招飞体检中复方托吡卡胺散瞳诱发青光眼2例

复方托吡卡胺滴眼液为快速散瞳药物，其成分为托吡卡胺与盐酸去氧肾上腺素。该滴眼液作用强、起效快、持续时间短、散瞳效果理想。招飞体检中用于散瞳检查眼底、屈光度，很少出现不良反应，偶见眼局部刺激症状。2007年在湖南、湖北两省招飞体检中，对体检的990名应届高中毕业男生常规以复方托吡卡胺滴眼液散瞳，进行屈光及眼底检查，其中两名学生诱发青光眼，经及时对症处理后治愈，现报道如下。     

托吡卡胺与阿托品散瞳检影结果比较

托吡卡胺作为一种较新的验光散瞳剂,能否在临床上完全取代阿托品?我们于1993年12月至1994年1月,对就诊的42名(83只眼)3岁—14岁的屈光不正患者,先后用托吡卡胺和阿托品散瞳进行验光检查,将其检查结果加以对照,报告如下。     

He-Ne激光治疗学生视疲劳62例

正目的:观察应用低强度He-Ne激光眼周围穴位照射治疗中小学生视力疲劳症的疗效。方法:挑选经医院检查排除远视,弱视,真性近视,散光,眼底病等病因而表现视力模糊、经常揉眼、眼干燥和眼睛疼等视疲劳症状62例,女性26例,男性34例,年龄6~12岁,视力0.5~1.0。大多患者均用过珍视明、托吡卡胺、托百士等不同眼药水。治疗期间停用所有眼药水观察激光照射治疗的效果。采用He-Ne激光治疗机照射,治疗功率4 mW,照     

Nd∶YAG激光行玻璃体条索松解术的疗效观察

资料:玻璃体膜或机化条索患者54例(54眼),男性32例,女性22例;年龄7～57岁。病因:外伤及视网膜脱离术后25例,眼内炎症16例,眼内出血性疾病13例。所有病例原有眼病均处于稳定状态。54眼中无晶体眼19例。方法:用米多林或托吡卡胺散瞳后,用05%丁卡因表面麻醉,上角膜接触镜后进行激光治疗。Ｎｄ∶ＹＡＧ激光光斑直径30μｍ,治疗时单脉冲能量选择范围28～87ｍＪ,击射次数3～103次,首次治疗总能量84～1503ｍＪ。如疗效不满意,可于1周后再次进行治疗。术后滴含激素眼药水1～3天。如碎屑较多,可口服乙酰唑胺1～3天,以预防眼压升高。结果:视力提高5行…     

综合治疗中小学生近视20例疗效评价

目的：我们采用的综合疗法治疗近视眼,与单一方法相比较。方法：每组选近视度数不超过-2.5D病人各30例。结果：综合治疗组疗效明显优于单一方法治疗组,P〈0.01。结论：治疗效果最好为综合治疗组,有效率为96.67%,治愈率为80%,最差为托吡卡胺治疗组,耳穴压豆组与枸杞桑椹冲剂治疗组疗效无明显差异。     

散瞳前后电脑验光屈光度分析

目的：探讨散瞳前后不同屈光状况下电脑验光屈光度的关系。方法：选择应用盐酸环喷托酯散瞳样本322例（644眼）,采集其散瞳前后电脑自动验光结果,按照散瞳后屈光度分为远视组、正视组和近视组,建立散瞳前后屈光度的回归模型。结果：不同年龄组散瞳前后屈光度差异显著（P〈0．01）;按照不同年龄组分别进行回归分析,各年龄组拟合方程的决定系数均在0．93以上;而远视组和正视组回归方程的决定系数较低。结论：近视组散瞳前后屈光度均呈现显著线性相关。     

