遠近視與智力的關係

faith

節錄﹕
一般來說：遠視眼不像近視眼般的引人注意，可能的原因通常它是因遺傳因素所造成，而這其中幾無環境因素的影響存在。它可能造成遠方與近方的視力都產生不良的狀態，取決於遠視者本身調節能力的強或弱。

然而遠視者通常的徵狀都發生於看近時，造成孩童的遠視伴隨著較差的閱讀能力，可能影響智力的發展，學習困難，和與視覺發展能力遲滯。但是，此種說法卻可能不盡真實。

Hirsch氏於1959年提出下列四個假設的來說明，雖非完整但在統計上似乎代表著屈光不正與智力測驗的成績之間有著某些關聯，因近視的人表現遠遠的超越了遠視的人:

1.遠視和近視可能代表著眼睛的發育不全或眼睛的過份發展，各自代表著與眼睛與腦部的發展有關。

2.智力測驗的分數可能與閱讀的速度有關，近視的人閱讀的量會比遠視的人來的多。

3.聰明的孩子可能讀的更多，也可能是他(她)變成近視的原因。相反地，比較不聰明的孩子可能讀的較少，因而較不容易變成近視；那也可能造成他(她)保持遠視的狀態。

4. 許多的智力測試中需要孩童在較長的時間內，感知近處精微的細節。此一情況讓近視的孩童處於較為優勢的地位，因為他所需要用到的調節力量小於遠視的孩童，特別是處於屈光未矯正的情況下時。

Grosvenor氏在1970年的一項研究，藉著使用一個不需任何閱讀能力的智力測驗，藉以達到使遠視與近視幾近無區別的狀態。證明在閱讀能力與屈光不正之間的關係。大於智力和屈光不正之間的關係。

faith

昨天陪同小兒到健康院作四歲視力檢查，晴天霹靂......他原來患有中度遠視....很快就給轉介到眼科中心，很快又check到他兩眼各有500度遠視，而且醫生說是遺傳居多....由於度數高，將來即使有改善也不會完全康復，他，他開始要戴眼鏡了。

突然，我開始又作了一些無謂的推論﹕之前覺得小朋友奇怪，拼圖怎會退步呢？別人覺得仔仔可能是資優，但我就向怹們說我也懷疑，資優應有的觀察、記憶、閱讀能力，他似乎不甚明顯，記憶力還比baby時退步了，2歲時不停翻書看，但這種情況卻慢慢消失，於是就覺得他不是，但有些能力卻又超乎一般小朋友。
我在想，會不會和他視力有關？遠視的孩子看東西容易累和辛苦，甚至會頭痛，會不會和他的問題有關呢？他剛才說要拼圖，選了一塊四十多塊的，拼完後立刻疲累不堪，上床休息了一陣子，現在又再起來玩玩具車了，啊，以前無刻意留意到，可能真的有關吧？？？
噢，會不會這也是他開始彈奏較深的琴譜時(音符較細小)，因為看不清和辛苦，所以突然喪失學習動機的原因之一？

雖然很傷心，他即將要配眼鏡了，四歲的小人兒，但另一方面，這也好，盡快給他戴上眼鏡，以後學習就不會咁痛苦了!!!!!這會不會也是造成他情緒不太好的其中之一呢？

所以，盡早發現孩子的問題，對他的幫助會很大的。

我問視光師，如果早一點知道(三歲)不是更好嗎？他說三歲的孩子可能很不合作和坐不定，很難驗....唉，.....為甚麼........?????養一個孩子真不容易，為甚麼很多人可以養超過一個架？好叻呀，我真係無用﹗

CCM

Hi Faith

No need to fret.  My son had the same problem diagnosed when he was 4 years old, and it was purely by chance that his problem was identified.

At first I blamed myself for not noticing his problem earlier letting him suffer for 4 years!   But the doctor said that becos' it was an in-born problem, my son had already adjusted his eye-sight to accomodate the problem.  To him, he probably thought that the world was blur all the time, without focus.

When he started wearing the glasses, my son seemed to enjoy his studies so much better.   I could always remember his eyes lighting up after putting on the glasses and seeing the world in real focus for the 1st time!   He refused to remove his eyes from the car window as we rode home with him on my lap..........

It is a long road but it will get better becos' the problem has been identified early.  At the most recent check-up, the optician was very pleased with his progress - no lazy eye (he had big difference of degrees for his left and right eyes), using up to 90% of the eye-sight now, and the degrees are going down steadily (almost 100 degrees for each eye since Jan 2004)!   

So don't blame yourself.  Get up and help your son to adjust to the world with the glasses.  You can also do daily eye exercises to improve his coordination, eye muscles/movements etc.  Good luck!


