Nowadays, many parents let their children watch TV with them. And children are used to imitating their parents to lie down and watch TV with their heads askew. However, such behavior has a great impact on children’s vision. Pediatric experts said: children watching TV with their heads askew is harmful, parents can no longer ignore it!
In clinical work, we often meet young parents with preschool or lower primary school children to see a doctor. The main complaint is that when the children watch TV, their eyes are tilted to one side, and their eyes are tilted to the other side at the same time. Their eyes are parallel. After a detailed examination of this phenomenon, we found that most of the children had intermittent exotropia. From April 2008 to July 2009, we analyzed the children who were watching TV with crooked head in the outpatient work, and collected 40 patients. The analysis is as follows.
1 object and method
1.1 the age of the subjects was 4-12 years old, 3 / 4 of them were men, 1 / 4 of them were women, and the medical history was 0.5-4 years.
1.2 methods after the anterior and posterior segments of both eyes were normal, visual acuity, near and far eye position, head position and near random spot stereopsis (Yan’s stereogram) were examined.
Vision: 0.15-0.34 cases, 0.5-0.612 cases, 0.7-1.024 cases. Eye position: 33 cm: all normal, 5 m away: right normal, left – 0 ° ～ – 5 °, 32 cases, controllable normal; normal: 8 cases. Compensatory head position: 20 cases turned to the right, the line of sight turned to the left; 18 cases turned to the left, the line of sight turned to the right. Near random point stereopsis: 60 second arc: 2 cases; 80 second arc: 4 cases; 100 second arc: 6 cases; 200 second arc: 28 cases. It can be seen from the above data that most of the small patients who watch TV with their heads askew have the characteristics of intermittent exotropia, and the stereopsis function has been gradually destroyed.
In this group of cases, the age is small, the course of disease is short, when the eyes are fixed at a short distance, they use more radiant function and near reflex, and keep their positive position; when the eyes are fixed at a long distance, the eyes are anatomically open, and the anatomical and physiological rest eyes are 10 ° – 20 ° exocline and upward transposition. With the increase of age, the strong radiant function gradually weakens, while the main cause of intermittent exotropia is aggregation The imbalance between syncretic and seperate functions, the insufficiency of collective function and the low fusion function result in the near positive position and the far (medium and long distance for TV) exotropia, which is related to the exposure of far exotropia and conforms to the development law of intermittent exotropia. The author thinks that the course of these children’s exotropia is short, and they are generally found to be hospitalized several months later, and they still maintain good three-level visual function. If they are inclined when watching TV or blackboard, they will have diplopia and confused vision, which will seriously affect the visual effect. Therefore, the way of crooked head not only preserves good visual function, but also avoids diplopia and confused vision. In order to achieve binocular monocopia, they use head position instead of eye position. In fact It is a natural choice for children to keep their visual function.
Many parents have said that when a child tilts his head and squints at the TV, his head will be straightened out as soon as he calls, which means that the child actively controls the eye position under the warning of others, so the head position is also corrected. There are two explanations for the phenomenon of watching TV with crooked head in adolescents and adults. One is that with the increase of age, some patients’ intermittent exotropia improved. Rutistein observed 408 cases of intermittent exotropia, all of them did not have any intervention. The observation time was 4-23 (average 10) years, and the average age was 20 (1-63). Results 73 cases met the research standard. The average far and near squint angles of the first examination were respectively At the last follow-up, the average far and near squint angles were 13.7 △ and 13.5 △ respectively. 51 patients with intermittent exotropia were observed by von Noorden. After 3 to 5 years, the exotropia increased by 75%, unchanged by 9%, and decreased by 16%.
Second, some patients’ non dominant eyes were restrained gradually, and the dominant eyes were used for far sight. The fusion function and stereopsis were destroyed gradually, forming obvious deviation and no head position. Some doctors explain that “watching TV with a crooked head” is habitual, whether it is related to the unprofessional examination or lack of relevant knowledge in the mind. A small number of patients have no exotropia, considering other factors, such as astigmatism, unbalanced retinal development or some unknown factors.
Children who watch TV with crooked head are not uncommon in clinical work. They should be examined carefully, and intermittent exotropia should not be missed. Reasonable explanation should be given to this phenomenon, and precautions should be put forward, such as regular follow-up, timely surgical correction when the degree of strabismus develops to the operation standard, etc.
Conclusion: vision is only a small part of visual development. Children with poor visual development will encounter many influences in their future study and life, such as not loving reading, dizzy and tired after watching for a while, not loving social intercourse, not liking bright sunshine, etc. I hope parents can pay attention to it and stop watching TV with their baby’s head tilted. Baibai safety net’s knowledge about children’s home electric shock prevention is still being updated. Please lock in our relevant columns!