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保护视力&学习两不能误的时代,我为大家准备了这份既学术又接地气的终极攻略! -pg电子试玩

2015
2021-4-22 10:22 原创 · 图片11

近期最火的《双减》文件中,对在线课程提出了要求:

 

线上培训要注重保护学生视力,每课时不超过30分钟,课程间隔不少于10分钟,培训结束时间不晚于21点。

 

保护视力和学习,好像天平两端,除非极特殊的情况(基因无敌或者天生大远视),否则很难真正两者兼得。

有主张保护视力的妈妈,暂时放弃了娃的学习,追求每日6小时 的大户外,甚至休学半年/一年去三亚/丽江的;有效果,但代价未免有点大。

有主张学习的妈妈,恨不得把孩子每分钟全部填满,丝毫不能浪费。

我都有点……精神分裂。

那么,有没有实用的方法和工具,尽可能寻求平衡?都1202年了,是不是得改进保护视力的方法了?

01每日2小时户外,仅是及格线

很多人想当然认为,父母近视或高度近视的,孩子才会近视。

遗传因素能够解释10%~30%个体差异(文献1),但无法解释60年前中国仅15%的人口近视(文献2),现在95%以上大学生近视;

更无法解释目前我国6岁孩子近视率不低于16.7%,可戳链接:

唯有阳光下的户外活动时间大幅缩短,才能略微解释这飙升的数据

每日阳光下户外活动2个小时,仅是及格线,能够大幅降低,但无法消除近视风险。

光照强度很重要,至少1万lux,最好4万lux以上。如果是阴天下雨天,户外时间还应进一步延长,才能有效果。

怎样保证户外活动时间及格?

上下学或去其他地方时,尽量用步行、骑行等方式代替开车接送。变速自行车买回来,一天30~60分钟的户外时间就有了。

如果学校的延时托管服务就是在教室坐着,建议有条件的接出来户外先。

放学后,如果天还亮着,先户外30~60分钟,再抓紧时间做作业。

尽量选择户外运动项目,锻炼 保护视力两不误。适合户外训练的,足、篮、排、网球、跳绳、跑步、轮滑,南方再加上游泳。

累计户外时间一样的情况下,比如都是一天2小时,将时间分散开,对保护视力更有利。

有条件的,可以把看书、听音频、写作业的地点,搬到人少/无人打扰的户外,或者开放式阳台。但要避免阳光直射。

尽量选择开阔的地方户外活动,避免选择被建筑物/树木完全遮挡的地方。后者光照度只有几百~几千lux而已,达不到效果。夏天太晒时,在稀疏的树荫下活动。

除非海边那种大太阳,防晒用帽子即可,尽量不用墨镜。如果做了散瞳畏光,也可以选择小孔镜,淘宝上就有。

某权威医生建议,在太阳光没那么刺眼的前提下,比如夏天上午10点,冬天中午12点,每日让孩子闭眼对着太阳10~30分钟,可以达到类似哺光仪的效果,又能避免其不可控的副作用。
 

加之学校的户外时间,至少在春夏两个季节里,一天累计2小时并不难。

为了平衡冬天户外的困难,强烈建议春夏增加户外时间!

图片

(我们曾在三亚顶楼游泳,北方再无可能了)

