by Glen Swartwout
Myopia or nearsightedness is a very prevalent condition among adults in the industrialized nations of the world. Yet, only 100 years ago, less than 2 percent of these same populations were myopic. This was before the advent of mandatory education with its attendant hours of visual closework, artificial lighting, and broad access to refined foods. Each of these factors plays a contributory role in myopia development. Most children have normal vision when they enter school, but myopia increases with each year of schooling. This is especially true during the teenage years, when the long bones are growing the most rapidly, placing a major demand upon the entire body’s metabolism. Key inter-related factors are calcium and sugar metabolism, metabolic connective tissue integrety, and pH regulation.
Myopia Prevention, Control and Reversal
|Diet||whole foods, fresh, raw, ripe fruits and vegetables||acid forming foods, especially refined and processed foods, especially sugars, refined carbohydrates, plus excess (or deficient) protein|
|Specific Foods||whole grains, vegetables, fruits other than sweet fruits, small cold-water ocean fish||sugar, chocolate, caffeine, carbonated beverages (carefully addSango-Coralpowder), well-done meats, dairy foods, especially low-fat dairy products, pickles, carob, seaweed|
|Vitamins||A (Vitamin A) and C (Triple Ascorbate C); D if deficient|
|Minerals||Chromium (GTF Chromium), Calcium, Magnesium, Zinc, Manganese (all in Structural Integrity Plus and StarGold)||heavy metals: lead (take Structural Integrity), mercury (take Ester-C Complex, MSM, NAC, etc.), cadmium|
|Body Chemistry||enhance pH balance (drinkMicrowater), sugar balance, connective tissue elasticity; Biofield Analysis||acidity, hypoglycemia, toxicity, some food allergies (Food Tolerance)|
|Fluids||(Microwater orSango-Coral) water taken 4 ounces every half hour during the day||carbonated, sugared and caffeinated drinks, even “decaf” coffee or tea|
|Light||color therapy(Syntonics or color therapy eyewear), sunlight (full spectrum Ott lightindoors)||deficient sunlight, and imbalanced light spectra of artificial light, reading or watching TV in the dark|
|Exercise||outdoor activities, eye stretch, acupressure on eye points, focusing exercises,rebounding and other vision training activities (NFT programs)||lack of eye and body movement: the eyes do not move through their full range of motion during sedentary activities like TV or reading|
|Stress||reduce visual and emotional stress, take frequent breaks to move around and stretch whole body as well as eyes, place a book marker a page ahead to remind you to take a vision break, even if it is just to look out the window; Biofield Analysis||visual closework, especially sustained under any pressure or time constraints; also fear, such as fear of failing to perform up to expectations of self, peers, parents, teachers, boss, etc.|
|Attitude||expressive, social, outward||fear, shyness, suppression ofemotions|
|Lenses||reduced correction, reduced wearing time, removal of lenses for close work, bifocals, specific stress-relieving or counter-stress lenses (Plus Performance lenses), contact lenses with reading glasses, orthokeratology to reshape cornea||full distance correction, especially single vision glasses worn full-time|
|Biofeedback||focus biofeedback, as well as EMG and EEG biofeedback to reduce stress in smooth and striated muscles as well as neurological stress level for reduction of neuromuscular sources of myopia|
Learning more about your biochemical individuality and how to be a good steward of your body are necessary in order to achieve your optimum potential for performance, health and longevity.
: Myopia: Prevention & Control
©: Copy-Claim: 1996, 2002
Nearsightedness, or myopia, is one of the most common chronic diseases in our culture, affecting about one out of three Americans. Prior to this century, the rate was only one in 50. Today in less industrialized nations this same low 2% rate prevails, as it does prior to school age in this country. Nearsightedness appears to be a cultural disease. When American style housing, food and education was introduced to the Eskimo population, within one generation vision deteriorated from less than 2% nearsighted to over 50% nearsighted. In Israel, where many myopic Jewish settlers from the cities of Europe settled on the Kibutz farms, their children did not develop nearsightedness in their new rural environment.
There are a number of critical cultural, dietary and environmental stresses that have been implicated in the development of myopia. Because of the multifactorial nature of myopia, In the industrialized nations around the world, the advent of nearsightedness as a common condition has coincided with the establishment of mandatory education for the general public. Historically, only a couple percent of most populations learned to read and write. These were the priests and scribes, and many of them did develop myopia. Myopia was also seen among certain craftsmen such as jewelers, who also had to sustain long hours of detailed visual work.
