable by almost all children in educational institutions.

Claims (1)

A method for the prevention of myopia, including increasing the accommodative ability of the eye by activating the parasympathetic component of the autonomic nervous system, characterized in that the accommodating ability of the eye is improved by developing a diaphragmatic type of breathing in a patient at a given ratio of inspiration and expiration 1: 4 using voice commands, and the duration of inspiration and exhalation is regulated under the control of heart rhythm with a total duration of the training session from 5 to 7 minutes daily.