兰州市区小学及初中学生弱视调查及分析报告

目的了解兰州市区小学及中学生的弱视发病情况,分析弱视的发病原因及分布情况。方法选择兰州市区5所小学及5所中学的初中生共计12361名进行视力普查,对矫正视力达不到0.9者进行验光矫正,对异常视力者进行视力损害原因分析,确定弱视发病者并分析发病原因。结果兰州市区12361名小学及中学生弱视发病人数为445人（512眼）,发病率为3.6%,引起弱视的主要发病原因为屈光不正227例,占51.01%;斜视89例,占20.00%;屈光参差64例,占14.39%;形觉剥夺34例,占7.64%;其它31例,占6.96%。结论兰州市区的弱视发病率较全国平水平偏高,屈光不正及斜视是弱视的主要原因。     

温州市区视力不良小学生屈光状态及相关因素

目的：研究视力不良小学生屈光状态及近视眼发病的相关因素,方法：随机抽取温州市视力不良的小学生4696名（有效眼9392眼）进行扩瞳视网膜检影验光,填写调查表,调查各年级小学生屈光状态及其相关因素。结果：本组小学生视力不良以屈光不正为主,占79．7％,其中近视性屈光不正最多,占48．9％,其次是散光25.6％。随学习阶段上升,近视患病率逐渐增高,屈光参差患病率23．7％,弱视患病率以远视性屈光参差最高,达97．9％。近视眼发病与遗传因素（20．19％）及环境、体质因素有关。结论：在小学生中普查视力和屈光状态,以早期发现屈光不正和弱视,进行及时防治,对控制小学生视力不良有重要意义。     

7岁以下儿童中度弱视的临床概况

目的：描述一组中度弱视儿童参加弱视治疗研究1的人口统计学和临床特征，其为1项比较阿托品与遮盖治疗的随机验证。方法：入选的儿童在7岁以下，有斜视性、屈光参差性、或混合的斜视性和屈光参差性弱视。采用围有干扰视标的单独HOTV视标，以标准化的测试方案测定视力，弱视眼的视力为20／40－20／100，双眼间视力差为3行或3行以上logMAR(logarithm of the minimal angle of resolution，即最小分辨角的对数－译注），入选儿童有419例，其中409例符合标准进入分析。结果：409例儿童的平均年龄为5.3岁。弱视的原因，斜视占38％、屈光参差占37%、斜视和屈光参差两均占24％。在斜视、屈光参差和混合组中，弱视眼的平均视力（约20／60）相似（P＝0.24），但健眼视力斜视组比屈光参差组更差（P＜0.001）。随机分至遮盖组患，开始有43％患每天作6h治疗，而有17％患进行全日遮盖。弱视眼视力较差的患比视力较好的患被嘱咐遮盖的时间更多（P＝0.03）。结论：在弱视治疗研究1中，斜视性和屈光参差性弱视患的比例几乎相等。不考虑弱视的原因，视力受损的水平相同。关于初期遮盖嘱咐多少小时，在治疗实践中有相当大的变化。     

四川省乐山市夹江县第一小学小儿斜弱视流行病学调查分析

目的：了解小学生斜弱视的流行病学及相关因素,为制定防治策略提供指导。
　　方法：对四川省乐山市夹江县第一小学600例学生进行视力、屈光及眼位等进行筛查,比较不同性别、年龄阶段的斜视患病率、弱视患病率,并统计不同弱视或斜视种类患儿的弱视程度及有无立体视。
　　结果：弱视患病率与斜视患病率分别为4.0%,2.5%;各年龄段、不同性别的学生斜视患病率、弱视患病率对比差异无统计学意义(P>0.05);屈光不正性是主要的弱视类型,占55.6%,且主要的弱视程度为轻、中度;屈光不正性弱视、屈光不正性弱视及外斜视大多数有立体视,而大部分的斜视性弱视及全部的内斜视均无立体视。
　　结论：屈光不正性弱视是小学生主要的弱视类型,其斜弱视的患病率与性别的关系不明显,但斜弱视的治疗效果、立体视的建立等与年龄、眼位存在密切的关系,应早发现、早治疗。     