硅凝胶后房型人工晶体前膜

自1986年1月至1989年5月成功植入硅凝胶后房型人工晶体182眼,出现人工晶体前膜42眼(23.01%),其中28眼在植入后4～6天出现(66.7%),伴有羞明,流泪、视力减退、Tyndall现象等。大部分前膜于7天内吸收,仅8眼1～2月后未吸收而遮盖瞳孔,影响视力,8眼均经外科处理,得到较好疗效。炎症是形成前膜的主要原因。避免硅凝胶人工晶体与空气直接接触、使用激素和托吡卡胺是防止形成前膜的重要力法。     

单针固定法治疗外伤性晶体脱位7例

晶体脱位的玻璃体切割法和双针摘除法均有设备昂贵、易引起眼内出血等缺点。为此 ,我们采用单针固定法处理脱入玻璃体内晶体 ,效果较好。1　临床资料1 1　一般情况　男 6例 ,女 1例 ;年龄 2 1～ 4 8岁 ,平均 39岁。晶体在后房呈半脱位 3例 ,晶体沉于玻璃体内 4例。均有外伤 1ｄ～ 4年。1 2　治疗方法　确诊后即用托吡卡胺滴眼液散瞳后 ,取头低、俯卧位 ,根据晶体具体位置调整头部偏斜角度 ,确保晶体进入散大的瞳孔区。晶体进入瞳孔区后 ,立即给予 2 %毛果芸香碱滴眼液缩瞳 ,保证晶体被虹膜嵌顿于瞳孔区。待晶体被虹膜嵌顿后 ,改为仰卧位 ,取…     

电脑验光在招飞体检中的应用价值研究

目的探讨自动验光仪（电脑验光）在招飞体检中的应用价值。方法用复方托品酰胺眼液按招飞体检方法散瞳,暗室内验光,由两名专业体检医师交叉检测确认屈光度。电脑验光由专业验光师操作,使用日本ＴｏｐｃｏｍＲＭ－７００型自动验光仪。结果对６２人（１２４眼）分别进行散瞳后电脑验光和散瞳后人工检影,对比两种方法屈光度结果：符合９８眼（７９．０％）,屈光性质相同２４眼（１９．４％）;不符合１眼（０．８％）,屈光性质不同１眼（０．８％）。５１眼（４１．１％）为屈度不合而屈光性质相同,电脑检光结果大于人工检影结果有３３眼（２６．６％）,电脑检光结果小于人工检影结果１８眼（１４．５％）。应用电脑验光测出各型散光１１２眼（９０．３％）,应用人工检影法测出散光８眼（６．５％）。结论散瞳前后电脑验光所得的屈光度是一样的,但本组资料显示,电脑验光所得屈光度偏大,因而在招飞体检时对一轮学生使用为宜,屈光淘汰者仍以检影所测得度数为准。电脑验光与散瞳检影有一定的差异,尽管电脑验光有简便实用的特点,但仍不能完全替代人工检影,只有掌握好时机、方法,才能发挥一定作用。     

外伤性近视的临床特点及治疗（附45例分析）

目的：探讨外伤性近视的临床特点和其损伤机制及治疗。方法：对在我院眼科门诊就诊的45例45眼外伤性近视进行回顾性分析,结果：小瞳检影验光发现所有外伤眼均存在近视,表现为轻、中度近视。睫状肌麻痹剂散瞳验光检查发现所有外伤眼的近视度数均有不同程度的减轻。用合适的凹透镜均可使外伤眼矫正视力达到1.0。经应用散瞳剂联合樟柳碱治疗有40例外伤眼3周内,5例外伤眼5周,视力恢复至≥1.0。结论：由于挫伤程度和损伤性质不同,外伤性近视的损伤机制各异,主要包括睫状肌痉挛、晶状体悬韧带断裂、睫状体水肿、眶内组织压迫等。外伤性近视的预后良好,散瞳剂联合复方樟柳碱应用可缩短病程,对视力恢复有明显疗效。     