Usually, at about the same time as the introduction of universal education, certain dietary patterns have changed as well. Refined foods, such as white sugar, white flour and polished rice, were historically available only to the wealthiest ruling class, many of whom were also the literate class. Only with industrialization did the price of refining of foods permit the average person to eat such nutrient depleted foods. It was not until this time that many vitamins began to be discovered, such as through the deaths of most of the sailors in the Japanese navy at the turn of the century when fed only white rice on extended voyages.
Today overt deficiency diseases such as scurvy, beriberi and pellagra are rare in this country, but relative deficiencies and nutritional imbalances are rampant. Much of our food supply is still refined and processed, depleting nutrient values by hundreds to thousands of percentage points below the levels eaten by our ancestors of the last century.
As one example, lets take a look at a common breakfast of today and yesterday. Compare an egg from a free ranging chicken to a commercial egg. The “old fashioned” egg has a yolk that is almost orange, being loaded with beta carotene, a very important antioxidant that helps prevent colon cancer and other degenerative processes. The commercial egg has a yellow yolk that is not just lower in protective factors like beta carotene and lecithin, but also about 4 times higher in cholesterol, which if the egg gets fried will oxidize due to the lack of anti-oxidant content. It is this oxidized cholesterol which is toxic to the liver and cardiovascular system, whereas cholesterol in its natural state is necessary for life, providing integrity to the cell membrane of every cell in the body. In addition, commercial chicken farms today have rampant salmonella bacteria, requiring the addition of arsenic to the shell to try to prevent transmission of these serious disease organisms.
Now, if we add some bacon, toast and juice to round out this timeless American breakfast, we find carcinogenic nitrates in the bacon today, in addition to the sutoxins and parasites naturally found in pork flesh. A significant amount of antibiotics are also present, since more antibiotics are fed to pigs than to humans in this country today as a means of artificially fattening these animals up. The antibiotics, as they do in humans, cause a fungal “Leaky Gut Syndrome,” allowing partially digested food and bowel toxins to be absorbed along with the antibiotics and made into toxic flesh. The toast is made from refined flour, a process which removes most of the nutrients, and then it may be “enriched,” still leaving out numerous crucial items like vitamin E (another critical antioxidant protector), fiber, and chromium. Finally the juice is probably from fruit grown thousands of miles away, processed, frozen, stored, shipped, and reconstituted. In the process, much of its nutrient value has been lost as well. For example, bioflavonoids, found naturally in citrus pulp is removed by processing of orange juice. These bioflavonoids, also known as vitamin P, are synergistic with vitamin C and represent a very important part of the antioxidant defence system along with the C, beta carotene, E and other lost nutrients.
The above breakfast was more common in the past than today, it is true. However, today’s popular substitutes are even more refined, and often contain refined sugar, such as most breakfast cereals. Eating refined sugars increases the risk of developing myopia by several hundred times. Even the dairy products often added to the cereal today can be part of the problem, since the removal of the cream to make low fat milk also removes important fat soluble nutrients like Chromium, leaving unbalanced levels of Vanadium in the skim fraction. This has been shown to be a risk factor for myopia.
Many more biochemical factors play a role in myopia, as well as familial patterns of inheritance. Diet and nutrition can help with many of these. The most important first step is to avoid sugar, chocolate, caffeine and carbonated beverages. Did you know that Americans drink more soda than water? Ideally, drink 4 ounces of Volvic or Canadian Glacier water every half hour during the day. As soon as possible, upgrade to Microwater and/or add Sango-Coral. Next, replace refined and processed foods with vegetables, whole grains and small cold water fish. Fresh, raw, ripe, organically grown vegetables and fruits should be eaten when available. Imbalances in specific nutrients like Vitamins A, C and D have been linked to the development of myopia, as well as trace minerals Chromium, Calcium, Magnesium, Zinc and Manganese. Also heavy metals like Lead, Mercury and Cadmium are risk factors. Even with strong familial patterns, there is hope for prevention, since homeopathy can eventually eliminate miasms, which are inherited tendencies toward certain types of disease.