674例3~6岁视力低常儿童屈光状态分析

目的分析3~6岁视力低常儿童的屈光状态分布并探讨不同屈光类型与弱视发生的关系。方法描述性研究。对674例（1 348眼）3~6岁裸眼视力低于正常（3岁≤20/40,4岁≤20/32,5岁及以上≤20/25）儿童进行阿托品散瞳后验光检查屈光状态及矫正视力。分析不同年龄段、弱视眼和非弱视眼的屈光状态分布,不同年龄段屈光参差分布以及屈光参差与弱视发生的关系。不同年龄段屈光分布的构成比及弱视发生率比较采用卡方检验。结果视力低常儿童中屈光分布以远视为主,近视发生率较低;随着年龄增加,远视所占比例逐渐降低,近视所占比例逐渐增加,差异有统计学意义（χ²=99.7,P＜0.001）。弱视眼和非弱视眼屈光分布差异有统计学意义（χ²=20.1,P=0.01）;弱视眼中前3位屈光类型分别为复性远视散光（59.4%）、单纯远视散光（17.8%）和混合性散光（15.8%）,而单纯近视眼中无弱视发生。双眼等效球镜度差值≥1 D时容易引起屈光参差性弱视,并且弱视发生率随屈光参差程度增大而升高（χ²=62.9,P＜0.001）。结论学龄前视力低常儿童的屈光状态分布以远视为主,远视性屈光不正、散光、屈光参差等屈光异常更容易引起弱视的发生。     

青海藏族儿童弱视调查

调查青海４－１２岁藏族儿童５６４８人，弱视患病率为１２６％；弱视以轻、中度为多见，占８４．７％；弱视类型以屈光不正性和屈光参差性为主，占７６．ｌ％，４－５岁儿童弱视患病率高，达２．３１％－２．５５％，差异有极显著性（ｐ＜００１）；轻度弱视屈光不正度数低，中高度弱视屈光不正度数高，弱视患病率与性别无关，差异无显著性（Ｐ＞０．０５）。     

弱视儿童非弱视眼的视觉诱发电位分析

双８４例儿童正常视力眼的视觉诱发电位（ｖｉｓｕａｌ ｅｖｏｋｅｄ ｐｏｔｅｎｔｉａｌ，ＶＥＰ）进行了分析，其中正常儿童２０人，屈光参差性弱视儿童２８人，治愈的屈光参差性弱视儿童８人，单卵双生子８对，双卵双生子６对。结果表明：弱视的对侧眼及已治愈的弱视眼，尽管视力完全正常，但ＶＥＰ仍表现异常，以Ｐ１００波潜伏期延长明显；双生子中遗传物质相同的单卵双生子，其视力正常眼与弱视眼间的ＶＥＰ差异无显著性意义     

4D数字化弱视斜视矫治系统对远视性屈光不正性及屈光参差性弱视的疗效观察

目的:评估4D数字化弱视斜视矫治系统对远视性屈光不正性及远视性屈光参差性弱视儿童的疗效。方法:招募3~9岁远视性屈光不正性及远视性屈光参差性弱视患者48例(其中远视性屈光不正性弱视18例36眼,远视性屈光参差性弱视30例30眼),所有患者排除其他眼病,在屈光矫正、合理遮盖的基础上接受4D数字化弱视斜视矫治系统的训练。初期训练以提高视力为主,视力达0.6以上者加上脱抑制训练及双眼视功能训练。比较训练前、后的视力及双眼立体视变化情况。结果:远视性屈光不正性弱视患者共18例36眼,其中轻度弱视组13眼,中度弱视组19眼,重度弱视组4眼。远视性屈光参差性弱视患者共30例30眼,根据弱视程度分为轻度弱视组5眼,中度弱视组13眼,重度弱视组12眼。治疗60次后视力均有明显提高。治疗60次后立体视有明显提高,且与屈光度无关(P>0.05),与初始视力及治疗后视力均呈正相关(P<0.05),与屈光参差量呈正相关(P<0.05)。结论:4D数字化弱视斜视矫治系统联合传统的弱视治疗方法能有效提高3~9岁远视性屈光不正性弱视和远视性屈光参差性弱视儿童的视力并改善其双眼视功能。     

