老年视力残疾患者的视觉康复

目的分析我国80年代与90年代老年低视力的病因学及变化,探讨助视器在老年低视力患者中的应用效果.方法对103例(198眼)＞60岁老年视力残疾患者的视力情况进行分析,其中盲24例,低视力79例,盲∶低视力为1∶3.3.59例老年患者选配了远用单筒或双筒望远镜助视器;44例选配了近用眼镜助视器.结果低视力门诊的病因学结果显示老年患者中第1位致盲和低视力的眼病是高度近视(31.10%);第2位是老年黄斑变性(15.53%);第3位是青光眼(10.68%).通过配用光学助视器,原22眼盲视力均提高≥0.05,有37眼≥0.5;近用眼镜助视器31眼≥0.5.结论光学助视器对低视力是必备的且有效的,可明显提高老年视力残疾患者的视力,改善视功能,提高生活质量.     

81例儿童低视力的病因及视觉康复

目的：分析儿童低视力的病因及配用助视器后视功能康复情况。方法：对3—14岁的低视力儿童83例（166眼）进行病因分析及验配助视器,并了解他们视觉康复情况。结果：儿童低视力病因以先天及遗传眼病为主,早产儿视网膜病变也是低视力的原因。83例中25例（30.1%）经常规屈光矫正后视力有改善;裸眼使用助视器脱残率低于戴镜后用助视器的脱残率（62.8%、89.2%,P〈0.01）。83例中有23例选用近用助视器,其中73.9%近视力≥0.5。结论：重视防止低视力发生;低视力儿童应常规进行屈光检查,配戴眼镜并配合使用助视器则效果更佳。     

低视力儿童的屈光状态分析

目的了解4~14 岁低视力儿童的屈光状态。方法对228 例4~14 岁低视力患儿(376 眼)行睫状肌麻痹下视网膜检影验光。结果学龄前组中远视72 眼(53%),近视56 眼(41.2%),混合散光8 眼(5.9%);学龄组中远视96 眼(40.0%),近视132(55.0%),混合散光12 眼(5.0%)。学龄前组远视发生率高于学龄组(P<0.05),学龄组近视发生率高于学龄前组(P<0.05)。两组的屈光不正程度均以高度为主。经屈光及低视力助视器辅助下有27.4%的低视力患儿视力得到提高,裸眼视力较好儿童的视力提高人数较多(P<0.01)。结论低视力儿童屈光状态4~6 岁以远视为主,7~14 岁以近视为主。低视力儿童的屈光不正程度以高度为主,部分低视力儿童经屈光矫正后视力得到提高。     

特殊教育学校视力障碍学生视觉相关生活质量调查北大核心CSCD

目的调查泉州市特殊教育学校普通班视障学生的生活质量现状及其影响因素。方法2020年11月对普通班最好眼最佳矫正视力>0.02的52例学生(年龄7~26岁)进行近视力检查、对比敏感度检查和中文版低视力生活质量量表(CLVQOL)调查。以研究对象最好眼最佳矫正远视力为依据,分为二级盲、一级低视力、二级低视力3组。结果三组间远视力(Z=45.671,P<0.001)、近视力(Z=24.972,P<0.001)、对比敏感度(Z=13.285,P=0.001)均存在非常显著性差异。近视力与远视力呈正相关(r=0.74,P<0.001),对比敏感度与远、近视力均呈负相关(r=-0.58,r=-0.57,P<0.001);CLVQOL总分与对数对比敏感度呈正相关(r=0.44,P<0.001)。三组间CLVQOL总分(Z=10.145,P=0.006)、远视力维度(Z=13.586,P=0.001)、心理调节能力维度(Z=7.824,P=0.020)、阅读精细工作维度(Z=7.923,P=0.019)评分有显著性差异。结论不同视障程度学生生活质量存在差异,特别是在远视力、心理调节能力、精细阅读等方面。对比敏感度与生活质量相关,对视障学生进行视功能评估时候应进行对比敏感度检查。     

自制电视助视器的研制

目的研究适合国人使用的电视助视器，解决低视力患者的阅读，达到可用、便利和实用化。方法使用电脑技术结合视像仪，对助视器行电视化研究。通过对显示范围的物像摄取，通过显示源（电视，电脑），放大倍数达到20～30倍。结果即使目标在1m以上，能以较低视力0．1～0．2清晰看清物像。摄像所需光亮度不用特别增加。便携，实用。低视力助视器对盲／低视力视觉康复有效。结论国内尚缺少同类产品，达国外助视器的水平。     