Get outside for at least 15 minutes a day and take a walk (without glasses) amidst the green foliage. The natural full spectrum light is our primary source of Vitamin D, and it also is the main regulatory stimulus to the body’s endocrine and autonomic nervous systems. In addition, green light is at the center of the visible spectrum and has a profound balancing effect on these systems, and even on the immune system. Walking barefoot on the beach or in dewy grass will give additonal benefits, by helping the body to discharge any buildup of unwanted positive electrical ions. While increasing exercise, also consider turning off the TV. Television is the most passive of all visual activities. Myopia is linked to lack of eye movement, so don’t let the media take away your vision. Also, don’t sit closer than 10 feet when you do watch. Electromagnetic fieldsemitted from television and computers can easily expose you to biologically significant ELF and VLF radiation up to that distance. If you need to work at a computer, make sure it has the lowest radiation emission possible. The most stringent standards in the world have been adopted by the Swedish office workers union and there are now computer monitors that surpass this standard by 80%. Electromagnetic fields are especially significant to the eye, because the retina itself is an electromagnetic receptor. This makes it more sensitive to the damaging effects of this non-ionizing radiation compared to other tissues in the body.
Eyeglass lenses and contact lenses can definitely have an effect on the development and progression of myopia. Even before the first sign of myopia, which is usually transient blur at distance after prolonged close work, stress relieving lenses, called performance lenses can help to prevent the buildup of visual stress that triggers the structural changes of myopia. These plus performance lenses have been shown to reduce heart rate by 10% during reading for children with normal 20/20 vision, while also reducing electromyographic (muscle) tension in the neck and back as well as the eyes. Even reading speed and comprehension often improve.
Once nearsightedness has begun, it tends to increase each year especially during the teenage years when the long bones are growing and Calcium metabolism is under its maximum strain. This can pull Calcium out of the white of the eye, the sclera, which is the connective tissue layer that gives the eye its shape. Calcium is not just needed for strong teeth and bones, but also for strong connective tissues like the sclera. When this tissue is weakened biochemically, especially by acid forming foods like sugar and other junk foods, just the stress of reading through glasses or contact lenses designed for distance vision is enough to stretch and thin this tissue. This speeds up the decline into higher levels of myopia, as well as increasing the risk of retinal detatchment and other eye diseases. Contact lenses tend to result in a slower progression than glasses, perhaps due to their massaging action on the eye, as well as optical factors like better peripheral vision, higher magnification and reduced focusing demand compared to glasses of equivalent strength. In any case, whether wearing glasses or contacts, a special lens power should be designed for near work versus distance vision. A special series of contact lenses can also be designed to gradually reshape the cornea back to a more spherical shape, in many cases improving uncorrected myopes from about 20/300 to 20/20. This method, called Orthokeratology, was originally developed to control severe myopic degeneration of the cornea, called keratoconus, beginning around 1960. Today, five university studies have shown it to be safe and effective for controlling and improving myopia. It is just as safe as any contact lens wear, and the only drawback is that retainer lenses must continue to be worn in order to maintain the improvements in unaided vision. Today, many pilots, policemen, athletes and others with critical vision requirements benefit from this approach. In contrast, the FAA does not allow pilots to fly if they have had eye surgery to reshape the cornea, since this causes scar tissue, resulting in disabling glare, as well as other visual and eye health problems. Consumer Reports, too, recommends against cosmetic eye surgery for improving myopia.
Another alternative that is safe, however, is to tap the power of the mind to control the eye, both through visual training activities as well as biofeedback. These methods, too, like “OrthoK” can help many myopes improve their vision, while also helping to improve eye health and function. Biofeedback for myopia was developed by NASA because in the space program, visual navigation can easily be impaired by spasming of the ciliary muscle in the eye which controls focus. This response is commonly triggered by darkness, called night myopia or space myopia, and is experienced by many people driving home in the dark after working with their eyes all day. Visual training owes much of its development to the thousands of pilots in World War II who couldn’t pass their flight tests for vision until they completed intensive programs of vision enhancement training.
The bottom line in dealing with nearsightedness is to become aware of how sensitive an instrument the eye is. It responds to all kinds of stresses from its environment, both internal and external. How we use our eyes and how we nurture them plays a large role in how well they will continue to serve us in the future. And to a large extent, how our eyes fare is determined by how we care for the whole body, how we develop the mind, and how we nurture the spirit. Centuries ago, the eyes were called the windows of the soul. Today, we are still just beginning to understand how true that really is.
