中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2012年
11期
1292-1295
,共4页
集合不足%视觉训练%双眼视
集閤不足%視覺訓練%雙眼視
집합불족%시각훈련%쌍안시
Convergence insufficiency%Vision therapy%Binocular vision
目的 回顾性分析集合不足患者的症状和体征情况以及治疗的效果评价.方法 采用回顾性分析的方法,收集2010年10月到2011年2月天津市眼科医院视光中心接诊的集合不足患者33例,其中男性18例,女性15例,年龄8～33岁,平均(14.12±5.77)岁.所有患者眼科检查均排除眼科疾病,矫正视力≥1.0.所有患者进行视疲劳主观问卷调查、双眼视功能检查和散瞳验光,确诊为集合不足,并进行视觉训练.采用描述性研究及配对t检验进行统计学分析.结果 集合不足患者屈光度范围为-6.88～+0.50D,均数为(-2.87±2.13)D,其中高度近视5例(15.2％),中度近视例11(33.3％),轻度近视13例(39.4％),4例(12.1％)为正视.症状问卷得分≧16分者为20例(60.6％),平均得分为(21.13±10.81).远处隐斜位平均值为外隐斜-4Δ,近处外隐为-11.7Δ,远近隐斜差值为7.7Δ.10例(30.3％)患者无立体视,23例(69.7％)有立体视.计算性AC/A平均值为2.85Δ/D.15例(45.5％)患者正相对调节(PRA)≦1.50 D,11例(33.3％)患者负相对调节≦1.50 D.所有患者进行视觉训练,训练后有2例患者失访.23例(74.2％)患者在训练后3个月内症状明显缓解,问卷得分均＜16.比较视觉训练前后的体征变化发现,患者眼位能控制在正常范围,看远跟位为外隐斜-1.7Δ,看近眼位为外隐斜-3.48Δ,远近差值明显减小,为1.59Δ,差异有统计学意义(t=-3.708、P=0.001,t=-8.154、P=0.000,t=-6.868、P=0.000).无立体视的患者中有5例(50％)恢复了立体视.AC/A(t=-7.821,P=0.000)、正相对调节(t=5.639,P=0.000)、负相对调节(t=-2.449,P=0.020)明显改善.结论 集合不足患者屈光度范围集中在轻中度近视.视觉训练后患者控制眼位能力明显提高,特别是近处外隐斜减少,半数无立体视患者恢复了立体视.同时调节功能也得到改善,集合不足症状明显减轻.
目的 迴顧性分析集閤不足患者的癥狀和體徵情況以及治療的效果評價.方法 採用迴顧性分析的方法,收集2010年10月到2011年2月天津市眼科醫院視光中心接診的集閤不足患者33例,其中男性18例,女性15例,年齡8～33歲,平均(14.12±5.77)歲.所有患者眼科檢查均排除眼科疾病,矯正視力≥1.0.所有患者進行視疲勞主觀問捲調查、雙眼視功能檢查和散瞳驗光,確診為集閤不足,併進行視覺訓練.採用描述性研究及配對t檢驗進行統計學分析.結果 集閤不足患者屈光度範圍為-6.88～+0.50D,均數為(-2.87±2.13)D,其中高度近視5例(15.2％),中度近視例11(33.3％),輕度近視13例(39.4％),4例(12.1％)為正視.癥狀問捲得分≧16分者為20例(60.6％),平均得分為(21.13±10.81).遠處隱斜位平均值為外隱斜-4Δ,近處外隱為-11.7Δ,遠近隱斜差值為7.7Δ.10例(30.3％)患者無立體視,23例(69.7％)有立體視.計算性AC/A平均值為2.85Δ/D.15例(45.5％)患者正相對調節(PRA)≦1.50 D,11例(33.3％)患者負相對調節≦1.50 D.所有患者進行視覺訓練,訓練後有2例患者失訪.23例(74.2％)患者在訓練後3箇月內癥狀明顯緩解,問捲得分均＜16.比較視覺訓練前後的體徵變化髮現,患者眼位能控製在正常範圍,看遠跟位為外隱斜-1.7Δ,看近眼位為外隱斜-3.48Δ,遠近差值明顯減小,為1.59Δ,差異有統計學意義(t=-3.708、P=0.001,t=-8.154、P=0.000,t=-6.868、P=0.000).無立體視的患者中有5例(50％)恢複瞭立體視.AC/A(t=-7.821,P=0.000)、正相對調節(t=5.639,P=0.000)、負相對調節(t=-2.449,P=0.020)明顯改善.結論 集閤不足患者屈光度範圍集中在輕中度近視.視覺訓練後患者控製眼位能力明顯提高,特彆是近處外隱斜減少,半數無立體視患者恢複瞭立體視.同時調節功能也得到改善,集閤不足癥狀明顯減輕.