江门市17201名学龄前儿童屈光不正性弱视普查

目的 探讨学龄前儿童屈光不正性弱视的患病率以及与屈光不正的关系等.方法 对广东省江门市10所幼儿园17201名学龄前儿童进行了视力普查、医学验光及屈光状态的调查等,分析视力异常儿童的屈光状态.结果 在17201名学龄前儿童中,视力低常率15.44%.弱视患病率为2.96%,以3～4岁组视力低常率和弱视患病率为最高,分别为19.28%和4.16%.6岁以上组视力低常率最低,为13.35%,5～6岁组弱视患病率最低,为2.45%.远视患病率为79.59%,随着年龄增长,远视发病率渐趋降低.近视患病率为2.05%,随着年龄的增长,近视患病率逐渐增加,3岁儿童近视患病率为1.83%,6岁为4.35%.散光患病率为58.00%,各年龄组散光患病率较为稳定.屈光不正性弱视以轻中度居多,引起弱视的最小远视度为+1.75 D,近视为-3.25 D,散光为1.0D.屈光参差性弱视的球镜最小差值为1.25 D,柱镜最小差值为0.75 D.但也有个例近视性届光参差达6.75 D,远视性屈光参差达3.00 D也未形成弱视.结论 视力低常率15.44%.弱视患病率为2.96%,随着年龄增长,远视患病率逐渐降低,近视患病率逐渐增加,散光则较稳定.屈光不正性弱视以轻中度居多,多为远视和散光引起.导致弱视的最小远视度为+1.75 D,近视为-3.25 D,散光为1.0 D.屈光参差球镜最小差值为1.25 D,柱镜最小差值为0.75 D.     

先天性上睑下垂患者100例弱视致病原因的探讨

目的:评估先天性上睑下垂患者的弱视发病情况。方法:在本横断面研究中,包括1岁以上的先天性上睑下垂患者100例(114眼)。最佳矫正视力小于10/10或两眼之间至少相差2/10者定义为弱视。年幼患者不能进行斯内伦视力表检测者,观察其注视情况。不同弱视患者的类型:1)屈光参差性弱视:散光性屈光参差≥1.00D;远视性球镜屈光参差≥1.00D,近视性球镜屈光参差≥-3.00D(睫状肌麻痹);2)斜视性弱视,3)形觉剥夺性弱视(SDA)。观察弱视的总发病率及类型,并对单侧和双侧上睑下垂患者进行比较。结果:弱视的发生率在上睑下垂患者为39/114(34.2%),其具体原因:屈光参差性弱视占29.8%,SDA占10.5%,斜视性弱视4.3%,严重的上睑下垂患者弱视发病率更高,视轴遮盖者(OA)占76%,而视轴未遮盖者只占22%。在视轴遮盖的单侧眼睑下垂患者,散光屈光参差性弱视发生率更高,在双侧眼睑下垂至少1眼视轴遮盖者,球镜屈光参差性弱视发生率更高。无论单侧和双侧上睑下垂,如果有视轴遮盖,则SDA比较多见。结论:由于屈光参差性弱视比SDA发生率更高,关注导致的弱视所有原因对于预防儿童上睑下垂所致的弱视极其重要。     