6～14岁低视力儿童行屈光矫正与助视器佩戴的视力康复情况研究

目的分析6～14岁低视力儿童行屈光矫正和助视器佩戴的视力康复情况。方法对163例低视力儿童临床资料进行回顾性分析,所有患儿均在检查眼光后接受屈光矫正、助视器验配等治疗,观察其视力康复情况。结果低视力儿童视力分布为近视率44. 78%(73/163),远视率44. 17%(72/163),盲眼率11. 05%(18/163)。单纯屈光校正患儿脱盲率、脱残率均显著低于屈光矫正联合助视器校正患儿(P 0. 05);三级、四级低视力儿童脱残率显著高于一级、二级儿童(P 0. 05)。结论屈光矫正联合助视器佩戴对6～14岁低视力儿童视力的恢复有积极意义,且视力康复效果与残余视力呈正比。     

儿童低视力康复与助视器

目的：探讨助视器在儿童低视力门诊的应用效果。方法：143例6～14岁低视力患儿分别配戴远用和近用助视器。结果：低视力患儿配戴远用和近用助视器后，24．5％远视力≥0．5；54．5％的近视力≥0．5。结论：低视力患儿助视器的应用，不仅能提高视力，改善视功能，而且视觉康复推动了特教事业的发展。     

助视器对低视力青少年学生阅读功能影响的观察

目的：评估低视力青少年学生使用光学及电子助视器对其阅读功能的影响。方法：在盲聋哑学校对其中低视力青少年学生进行常规眼科检查、屈光矫正、双眼最佳矫正视力和必要的辅助检查等明确诊断及视功能检查。采用5号字体数字阅读测试卡,分别使用光学助视器（OVA）及电子助视器（EVA）进行助视阅读,并测试阅读速度。结果：43名低视力青少年学生根据视觉损伤程度分组,随着视力损伤程度的加深,能够使用OVA阅读的人数百分比下降,而使用EVA阅读的人数百分比没有下降。在能同时使用OVA及EVA阅读的32名学生中,使用EVA的阅读速度为99.32±40.35（字/min）,快于使用OVA的阅读速度74.84±39.05（字/min）,两者具有统计学差异（t=5.99,P＜0.05）;其双眼最佳矫正视力与分别使用OVA（P=0.249）及EVA（P=0.635）的阅读速度之间没有直线相关性。 结论：使用EVA较OVA可以明显提高低视力青少年学生的阅读成功率并提高阅读速度;低视力青少年的阅读速度与双眼最佳矫正视力不相关。     

广州市盲校学生盲与低视力状况调查

目的调查广州市盲校在校学生盲及低视力病因状况。方法采用国际标准视力表检查254名盲校学生的裸眼视力和矫正视力,并进行常规内、外眼检查,对盲及低视力学生的主要病因进行诊断、分析。结果254名学生中盲222例(87.4%),低视力32例(12.6%);早产儿视网膜病变(ROP)(32.88%)是首位致盲眼病;低视力病因主要为先天性遗传性眼病,其中先天性白内障居首位(31.25%)。结论ROP是广州市盲校学生的首位致盲眼病。     

湖南省凤凰县50岁以上人群低视力与盲流行病学调查

【目的】调查分析湖南省凤凰县≥50岁人群低视力与盲的患病率及其病因。【方法】采用分层整群随机抽样的原则,按比例抽取乡镇,然后再按乡镇抽取行政村,根据居民户口簿来确定调查对象;按照WH0制定的低视力及盲标准,由眼科医师作外眼、角膜、前房、虹膜、晶状体、玻璃体及视网膜等详细检查并对所有视力d0．3的患眼进行主要眼病原因诊断。【结果】检录人数为4857人,实际受检人数为4484人,总受检率92．32％。双眼低视力患病率3．81％,双眼盲患病率1．56％;单眼低视力患病率4．53％,单眼盲患病率1．92％。致盲的主要眼病依次为白内障（51．43％）、玻璃体视网膜病（17．14％）、角膜病（5．71％）、葡萄膜病（5．71oA）、青光眼（4．29％）及高度近视（4．29％）等。【结论】凤凰县≥50岁人群中低视力与盲仍然是严重的公共卫生问题。白内障仍然是导致盲和低视力的首位原因。     