Low-Level Laser Stimulation of Ciliary Body Function in Myopia Prevention
Laser Physics, Vol. 5, No. 4, 1995, pp. 917 – 921. Original Text © 1995 by Astro, Ltd. English Translation © 1995 by MAHK
Hayka/Interperiodica Publishing (Russia).
LASER METHODS IN CHEMISTRY, BIOLOGY, AND MEDICINE
Applying Lasers to Accommodation Disorders
E. S. Avetisov, I. P. Khoroshilova-Maslova, E. B. Anikina, E. I. Shapiro, and G. L. Gubkina
Moscow Helmholtz Research Institute of Eye Diseases
Received December 7, 1994
Disorders of the accommodation ability of eyes, which accompany various diseases, are rather widespread. Disorders of the accommodation ability of eyes occur in such pathological states as nystagmus, strabismus, visual
fatigue, myopia, etc. Of particular importance are changes in the accommodation apparatus that accompany myopia pathogenesis (1).
Thus, developing therapy of pathologies of the accommodation apparatus is a very urgent problem. Various methods have been proposed to solve this problem. Specifically, one can use such methods as physical exercises,
medicamental action, and physiotherapeutic treatment.
However, the efficiency of the existing methods of therapy of disorders in
the accommodation ability of eyes, is insufficient. Therefore, researchers
are highly interested in developing new methods of therapy of this pathology, especially in the case of progressive myopia in children and adolescents.
Numerous recent medical and biological investigations revealed an effect of the stimulating action of lowenergy laser radiation on tissues of eyes. Such investigations provided a background for developing several new therapeutic methods in ophthalmology. One of these methods is the technique of transscleral action on the ciliary muscle using radiation of a helium-neon laser at the wavelength of 0.63 gm. This method provides the opportunity to remove visual fatigue in workers engaged in precision operations (2).
We performed investigations aimed at revealing optimal spectral and energy parameters of laser radiation for therapy of accommodation disorders. These studies demonstrated that the best results can be achieved by using radiation with a wavelength of 1.3 gm. For determining doses of laser radiation that ensure the safety therapeutic action of laser radiation, we performed experimental investigation for 22 eyes of chinchilla rabbits. For comparison, we used six intact eyes that were not subjected to irradiation. The experimental study implied transscleral irradiation of the ciliary muscle in rabbit eyes. We alternately irradiated the ciliary muscles for about 3 and 9 h (Fig. 1).
In these investigations, we used the laboratory setup that is diagramed in Fig. 2. As a source of radiation 1, we used a semiconductor AsGa laser diode with the output power up to 10 mW and the wavelength of 1.3 gin. For directing and focusing laser radiation, we used an optical system (3 and 4) with the focal length of 10 cm and a fight-emitting diode 2, which produced radiation in the red region of the spectrum. The focus of laser radiation in this device coincided with the focus of the sighting beam.
We irradiated the ciliary muscle in two energy regimes. In the first regime,
the power of laser radiation at the level of sclera was equal to 0.5 mW. In
the second regime, this power was 5 mW. The duration of laser irradiation of each region during one irradiation session was equal to 3 min. The size of the irradiated spot ranged from 2 to 3 mm. Using the results of calculations and experimental data and taking into account the divergence, scattering, reflection, and absorption of a laser beam in the region of the ciliary muscle, we can estimate the irradiation doses that corresponded to each irradiation session as 0.2 – 0.3 and 2 – 3 J/cml2 for the first and second regimes, respectively. We performed irradiation every day. We conducted a total of 10 irradiation sessions.
Irradiated eyes were enucleated within 7 and 30 days after the course of
irradiation. In this study, we used Fig. 1. An eye of a patient: (1) laser beam and (2) laser source.
histological and histochemical techniques, as well as the method of electron microscopy.
Investigations of rabbit eyes enucleated within different periods after
irradiation showed that both strong and weak laser action did not change the cornea. Epithelium remained intact throughout the entire period of
investigation, and the parallelism of collagen cornea plates remained
undisturbed. Descernete shell was well pronounced, and the endothelial layer did not display any pathological changes. Episclera and sclera proper had no pathological changes, and the structure of collagen fibers remained
undisturbed. The angle of the anterior chamber was open, and trabeculas
remained unchanged. The lens did not feature any pathology. The lens capsule, subcapsular epithelium, and the lenticular substance lens did not disclose any changes. We did not observe any pathology in the iris. The width of the pupil of the studied eye was equal to the width of the pupil of the reference eye.