招飞体检中用检影镜鉴定角膜塑型术眼

目的：掌握角膜塑型术眼在检影镜下角膜影像特征，使检影法成为一种迅速准确鉴定角膜塑型术眼客观有效的方法。方法：招飞体检中对散瞳进入暗室者进行人工检影，对比正常眼及角膜塑型术眼的角膜影像，确定后者角膜影像特征，据此鉴定角膜塑型术眼并追问病史。结果：依据角膜影像特征，在2000－2002年招飞体检中，共确认角膜塑型术者23例43眼。结论：用检影镜鉴定角膜塑型术眼，是一种简便、迅速、可靠的客观鉴定方法，尤其适用于大数量的招飞体检，值得推广应用。     

Performance of Eye Protectors for Squash and Racquetball

Although squash and racquetball eye protectors are available and many people wear them, eye injuries still exist. The authors studied the ability of the 13 eye protectors currently available in Canada to protect the players' eyes. The eye guards were mounted on a headform, and balls were thrown at it at speeds from 50 to 100 mph. This was recorded on high-speed film that was analyzed to determine ball speed, lens or frame deformation, and damage during impact. Eye contact with protectors having lenses was confirmed only once in 54 impacts. All 17 hits to the open eye guards produced ball-eye contact. The authors suggest that standards for eye protectors should be established.     

Effects of supportive hand contact on reactive postural control during support perturbations

There are many everyday situations in which a supportive hand contact is required for an individual to counteract various postural perturbations. By emulating situations when balance of an individual is challenged, we examined functional role of supportive hand contact at different locations where balance of an individual was perturbed by translational perturbations of the support surface. We examined the effects of handle location, perturbation direction and perturbation intensity on the postural control and the forces generated in the handle.There were significantly larger centre-of-pressure (CoP) displacements for perturbations in posterior direction than for perturbations in anterior direction. Besides, the perturbation intensity significantly affected the peak CoP displacement in both perturbation directions. However, the position of the handle had no effects on the peak CoP displacement. On the contrary, there were significant effects of perturbation direction, perturbation intensity and handle position on the maximal force in the handle. The effect of the handle position was significant for the perturbations in posterior direction where the lowest maximal forces were recorded in the handle located at the shoulder height. They were comparable to the forces in the handle at eye height and significantly lower than the forces in the handle located either lower or further away from the shoulder.In summary, our results indicate that although the location of a supportive hand contact has no effect on the peak CoP displacement of healthy individuals, it affects the forces that an individual needs to exert on the handle in order to counteract support perturbations.     

CR影像系统在传统曲面断层设备中的应用

目的 介绍一种简便实用的儿童数字牙片摄影装置.方法 利用现有的panouraULTRA曲面断层牙片机设备,将曲面断层牙片机的成像载体支架轴承杆和胶片盒手柄位置进行改进,使其支持把传统增感屏-胶片,改为装载数字X线成像IP板进行摄片,用FCR5000R读取器对IP板进行读取,再经终端处理器对所获图像进行计算机后处理,最后用FUJIFILM DRY PIX7000激光相机打印,从而得到1张高清晰、高质量的数字牙片.结果 利用改进后的曲面断层牙片机的成像载体支架,随机对200例适龄患儿进行曲面断层摄影,甲片196张,甲片率达98%以上.结论 改进后的曲面断层牙片机具有多种优点,在口腔临床及科研教学方面有良好应用前景.     