透气性硬性接触镜和框架眼镜矫正中高度散光视觉质量的比较

目的比较中高度散光患者配戴框架眼镜和透气性硬性接触镜(RGPCL)的主客观视觉质量。方法选取2008年6月-2011年5月中高度角膜散光20例共40只眼进行角膜地形图、综合验光仪验光等检查后,选择合适试戴片作配适评估并定制RGPCL。要求患者戴镜后1周、1个月、3个月和6个月复查,记录矫正视力、镜片配适、眼部情况,并在第4次复查时进行对比敏感度视力检查及主观问卷调查。结果 RGPCL矫正视力优于框架眼镜,但两者对比敏感度视力在各空间频率均无明显差异。主观评分时,远视力两者无明显差别;中距离视力框架眼镜评分(3.825±0.245)分,RGPCL评分(3.525±0.302)分,差异有统计学意义(t=5.339,P=0.000);近距离视力框架眼镜评分(3.795±0.233)分,RGPCL评分(3.690±0.194)分,差异有统计学意义(t=3.462,P=0.030)。有45%患者选择RGPCL为主要配戴方式;40%患者选择RGP CL和框架眼镜交替使用的方式;10%患者选择仅在有特殊社交需求时使用RGPCL;另5%患者放弃使用RGPCL。结论 RGPCL和框架眼镜矫正中高度角膜散光均能取得较满意效果,在中近距离精细作业时框架眼镜矫正视力更为稳定清晰。但由于RGPCL在成像质量和外观上的优势,多数患者仍愿意坚持配戴RGPCL。     

综合疗法治疗大龄儿童弱视的效果分析

目的 观察综合疗法治疗大龄儿童弱视的疗效.方法 回顾分析2008年1月-2010年10月在我院初诊并经综合治疗的8～13岁弱视儿童62例85只眼的临床资料.治疗前最佳矫正视力0.1～0.7,平均0.46±0.17.观察患者经弱视综合治疗后视力、空间对比敏感度及立体视提升效果.结果 治疗后视力正常22例31只眼(36.5...     

外伤性视神经损伤的治疗方法及手术时机

目的 探讨外伤性视神经损伤的治疗方法及手术时机。方法 回顾分析94例眼外伤性视神经病变患者,分别行以鼻内窥镜下视神经管减压术为主的手术治疗(58眼)和以药物治疗为主的非手术疗法治疗(36例)后的视力恢复情况。结果 治疗前有光感至0．02视力者手术治疗组疗效好于非手术疗法治疗组;手术治疗组术前有视力者疗效显著优于术前无视力者;术前病程7d以内者疗效显著优于病程7d及其以上者。结论 对于外伤性视神经压迫病变严重影响视力,应在受伤后7d内越早手术越好。术前视力的有无是影响手术效果的重要因素,而术前病程的长短是影响效果的一个更重要因素。     

Spatial contrast sensitivity of migraine patients without aura

Visual disturbances are frequent symptoms in migraine. Since there is a possibility of separate damage in the magno- or parvo-cellular visual pathway in migraine patients, we performed a study including the measurement of static and dynamic spatial contrast sensitivity on 15 patients suffering from migraine without aura under photopic and scotopic conditions. Fifteen healthy volunteers without primary headache served as controls. The results revealed a marked decrease in contrast sensitivity at low spatial frequencies in the migraine patients. Spatial contrast sensitivity demonstrated some lateralization, as the sensitivity to low spatial frequencies obtained through separate eyes showed significantly larger side-differences in migraine patients than in control subjects. These findings suggest that the mechanisms responsible for vision at low spatial frequencies are impaired in migraine patients. This might indicate impaired function of the magnocellular pathways in this condition.     

三壁微创眼眶减压术治疗Graves眼病的护理

<正>眼眶减压手术治疗Graves眼病已有100年历史。随着手术技术和适应证的不断进展,被越来越多的患者所接受。我院于2005年9月至2007年3月对6例10眼Graves眼病重度突眼患者采取三壁微创眼眶减压术联合短期甲基强的松龙冲击治疗,配合良好的术前、术后护理,取得了较满意的疗效,现将护理体会报告如下。1临     

Ranibizumab for the treatment of neovascular AMD

Age-related macular degeneration (AMD) is the leading cause of adult blindness among individuals aged 50 and older in the Western world, with the neovascular form of AMD responsible for the most severe and rapid visual loss. Although monotherapy with currently available treatments can slow the rate of loss of vision in eyes with neovascular AMD, they do not significantly improve vision. Vascular endothelial growth factor-A (VEGF-A) plays a critical role in the pathogenesis of neovascular AMD, and ranibizumab is a promising new treatment that targets all VEGF-A isoforms and their biologically active degradation products. Clinical trials have reported that ranibizumab treatment resulted in greater proportions of patients achieving a < 15 letter loss of visual acuity and improved vision at 12 and 24 months than control groups. The incidence of serious ocular and systemic adverse events was low in all ranibizumab trials to date. Currently, ranibizumab is the only treatment for neovascular AMD to demonstrate significant improvement in vision for many patients and represents a major advance in treating neovascular AMD.     