For low irradiation doses, we observed wholesome changes in the epithelial layer of the ciliary body for all enucleation times. Reference eyes had a smooth singlelayer ciliary epithelium. Pigment in the cytoplasm of cells in reference eyes was absent. The shape of cells in the reference eyes changed from cylindrical to cubic. In the region adjacent to the retina, the cells had an elongated shape. As a rule, nuclei were located near the basis of cells (Fig. 3). In experiments using low doses of laser radiation (from 0.2 to 0.3 J/cm2), we observed a focal thickening of pigment-free epithelium of the ciliary body. In this region, pigment-free epithelium featured a multilayer structure and consisted of small-size homogeneous cells. Among these cells, we revealed separate giant multinucleus cells. We observed the abovedescribed changes in ciliary epithelium within both 7 and 30 days after irradiation (Fig. 4). In experiments with laser radiation of a higher energy density (2 – 3 J/cm2), we dic not observe any changes in ciliary epithelium.
Obviously, the absence of any changes in this case can be accounted for by the fact that we replace the regime of stimulating action of laser radiation by the regime of moderate oppression.
Fig. 2. Diagram of the method of laser therapy: (1) laser source, (2) optical waveguide, (3) rotating mirror, (4) optical system, (5) eye of a patient, and I and II positions of fixed sight angles that ensure irradiation of prelimbic zones from 3 to 9 h.
Fig. 3. Reference sample of the ciliary body of a rabbit. Single-layer
cylindrical pigment-free epithelium of the ciliary body. Coloring is
performed by hematoxylin eosin. The magnification of the picture is 80.
Fig. 4. Laser-irradiated ciliary body. The proliferate focus of pigment-free
epithelium of the ciliary body. Coloring is performed by hematoxylin eosin.
Ile magnification of the picture is 80.
Electron-microscopic studies of epithelial cells of the ciliary body after irradiation showed that the nucleus has an orbicular-oval shape and contains chromatin in the disperse state. We observed a pronounced cytoplasm net with various channeled cisterns , a large number of free ribosomes and polysomes, numerous vesicles, and disordered thin microtubes. In cytoplasm, we revealed numerous chondriosomes that formed activation aggregations, which may be associated with the necessity of synthetic processes.
LASER PHYSICS Vol. 5 No. 4 1995
AVETISOV et al.
In reference samples, chondriosornes did not form aggregations. In addition, chondriosornes in the reference samples were less in number and smaller in diameter, and they were diffuse-scattered in cytoplasm.
Histochemical investigations of irradiated eyes revealed intense accumulation of free glycosamine glycans in the main cementing substance of the main binding tissue of the ciliary body. The sprout part of the ciliary body contained a greater number of free glycosamine glycans as compared to the plane part of the ciliary body. Coloring of the substance was uniform and diffuse. In certain cases, we observed focal accumulations of coloring. In the reference series of eyes, we did not observe such an intense accumulation of glycosamine glycans in the sprout part of the ciliary body. In certain irradiated eyes, we detected active accumulation of glycosamine glycans in the inner layers of cornea and sclera adjacent to the ciliary body.
Thus, a complex of morphological investigations of the ciliary body demonstrated that, for all times of observation and for various doses of
laser radiation, the eye membrane do not disclose any destructive changes,
which indicates the safety of laser action.
Radiation doses with a low energy density (from 0.2 to 0.3 J/cm2) enhance proliferation activity of cells of pigment-free epithelium, which can be considered as the most active structure of the ciliary body, and activate
metabolism of binding tissue of the ciliary body.
Experimental studies allowed us to develop the procedure of applying low-energy laser irradiation under clinical conditions. The method of medical treatment applied to patients was similar to the above-described experimental technique. We performed daily irradiation of the prelimbic zone of each eye in two sectors along the horizontal meridian (from 3 to 9 h). The dose of irradiation of the ciliary muscle ranged from 0.2 to 0.3 J/CM2.