干眼症相关因素的初步研究

目的对干眼症的相关因素进行分析,以指导干眼症的预防与诊治。方法对2008年6月～2010年5月于我院眼科门诊以干眼症状就诊的患者335例进行Schirmer test检测及泪膜破裂时间（BUT）检查,对患者性别、出现症状的季节、屈光不正与否及每天视屏幕的时间等因素进行分析。结果 335例患者中确诊为干眼症的患者为195例,确诊为干眼症的比率在春季最高;屈光不正患者较非屈光不正患者中确诊为干眼症的比率高;每日注视屏幕时间长的患者确诊为干眼症的比率较高。结论综合考虑干眼症的相关因素有助于干眼症的预防与诊治。     

眼化学伤115例临床分析

目的总结眼化学伤的治疗经验。方法(1)生理盐水冲洗后,酸性烧伤用500ml2%碳酸氢钠,碱性烧伤用3%硼酸水冲眼;(2)球结膜高度水肿行球结膜放射状切开,重症碱烧伤或房水混浊者2h内行前房穿刺;(3)碱性烧伤球结膜下注射维生素C,酸性烧伤球结膜下注射磺胺嘧啶;(4)阿托品点眼散瞳,EDTANa眼药水等点眼;(5)自家血清球结膜下注射,及全身用药等。结果治疗后角膜平均修复时间:Ⅰ度烧伤3d,Ⅱ度烧伤6d,Ⅲ度烧伤12d,Ⅳ度烧伤52d。随访0.5～2年,角膜透明,或形成云翳,染色阴性,视力恢复,矫正视力1.0以上,占74.85%(125/167),无1例发生角膜穿孔。结论眼化学伤及时正确处理是提高疗效、改善预后的关键。     

Prevalence of eye strain among radiologists: influence of viewing variables on symptoms

OBJECTIVE: To determine the prevalence of and factors contributing to eye strain among radiologists, we examined the influence of the viewing method (PACS vs hard-copy film), age, case volume, technique, work habits, and workstation design on symptoms. MATERIALS AND METHODS: An Internet-based survey was sent to 2,700 radiologists randomly selected from the membership database of the Radiological Society of North America. Questions included demographic information, viewing method, work habits, and workstation design. Common eye strain symptoms were evaluated on a 5-point Likert scale. Chi-square analysis, analysis of variance, and step-wise and regression analyses were performed to evaluate codependence of the explanatory variables with eye strain. RESULTS: The adjusted response rate was 14% (380 respondents). The largest age cohort was 36-50 years. The prevalence of eye strain was 36% and was not affected by the viewing method (PACS vs film). Increased symptoms could be independently predicted in radiologists who were women (p <0.001), had longer work days (p=0.009), took fewer breaks (p=0.03), reported screen flicker (p=0.0003), and performed CT screening (p=0.04). Working hours had the strongest influence on eye strain. Eye strain was increased in those who reported studies for longer than 6 hr per day (p=0.01) and decreased in those who took breaks every hour (p=0.04). Symptoms were independent of the length of the break taken and of other workstation and technique factors. CONCLUSION: Eye strain was common among the radiologists in our study population, with no significant difference between PACS and hard-copy film users. Taking frequent short breaks, eliminating screen flicker, and limiting the number of CT screening studies interpreted may improve symptoms.     

10例 60 Co源辐射事故受照者眼晶状体的随访观察

目的 观察 ⁶⁰Co源辐射事故对受照者眼晶状体的远后效应。方法 对河南省1986年至2000年期间发生的4起⁶⁰Co源辐射事故共10例受照者进行眼晶状体远期医学观察。用复方托吡卡胺充分散瞳后在裂隙灯下检查眼晶状体,记录病变特征。结果 开封事故中"亮"、新乡事故中"梅"分别于照后2、3年出现典型放射性白内障;许昌事故中"许",照后6年出现典型放射性白内障;开封事故中"燕"、郑州事故中"杰"、新乡事故中"天"、"勇"、"义"照后随访观察仅出现双眼晶状体后囊下少量点状、颗粒状浑浊等放射性白内障的初期改变,未观察到典型放射性白内障的形态特点;新乡事故中"旺"、"民"则未观察到晶状体后囊下的浑浊。结论 眼晶状体是辐射事故受照者远期随访观察应重点关注的靶器官。电离辐射致眼晶状体浑浊的发展程度与照射剂量密切相关。     