Chronic peritoneal dialysis in juvenile-onset diabetes mellitus: a comparison with hemodialysis.

Fourteen juvenile-onset diabetic patients accepted for renal transplantation and maintained on chronic peritoneal dialysis during a 3-year period were compared with a similar group of 43 patients accepted for renal transplantation and maintained on hemodialysis. The 1-year survival in each group was similar (52% on chronic peritoneal dialysis; 55% on hemodialysis), but there was a striking difference in progressive morbidity. Seven patients on chronic peritoneal dialysis were blind in one or both eyes at the onset, and visual acuity improved in two, including one bilaterally blind patient who achieved 20/35 vision bilaterally; none worsened. In the hemodialysis group, 12 patients were totally blind in one or both eyes and 11 additional patients became blind or had severe deterioration in vision; none improved. Neuropathy progressed in only 1 patient on chronic peritoneal dialysis, whereas it worsened in 17 patients on hemodialysis--9 to the extent that they needed braces or canes or were nonambulatory. All patients on chronic peritoneal dialysis were home trained and were dialyzed at night, with seven being able to work full or part time; virtually none of the patients on hemodialysis were able to work. Chronic peritoneal dialysis was relatively free of technical complication, and no significant difficulty was encountered in diabetic control, in the anephric state, or during abdominal surgery. Chronic peritoneal dialysis appears to have less associated morbidity than does hemodialysis in the treatment of chronic renal failure of juvenile-onset diabetes mellitus.     

玻璃体切割手术治疗内源性葡萄膜炎

【目的】探讨玻璃体切割手术对内源性葡萄膜炎的治疗效果。【方法134例严重葡萄膜炎患者分别合并有视网膜脱离、玻璃体混浊或积血、黄斑囊样水肿和并发性白内障。34例患者均行标准三切口玻璃体切割术,联合观膜环扎、剥膜、视网膜光凝或巩膜冷凝、膨胀性气体或硅油眼内真充术。根据病情联合行白内障超声乳化或经睫状体平坦部的晶状体切除,术后患者随访6～12个月。【结果】25只（73％）眼术后视力均有不同程度的提高,下降3眼（9％）,不变6眼（18％）。其中视力≥0．05者,术前5只眼（14％）,术后14只眼（41％）。以矫正视力≥0．05者为脱离盲的标准,术前,术后视力比较差异有显著性（P=0．029）。患者术后全身用药减少,炎症得到控制。【结论】玻璃体手术是治疗内源性葡萄膜炎的有效方法,可以明显提高患者视力,减少全身用药量。     

Low visual acuity is associated with the decrease in postural sway

Vision contributes to upright postural control by providing afferent feedback to the cerebellum. Vision is generally classified into central and peripheral vision, but little is known about the respective role of central and peripheral vision for postural control with different visual acuity levels. This study examined the influence of visual acuity and visual field conditions on upright posture. Eleven males (21.1 +/- 2.0 yrs) and 15 females (22.2 +/- 2.2 yrs) were classified into high (above 1.0 binocular vision) and low (below 0.3) visual acuity groups. Postural sway was measured for 1 min in each of three visual field conditions (central vision, full vision, and no vision). Participants were given only central visual information (central vision), central and peripheral visual information (full vision), or no visual information (no vision). The effect of central vision on postural sway was detected as a difference between no vision and central vision conditions, and the effect of peripheral vision was assessed as a difference between central vision and full vision conditions. The low visual acuity group decreased their sway amplitude in antero-posterior direction using central plus peripheral visual information, but the high visual-acuity group did not. The high frequency sway was significantly smaller in the low visual-acuity group than that in the high visual-acuity group under the no vision and central vision conditions. These findings suggest the necessity of considering participants' visual acuity in examining the role of the visual information from the central and peripheral visual fields.