목적 회고성분석집합불족환자적증상화체정정황이급치료적효과평개.방법 채용회고성분석적방법,수집2010년10월도2011년2월천진시안과의원시광중심접진적집합불족환자33례,기중남성18례,녀성15례,년령8～33세,평균(14.12±5.77)세.소유환자안과검사균배제안과질병,교정시력≥1.0.소유환자진행시피로주관문권조사、쌍안시공능검사화산동험광,학진위집합불족,병진행시각훈련.채용묘술성연구급배대t검험진행통계학분석.결과 집합불족환자굴광도범위위-6.88～+0.50D,균수위(-2.87±2.13)D,기중고도근시5례(15.2％),중도근시례11(33.3％),경도근시13례(39.4％),4례(12.1％)위정시.증상문권득분≧16분자위20례(60.6％),평균득분위(21.13±10.81).원처은사위평균치위외은사-4Δ,근처외은위-11.7Δ,원근은사차치위7.7Δ.10례(30.3％)환자무입체시,23례(69.7％)유입체시.계산성AC/A평균치위2.85Δ/D.15례(45.5％)환자정상대조절(PRA)≦1.50 D,11례(33.3％)환자부상대조절≦1.50 D.소유환자진행시각훈련,훈련후유2례환자실방.23례(74.2％)환자재훈련후3개월내증상명현완해,문권득분균＜16.비교시각훈련전후적체정변화발현,환자안위능공제재정상범위,간원근위위외은사-1.7Δ,간근안위위외은사-3.48Δ,원근차치명현감소,위1.59Δ,차이유통계학의의(t=-3.708、P=0.001,t=-8.154、P=0.000,t=-6.868、P=0.000).무입체시적환자중유5례(50％)회복료입체시.AC/A(t=-7.821,P=0.000)、정상대조절(t=5.639,P=0.000)、부상대조절(t=-2.449,P=0.020)명현개선.결론 집합불족환자굴광도범위집중재경중도근시.시각훈련후환자공제안위능력명현제고,특별시근처외은사감소,반수무입체시환자회복료입체시.동시조절공능야득도개선,집합불족증상명현감경.
Objective To study the distribution of the symptoms and signs of patients with convergence insufficiency and to evaluate the effectiveness of vision therapy.Methods Thirty-three patients aged 8 to 33 years were recruited in our optical center from October 2010 to November 2011.Eiteen of them were male,the other 15 were female.All patients had routine eye examinations to excluding eye disease.Based on the results of binocular vision examination and refraction with phoropter,all patients vere diagnosed as convergence insufficiency and personalized vision therapy was performed.All data were statistically analyzed by descriptive approach,Paired-samples t Test.The refraction range of patients was-6.88～+0.50D,the mean was(-2.87±2.13)D,5(15.2％)of them was high myopia,11(33.3％)moderate myopia,13(39.4％)mild myopia and 4(12.1％)emmetropia.The score of questionnaire more than or equal 16 accounted for 20(60.6％),the mean was 21.13±10.81.The far exophoria was-4Δ,the near exophoria was-11.7Δ,and the difference was 7.7Δ.There were 10(30.3％)patients without stereo vision.The calculated AC/A ratio was 2.85Δ/D.Positive relative accommodation(PRA)less than 1.50D accounted for 15(45.5％)and negative relative accommodation(NRA)less than 1.50D accounted for 11(33.3％).After 3 months vision therapy,2 patients was lost because of their phone call changed,23(74.2％)patients'symptoms was relieved(x2=6.515,P=0.011).After vision therapy the far exophoria was reduced to-1.7Δ(t=-3.708,P=0.001),the near exophoria was reduced to-3.48Δ(t=-8.154,P=0.000),and the difference was reduced to 1.59Δ(t=-6.868,P=0.000).The calculated AC/A ratio(t=-7.821,P=0.000),PRA(t=5.639,P=0.000)and NRA(t=-2.449,P=0.020)was improved.Conclusions The majority of patients are moderate and mild myopia.The ability to control the position of eye is improved,and half of patients without stereo vision are cured.The accommodative function is improved after reasonable vision therapy.The symptoms of visual fatigue relieve remarkably.