    

frodo

小兒也是3歲多時己配帶眼鏡，而且他有100度遠視更有外斜視，近視倒沒有，不過他一帶就很適應，從來沒有不肯帶，所以你不用太擔心。你說因有視力問題而影响學習動機，這个我很認同。

faith

Dear Frodo,
      你仔仔出世時眼晴有沒有異樣？外斜視是因為遠視嗎？他現在斜視和遠視有沒有好轉？要不要做糾正斜視的手術？
還有眼鏡會不會很容易刮花？要不要用橡根箍住個頭？有沒有同學仔笑佢呢？
我個仔500度是否很嚴重？你仔仔兩隻眼都是同一度數嗎？
我仔仔兩隻眼都係500，醫生說是不幸中之大幸，因為如果兩隻眼不相同容易會有弱視呢。

faith

dear ccm
      你孩子最初驗出是幾多度？500度的遠視不知可以退到多少呢？

我仔仔在驗視力時兩眼一切正常，六張咭由大至小都看得到，當時很奇怪竟然要戴眼鏡，一時間無法接受。

最初在想，上帝呀，怎麼這樣對我呢？但後來得知鄰居囡囡早於幾個月前到健康院檢查視力時，仍是護士作很簡單的檢查，沒有視光師，如果仔仔當時由護士來測試純視力的話，肯定說我阿仔一切正常....鄰居得知，馬上致電健康院希望可以重驗(由駐那兒的視光師)，因為她女兒看電視時都是斜著眼睛看東西，又常擦眼睛。
因此，我真的十分慶幸輪到阿仔驗眼時是視光師。及thanks god

我開始推想，我會不會也曾有遠視呢？以前我看書看一陣便累得要命，很頭暈，但現在只在身體不適時會如此，除此不再有以前的情況了。

THANKS A LOTS, 我會TRY TO 要他做眼部運動了。

frodo

小兒出世時眼晴是沒有異樣的，但2 歲多左眼開始往外跑，遠視好多小朋友都有，一般遠視是因孩子眼球未發肓完成引致，但完成後多變成近視，你仔500度是算幾深，應該他睇嘢好辛苦喎。而小兒眼鏡會不會很容易刮花？ 非常易！！如果仔仔是活活潑潑就更慘，而且依家啲鏡質數差d....不會用橡根箍住個頭，好怪相喎.....有沒有同學仔笑佢呢？都有d架，你要預咗囉！！你仔仔兩隻眼都是同一度數嗎？差不多啦，其實仔最大問題都是外斜視，現正考慮做糾正斜視的手術，因為完全沒有好轉過！放輕鬆d吧，佢有遠視已成事實，唯有陪他度過，太擔心只會令你仔仔覺得他自己有事，就算不開心係佢面前都要死挺。我都曾經多次晴天霹靂，仔仔除了眼有問題，他亦有哮喘和行為問題。

CCM

Hi Faith

My son's left eye was 750+ and right eye was 600+.  Now, apparently the right eye is down to 400 and left eye also down to 500 (I am not there for the most recent check-up last Saturday).  Becos' of the differences in the degrees, he had high possibility of getting lazy eye and we really worked with him on the exercises to make sure he utilised both eyes frequently.  So you see, my son's case is worse than your son's.
  

My son also had no indication that his eye sight was so bad when young.  But he had the tendency to bump into things when walking but we thought it was his coordination problems as he was always very clumsy.  Come to think of this now, it might be becos' of his "focus" problem   

The doctor said that my son's eye problem could be due to his premature delivery at 32 weeks but there was nothing to substantiate that.  We do not have eye problems in the family, just normal wearing of glasses for short-sightedness.

Don't blame yourself and should feel great for having identifying his problem at an early age, helping him to develop properly.

ALAL

My son's case is the worst so far. Far-sighted 750 and 600 plus 'disperse sight' 300.

And I always blame myself to rely on only the 'opticmist' of the assessment centre, because my son has gone for checking there for 1.5 yrs, but recently she told me my son's far-sight is 750 and 600 instead of the previous result of 500 and 450.

So mums pl you must bring your kids to glass shop with an 'opticimist' for second checking, or go to private and reliable opticimist instead of government's or both.

Thank you Faith for the passage you post here.

Any mums who know how to do eye exercise pl kindly share.

faith

謝謝ＡＬＡＬ，CCM ,FRODO 的分享，我要感激你們才是，至少知道更多有關的資料，個人就會定Ｄ，冇咁徬徨．．．
現在健康院有視光師已經好好了，之前只是那些護士隨便作簡單的ＴＥＳＴ。

視光師用尺量度到他左眼三百多度，右眼一百多度，但已告訴我只是初步檢驗，實質一定要滴眼藥水放大瞳孔來量度先至準，並告知有心理準備到時可能會更高度數。
果真，在容鳳書量度到就是更高度數，但慶幸兩隻眼的度數一樣．．．講起來，比較起你們的孩子，我不應該如此看不開的了。

眼部運動，是不是頭部不動，光是移動雙眼，上下左右咁樣？

CCM

Faith

    

Good that you are happier now about the situation.

For my son, after I knew about his problem from the specialisit, I went to the 健康院 and guess what?  The nurses tested him and said "No problem at all!".  Only when I produced the specialist's note did they write a recommendation letter for my son to attend the Eastern Hospital.

Eye exercises - I can't really rem now but my son had to wear an eye patch over his right eye for 2-3 hours every day.  This was to train him to use the left eye as it was worse.  Then there were ball catching exercises.  Also, the rolling of eyes as you said.  We did these exercises almost everyday for 1.5 years before we saw the results.