飞行学员低常远视力变化趋势的动态追踪观察

目的 追踪观察低常远视力飞行学员远视力变化趋势,为现行招飞体检标准的修订提供客观依据.方法 选择招飞时0.8≤远视力＜1.0的飞行学员共137人为观察组;同期招飞时远视力≥1.0的飞行学员134人为对照组;分别复查双眼散瞳前后远视力,采用配对秩和检验、x2检验进行组内不同时间远视力的比较及组间比较.结果 ①1年后观察组远视力散瞳前后达标率分别为95.62%和98.18%,对照组为94.78%和97.76%;散瞳后最低远视力两组分别为0.6和0.7.⑦两组远视力在招飞时、散瞳前和散瞳后呈逐步提高趋势,差异有统计学意义(Z=230.72、12.76,P＜0.01).③复查时两组远视力均较招飞时提高,散瞳后尤为明显.④两组均存在不同程度的睫状肌调节痉挛,观察组更为显著.结论 两组远视力绝大多数都符合招飞体检标准;调查阶段两组远视力均以稳定和上升趋势为主. Abstract： Objective To figure out the change tendency of flying cadet's subnormal distant vision based on one year follow-up study and to provide objective reference to the standards of physical examination for pilot recruitment.Methods One hundred and thirty-seven flying cadets, who had the subnormal distant vision in the range from 0.8 to 1.0 (include 0.8) that determined in physical examination of recruitment, were chosen as study group while other 134 homo-session flying cadets with 1.0 or better distant vision were randomly selected as control group.The distant vision of both groups was respectively rechecked under ante- and post-mydriasis states 1 year after enrollment.Results were statistically compared between states and between groups by matched-pairs rank test.Results ① Most cadets of study group remained stable distant vision according to 1 year later recheck and respectively 95.62% and 98.18% cadets, corresponding to ante- and post-mydriasis states, kept up to standard, comparing to 94.78% and 97.76% in control group.There were only few cadets in 2groups had their distant vision declined after 1 year and there was no significant difference between groups.The worst case was the going down to 0.6 and 0.7 post mydriasis vision respectively in study and control group.② Comparing to 1 year ago, both groups showed gradually improved distant vision both for with and without mydriasis and significance was found between groups (Z= 230.72, 12.76,P＜0.01).③ The distant vision of 2 groups showed significant increase under both ante- and postmydriasis state comparing to that of one year before, especially for the post-mydriasis state.④ The episode of ciliary muscle cyclospasm was appeared in various degrees in both groups.Conclusions Most of flying cadets in two groups keep their distant vision in stable improvement and match exam standard according to 1 year follow-up.Since ciliary muscle cyclospasm is common in flying cadets the oriented education of eye protection should be strengthened.     

Central retinal and posterior ciliary artery occlusion after intralesional injection of sclerosant to glabellar subcutaneous hemangioma

The aim of this study is to describe vision loss caused by central retinal artery and posterior ciliary artery occlusion as a consequence of sclerotherapy with a polidocanol injection to a glabellar hemangioma. An 18-year-old man underwent direct injection with a 23-gauge needle of 1 mL of a polidocanol-carbon dioxide emulsion into the glabellar subcutaneous hemangioma under ultrasound visualization of the needle tip by radiologists. He developed lid swelling the next day, and 3 days later at referral, the visual acuity in the left eye was no light perception. Funduscopy revealed central retinal artery occlusion and fluorescein angiography disclosed no perfusion at all in the left fundus, indicating concurrent posterior ciliary artery occlusion. The patient also showed mydriasis, blepharoptosis, and total external ophthalmoplegia on the left side. Magnetic resonance imaging demonstrated the swollen medial rectus muscle. In a month, blepharoptosis and ophthalmoplegia resolved but the visual acuity remained no light perception. Sclerosing therapy for facial hemangioma may develop a severe complication such as permanent visual loss.