To develop and test the method of transscleral. action of laser radiation on
the ciliary muscle, we selected 117 schoolchildren (234 eyes) aged from 7 to 16 that had suffered from myopia during the last 0.5 – 1.5 years. The main group (98 patients) included adolescents with myopia from 1.0 to 2.0 D. We found that all the patients had stable binocular vision, and the strength of vision with correction was equal to 1.0.
The inspected children with myopia of the initial -degree suffered from a pronounced disorder of all characteristics of the ocular accommodation ability. For these children, we revealed a considerable decrease of the positive part of negative accommodation, an appreciable lowering of the working capacity of the ciliary muscle, and a change in the position of the nearest point of clear vision.
We estimated the efficiency of the influence of laser irradiation on the accommodation ability of eyes by measuring the reserve of the relative accommodation, by determining the position of the nearest point of clear vision, and by using the results of ergography and rheoophthalmography.
Analysis of Tables 1 – 4 shows that laser stimulation of the ciliary body has a pronounced wholesome effect on all aspects of the accommodation process.
The data presented in Tables 1 – 4 are statistically reliable; the Student coefficient P is equal to 0.05.
The data summarized in Table 1 show that the laser irradiation of the ciliary muscle leads to a stable increase in the mean values of the positive part of the relative accommodation by no less than 2.5 D for all age groups.
According to the reference data of [ 1 ], after irradiation, these characteristics corresponded to normal parameters.
The observed increase in the positive part of the relative accommodation is typical of almost each patient. The difference in the manifestations of this effect is reduced to the difference in the increments of the relative volume of accommodation. The maximum growth of the reserve was equal to 4.0 D, and the minimum growth of the reserve was 1.0 D.
Table 2 summarizes the data concerning a variation in the position of the point of clear vision after transscleral action of laser radiation on the ciliary muscle. As can be seen from Table 2, the most considerable decrease in the distance to the nearest point of clear vision is achieved for adolescents at the age of 10 – 12. For adolescents of this group, on the average, the nearest point of clear vision approaches an eye by 0.88 cm, which corresponds to 2.2 D. For adolescents aged 13 -16, the nearest point of clear vision approaches an eye by 0.72 cm, which indicates the increase of
the absolute accommodation volume by 1.6 D. For schoolchildren aged 7 – 9, we observed a somewhat smaller growth in the absolute accommodation volume (by 0.9 D).
Table 1. The positive part of the relative accommodation for children with
myopia before and after medical treatment
|Myopia||Positive part of the relative accommodation (D)|
|Age of children (years)||Number of children||before medical treatment||after medical treatment|
APPLYING LASERS TO ACCOMMODATION DISORDERS
LASER PHYSICS Vol. 5 No. 4 1995
Of particular importance for estimating the efficiency of laser therapy are the results of ergography because this method thoroughly characterizes the working capacity of the ciliary muscle. As is well known, according to the Avetisov-Mats classification , the majority of ergographic curves belong to one of three types. Curves of the I type are referred to as normograms, Curves of the II type (Ila and IIb curves) characterize the mean magnitudes of disorders in the working capacity of the ciliary muscle. Finally, curves of the III type (IIIa and 111b curves) describe the maximum decrease in the working capacity of the accommodation apparatus .
Table 3 presents the data of ergographic studies for schoolchildren before and after laser irradiation. We performed investigations with a total of 42 schoolchildren (84 eyes).
Table 2. Position of the nearest point of clear vision before and after transscleral laser action on the ciliary muscle
|Myopia||Position of the nearest point of clear vision (cm)|
|Age of children (years)||Number of eyes||before treatment||after treatment||Variation in position of the nearest point of clear vision (cm)|
Table 3. The character of ergographic curves before and after laser
|Type of the ergo-graphic
|The number of eyes before treatment||absolute %||The number of eyes after treatment||absolute %|
Table 4. The rheographic coefficient before and after the course of laser
|Myopia||Rheographic coefficient (%)|
|Number of studied eyes||before medical treatment||after medical treatment|
As can be seen from Table 3, laser therapy appreciably improves the working capacity of the ciliary muscle. All the children with myopia suffered, to a variable degree, from disorders of the working capacity of the ciliary muscle. Before laser irradiation, ergograms of the IIb type were predominant (70.9%). Ergograms of the Ha type, which correspond to a slight decrease in the accommodation ability, were obtained for 21.4% of children. Finally, for 4% of patients, we observed ergograms of the IIIa type, which indicated a considerable disorder in the working capacity of the ciliary muscle.