If your son is a good and quiet boy, then you can get him nice frames and make him feel good in the glasses.   

ALAL

mums,
my son can't read clearly the small Chinese character in dictionary for adult, even though he is wearing glasses. Any one can share if your son, if have far-sight, has this problem?

What is V.A. means in the report from 'opticmist'. My son's reading is 6/9 and 6/6.

ccm,
Would you share with us what is eye rolling exercise. thanks.

frodo

ALAL

阿仔最近老是說看不到琴書內音符，又係看不到中文書的細字喎，但剛剛check 過眼話佢視力無變差喎...
不過佢亦有散光...

CCM

ALAL

The eye rolling exercise is as per what Faith had indicated :

頭部不動，光是移動雙眼，上下左右咁樣

Suppose to help in eye muscles and also the coordination of eyes (using both of them together).

As for my son, he is ok in reading the fine words.  In fact, we are the ones who tried to stop him from reading.      But it could be that your kids are still too young and have not fully gain the eye focus.  Like my son, he only reached 90% of eyesight power recently (5-6 years after the first diagnosis).

jeffreyhouse

delete

faith

Dear CCM and any mums
     想問如果有遠視(散光也好)，是否不能看太多書(即使配戴了眼鏡)？
     如果看很多很多書是否會加深或有不良的影響？我很擔心這個問題，我們家沒甚麼能力可以栽培仔仔，惟獨最多的資產就是書了(因空間所限，但也有整幅牆(再加半幅)到天花的書櫃)。於果常常看書對眼睛會不利，那他.....真的十分影響他的學習和生活，..........連拼圖都不太好的話....人生真係無樂趣了，希望有人可以回應我這個問題啦﹗

CCM

Hi Faith

Your house sounds like mine  

Don't think it has an effect about not being able to read.  My son reads alot, and yet his eye-sight continues to improve as he grows older.

But I do try to consciously remind him to stop and rest his eyes after a period of time.  Also, we bring him for football, games outside of the house during the weekends.  TV watching should be kept at a minimum and he should not stare at it for hours without stopping.

The main thing is that you have to be very conscious about training his eye-sight now as this is the golden period for eye devleopment.  Once the child reaches about 9 years old, it won't be too effective to help him re-adjust.   That's why I said that you are lucky to have identify your son's problem early.

Good luck!

faith

dear ccm
       你意思是說仔仔一樣可以看很多書，只是每次用眼時間不要太長，分開小段小段，是不是如此？如果是我就放心了。
sorry，還有一些問題﹕
1.我想知如何train his eye-sight?how to help him readjust?是戴眼鏡嗎？
2. 還有，在你知道仔仔眼睛有問題開始(幾多歲呢)，當時是幾度呢?過了多久才開始減度(例如是一年或兩年)和減了幾多度？ 我想知減度數的約略時間和度數﹗
3. 要隔多久再去覆驗？   
4. 有機會完全康復不用再戴嗎？

thanks

CCM

Hi Faith

1.我想知如何train his eye-sight?how to help him readjust?是戴眼鏡嗎？
You can buy eye patches to cover the eyes (1 at a time), for about 2 hours each day.  Then we will play ball catching games with him.  Also, the rolling of eyes for about 10 minutes.

It is best to perhaps ask the professionals what to do for training as some of these exercise are tailored based on the kid's problem.

This is because every kid could have a mixture of long-sightedness with astigmatism or short-sightedness etc.

2. 還有，在你知道仔仔眼睛有問題開始(幾多歲呢)，當時是幾度呢?過了多久才開始減度(例如是一年或兩年)和減了幾多度？ 我想知減度數的約略時間和度數﹗
My son was 3.5-4 years when he got diagnosed, left eye was 750+ and right eye was 600+.   I remembered that the degrees didn't really start go down until 2 years later.  

His right eye is down to 400 and left eye also down to 500 now so it has taken 5 years to get there.

3. 要隔多久再去覆驗？
At the government hospital, it was 6 months at first and afte 3 appointments, the period was extended to 9 months.  

But I go to a private optician for regular checks on a 6 monthly basis as well.

4. 有機會完全康復不用再戴嗎？
With the degrees of 500 and higher, it is unlikely that he will be totally OK.  If it goes down to 300-400 degrees for each eye, it will be very good - at least for my son's case.
   

ALAL

CCM,
Your kid's diagnosis is same to mine, except mine has 300 'disperse eyesight.'

Once an OT teach me to do this: at night, use torch to shed light on the ceiling of bedroom in one anti-clockwise and another clockwise circle slowly. Ask kid to follow with eye. Easier for them to do exercise.

Another is the eye exercise in brain gym. But my son cannot do it. Use finger to write in air in front of his eye 'lazy eight' - horizotal eight, with eyeball following.

Why my specialist tell me that with far-sight my son should watch more TV or computer or reading, of course with regular rest, for eye stimulation. This is just opposite to condition of short-sight.

Anyone share? Any professional here? Thanks.