02用眼先松后紧&四条原则

学龄前孩子,大脑还没发育成熟,如果将过多精力放在学习上,不但低效,还容易过早近视或消耗太多的远视储备。

这是一份不同年龄孩子的远视储备参考值,6~7岁至少应有175~200度远视储备。有些医生认为,6岁孩子至少应有300度远视储备。

有几个孩子能按表格发育?一旦存了一颗要学习的心,就几乎无法做到。

图片

果果也会看书、写字、上网课,最近还不小心迷上了围棋,但我们尽量还是每日保持3~4小时户外。

能看书,就不要上网课;能听音频,就不要看书及看视频。

即使网课及视频时间难以避免,我们也得控制总量。

三岁前不要接触任何电子设备。三岁后的学龄前儿童一天累计不超过1小时,单次不宜超过20~30分钟。

网课太多,除了难以控制近视,还容易出现睑板腺问题,引发干眼症。万一出现此种情况,注意多热敷、多眨眼。

总之,我们不能太过揠苗助长,否则以后会有更多烦恼。

很多英文原版书、原版教材的字体奇小无比,不如使用电子书调大字体后,用kindle等阅读器或者打印出来阅读。

集中说下四条护眼原则。

第一,用眼距离,书本阅读距离40厘米以上(文献1、3),电脑观看距离2英尺(60厘米)以上,电视投影观看距离10英尺(3米)以上。

第二,写字姿势,应保持“一寸一拳一尺”,即握笔时手指离笔尖一寸,胸口离桌一拳,书本离眼睛一尺(33厘米);同样,也是越远越好。

第三,定时休息,无论看书/手机/电脑/平板,还是玩积木/乐高/画画/弹琴/围棋,都应该每用眼20~30分钟,望远20英尺(6米以外)至少2~3分钟。很多研究指出,旧的“20-20-20”法则不足以放松视觉系统(文献1)

第四,注意近距离用眼时的光照,将学习桌摆到窗户旁边,尽量开窗让阳光照进来。晚上台灯亮度不能低于500lux。

上学时,不让户外的课间,也应尽量闭眼休息,或者看窗户外面。无法改变的事儿,只有适应一条路。

以上提到的距离,都只是最低要求实操中,在能看清的前提下,当然越远越好

朋友的新一年级娃,坚持1米距离看书,平均每天3~4小时户外(上幼儿园时还请假户外),还有不少网课,没有任何医学措施干预,四个月眼轴居然缩了0.15mm、0.07mm,连角膜曲率都下降了一丢丢。

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果果上网课时,干脆投屏到电视上,距离约5~6米。看书写字距离也在1米以上。五个月眼轴几乎没有增长。

为啥不能再缩呢?老母亲很贪心。之前倒是缩短过,可戳链接:

从改变用眼习惯或者加了医学措施后,少部分孩子眼轴会缩短一点,个别甚至可以达到0.4mm,但不可能一直缩短。

一般来说,角膜厚度超过500μm的,眼球弹性稍好,缩短的可能性更大一点。

我们更恰当的目标应该是控制增长速度!尽可能不涨!已经发生近视的,如果能控制一年眼轴不涨,近视度数很可能会下降。

上述四条原则里,最难做到的是定时休息。总被打断的感觉,有没有?

做到这些很难,只有将保护视力放在和学习一样的重要地位,才有可能执行到位。

03保护眼睛必备&不必的常见装备

以下是我总结的对预防近视有利的产品,可以根据情况选择性购入。但不含医学类产品,可以请教医生,也可参考

顶灯&台灯

在学术界,似乎已经默认白炽灯、荧光灯、卤素灯比led灯对眼睛更友好(文献4、1等等)。但实际上,由于白炽灯耗能高、发光效率低,不符合节能减排精神,在全球都基本已经退出历史舞台。

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 (文献4:使用led灯、白炽灯、荧光灯孩子眼轴长度的影响)

所以,我们只能在led灯里,选择比较好的。

如何选led台灯挺复杂,不要看宣传语,而是看各项参数。注意事项如下:

led灯选择标准

知名大品牌

蓝光危害无危险类(rg0

照度aa级

照度均匀度较好(≤3,越小越好

显色性cri/ra>90(越接近100越好

色温接近但小于4000k

遮光性较好/无眩光危害

使用时,建议桌面照度800-1200lux,入眼照度300-500lux,以眼睛舒适为准。

顶灯必须要打开,且亮度应该和台灯接近,孩子才不容易视疲劳。

买台灯、顶灯不是一劳永逸的,led灯都会有光衰现象,一般3~5年需要更换一次。

多说一句,所有的led灯的宣传口号都是“和太阳光谱最为接近”,这也默认了它们只能接近但不可能超越太阳光。

这给了我们重要提示:我们应该保证孩子的睡眠、早睡早起,将晚上的一些学习任务挪到早上太阳升起之后,在自然光下学习,更有利于保护视力。
 

学习桌&坐姿矫正器&阅读架

果果小时候经常在客厅的餐桌上看书,采光很差,高矮也不合适,又没注意定时休息。如今我是后悔不迭。

后来,我把看书地点挪到了卧室窗户旁,但因老人拒绝浪费,只买了个宜家的桌椅(也要小两千),高矮很不合适,但只看书不写字,还勉强够用。

现在,他开始学习写字,终于不能再忍了。我这才换了一套专业学习桌。买好之后,只有一个想法,早干嘛去了……

坐姿矫正器、阅读架同理,宜早不宜迟。

学习桌和台灯的摆放位置也需要注意,应保证光线从写字的对侧照入,即右撇子灯和窗户都在左边,以免遮挡视线。

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将学习桌椅调到最合适的高度。看书时,可以把书架在学习桌最远处,椅子往后、往后、再往后挪,视距就能达到1~1.5米左右了……

可投屏电视 or 投影

我曾经迷信所谓的漫反射原理,用了相当长时间投影。

这么暗沉,只能毁了眼睛。要想不暗沉,价格起码得一万左右。

建议直接买个可投屏电视,经济实惠,距离还能更远。

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(左边是投影的效果,费不费劲?)
辅助阅读工具

我反复强调了距离的重要性。看书还能如上保持1~1.5米的距离,写字就很难了。

所以,当我听到三个医生提过阅读辅助工具后,赶紧咨询了数位医生,让我家物理博士队友亲自用公式计算了下距离后,就入手了这款工具。至今已五个多月。

产品宣传中,说能放大并拉远到3~6米距离,这主要和书本离物镜的距离有关。

保守估计,看书3米,写字1米,问题不大。裸眼视力或者矫正视力至少需要0.8以上,否则放远了都看不清。

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翻转拍

关于近视形成的确切原因,没有准确答案,只有很多假说,比如周边远距视离焦假说、调节滞后假说等。

翻转拍就是为了解决调节力滞后的,尤其是用了低阿治疗的,可以配合使用。但最好在医生指导下使用:头三周,一天一组;三周之后,一周2组;每组12~15分钟。

我家现在还没入,不过倒是经常打羽毛球……

其他

对近视防控有利的其他产品,我总结在下表了,以供大家参考。

对保护眼睛没有好处的产品,比如防蓝光眼镜、小夜灯、各种甜食等,就免了吧。

至于哺光仪,争议较大,不急的可以缓缓,多看看临床数据。前面也有免费的替代方案哦~

别看上文头头是道的,但都是我曾经忽视的点(时间、距离、光照),各种血泪教训……

所有保护眼睛的措施,我是按照重要性顺序阐述的。

参考文献:

1、myopia management: how to get started a step-by-step guide to integrating myopia management into practice,langis michaud.

2、axial eye growth and refractive error development can be modified by exposing the peripheral retina to relative myopic or hyperopic defocus,benavente-pérez a, nour a, troilo d.,invest ophthalmol vis sci. 2014;55(10):6765–73.

3、role of near work in myopia: findings in a sample of australian school children. ip jm, saw sm, rose ka, et al. invest ophthalmol vis sci. 2008 jul;49:2903-2910.

4、types of lamp for homework and myopia among chinese school-aged children. pan cw, wu rk, liu h, li j, zhong h. ophthalmic epidemiol. 2018 jun;25:250-256.


赞36
收藏180
3年前
当了四年半妈才刚刚知道要爱护眼睛。好内疚好想回到过去再陪孩子从新走一次。四岁半远视储备不足医生说一年级就得近视了
3年前
碍口识羞的怪兽 当了四年半妈才刚刚知道要爱护眼睛。好内疚好想回到过去再陪孩子从新走一次。四岁...
是不是平常看书时间比较长?
3年前
写字距离一米?
3年前
有些设备确实是必须的。
3年前
请问你这款阅读辅助工具叫做什么,哪里可以买到呢,搜遍淘宝也没看到
1年前
热敷用的什么仪器?
1年前
请问辅助阅读器是拉远镜吗

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