The conducted course of laser therapy changed the situation. Before the
course of therapy, we observed ergograms of the I type for 3.6% of schoolchildren. After the course of therapy, the normal working capacity of the ciliary muscle was characteristic of 16 eyes (19%). In 75.4% of cases, we detected ergograms of the Ha type with less pronounced pathological changes.
Instead of 59 ergograrns of the IIb type, which was the most widespread type before laser irradiation, we detected only five (5.6%) ergograms of this type after irradiation.
Rheoophthalmography characterizes the state of the vascular system in the
front section of an eye. We carried out rheoophthalmographic investigations before and after performing 10 sessions of laser stimulation of the ciliary muscle. Table 4 summarizes the calculated rheographic coefficients before and after laser irradiation.
As can be easily seen from the data presented in Table 4, for patients with
myopia of the initial degree, the rheographic coefficient is considerably
lower. On the average, laser therapy allowed us to increase the rheographic coefficient from 2.07 to 3.44%, which indicates the increase in the blood filling of vessels of the ciliary muscle by a factor of 1.7.
The results of rheographic investigations indicate the intensification of
blood circulation in the ciliary body after the course of laser stimulation,
which improves the functioning of the ciliary body. The changes caused by
laser therapy of accommodation disorders featured stability during 3 – 4
months. In certain cases, after this interval of time, the reference
parameters decreased. However, repeated courses of laser irradiation improved and stabilized these parameters.
Studying refraction during three years of observation demonstrated that, for 65.8% of patients subjected to laser therapy, a complete stabilization of myopia occurred at the end of the first year, whereas for the reference
group, a complete stabilization was observed for 36.7% of patients. By the end of the observation period, the stabilization of refraction occurred for 59.8% of patients subjected to laser irradiation. In the second (reference) group, stabilization of refraction was observed for 28.6% of patients. The average annual gradient of progressive myopia for patients subjected to laser therapy was equal to 0.43 D, whereas for the reference group this parameter was equal to 1.6 D.
APPLYING LASERS TO ACCOMMODAT1ON DISORDERS
LASER PHYSICS Vol. 5 No. 4 1995AVETISOV et al.
Thus, the performed experimental and clinical investigations demonstrated the efficiency and safety of applying transseleral laser irradiation in the
infrared range for therapy of progressive myopia.
The mechanism of action of laser radiation on ocular tissues is not clear
yet. Our experimental studies showed that low-energy doses of laser radiation (up to 0.2 – 0.3 J/cm 2) have a wholesome effect on cells (the increase in the number and the growth in the size of chondriosomes and the enhancement of the proliferative activity of cells of pigment-free epithelium). These effects were also observed in other studies (2).
The biological effect of laser irradiation on tissues may be accounted for by absorption of radiation energy in specific cellular chromatophores with
subsequent enhancement of the enzymatic activity, which is favorable for
activating metabolism in the ciliary body (3).
To a great extent, stabilization of myopia by transscleral laser irradiation is due to the stable normalization of accommodation characteristics. In the overwhelming majority of cases, we observed an appreciable improvement of the working capacity of the ciliary muscle and a twofold increase in the sizes of relative accommodation. Along with the activation of metabolism in tissues of the ciliary body, the most probable mechanism of this phenomenon is the influence of laser radiation on the characteristics of microcirculation and improvement of blood circulation in the ciliary muscle, which is indicated by the rheographic data.
Thus, wholesome effect of laser irradiation of an eye in the case of progressive myopia is mainly due to specific biological effects that are associated with the improvement of microcirculation in the ciliary muscle.
The data of our investigations indicate a considerable stable improvement of the functioning of the accommodation apparatus after transscleral laser
therapy. The results of our study suggest that this method is promising not
only for therapy of progressive myopia but also for a medical treatment of
other ophthalmic diseases, such as nystagmus, accommodative strabismus,
visual fatigue, etc.
1. Avetisov, E.S., 1986, Myopia (Moscow: Meditsina) (in Russian).
2. Belkin, M. et al, 1987, Oftal’mol. Zh., 28,108.
3. Lobko,V.V., Karu, T.I., and Letokhov, V.S., 1985, Bioftzika, 30,400.