兰州市中学生屈光状况及其影响因素的调查分析

目的:调查兰州市中学生屈光不正的发病率并探讨近视发病的危险因素。方法:采用前瞻性调查设计,对抽样的学生进行有关家庭因素及用眼状态的问卷调查,并进行视力测量以及包括裂隙灯、视网膜镜、矫正视力等的全面眼部检查。采集各项指标,输入应用程序,采用SPSS11.0软件进行统计分析。结果:在2256名年龄介于15～19岁的学生中,2037名(90.3%)学生患有屈光不正。近视是引起屈光不正的首要原因(1951/2256,86.5%),散光为第二位原因(921/2256,40.8%),弱视(10/2256,0.4%)、斜视(5/2256,0.2%)、远视(4/2256,0.2%)和其它眼病的发病率相对较低。在患有屈光不正的学生中约有95.3%在接受调查前已经佩戴眼镜。年龄、性别、用眼状态及家族史是近视发病的危险因素。结论:兰州市中学生屈光不正发病率及其发病的危险因素与国内其它地区类似,采取一定的干预措施保护中学生的视力是有必要的。     

Prevalence of refractive errors in middle school students in Lanzhou city

AIM: To assess the prevalence of refractive errors in middle school students in Lanzhou city and explore the risk factors for myopia. · METHODS: A cross-sectional survey was conducted. A questionnaire assessed the students' socioeconomic background and visual tasks followed by visual acuity assessment and a full eye examination including slit-lamp examination, fundus evaluation, retinoscopy, and subjective refraction. · RESULTS: Among 2 256 enumerated students aged 15-19 years,2 037(90.3%) students had significant refractive errors. Myopia was the leading refractive error (1 951/2 256, 86.5%), astigmatism was the second most common refractive error (921/2 256, 40.8%), but amblyopia (10/2 256, 0.4%), strabismus (5/2 256, 0.2%), hyperopia (4/2 256, 0.2%) and other treatable eye disorders were uncommon. Almost 95.3% of students with significant refractive errors wore spectacles before the survey. Age, sex, visual tasks, and a parental history of myopia were risk factors for myopia. · CONCLUSION: The prevalence of refractive errors and the risk factors for myopia in schoolchildren in Lanzhou city are similar to those reported in other regions of China. Interventions of myopia progression should be performed to protect the visual acuity of school-aged students.     

Myopia in secondary school students in Mwanza City,Tanzania: the need for a national screening programme

BACKGROUND/AIMS: The prevalence of significant refractive errors and other eye diseases was measured in 2511 secondary school students aged 11-27 years in Mwanza City, Tanzania. Risk factors for myopia were explored. METHODS: A questionnaire assessed the students' socioeconomic background and exposure to near work followed by visual acuity assessment and a full eye examination. Non-cycloplegic objective and subjective refraction was done on all participants with visual acuity of worse than 6/12 in either eye without an obvious cause. RESULTS: 154 (6.1%) students had significant refractive errors. Myopia was the leading refractive error (5.6%). Amblyopia (0.4%), strabismus (0.2%), and other treatable eye disorders were uncommon. Only 30.3% of students with significant refractive errors wore spectacles before the survey. Age, sex, ethnicity, father's educational status, and a family history of siblings with spectacles were significant independent risk factors for myopia. CONCLUSION: The prevalence of uncorrected significant refractive errors is high enough to justify a regular school eye screening programme in secondary schools in Tanzania. Risk factors for myopia are similar to those reported in European, North-American, and Asian populations.     

北海市少年儿童视力低常者屈光状态调查

目的:了解北海市3～15岁少年儿童视力低常者屈光状态。方法:对北海市3～15岁在校学生共19032例进行普查,其中男10503例,占受检总人数55.2%,女8529例,占受检总人数44.8%。结果:裸眼视力≥1.0者,男6650例,占受检男生总人数63.3%,女4575例,占受检女生总人数53.6%。视力低常者,男3853例,占受检男生总人数36.7%,女3954例,占受检女生总人数46.4%。视力低常发生率:幼儿组<小学组<初中组。各组之间视力低常发生率均为女生>男生,且随着年龄的增长视力低常发生率呈现增长趋势,从小学到初中有显著增长。视力低常的屈光状态:3～6岁以轻度远视眼多见,从7岁开始以近视眼为主,10岁开始轻度近视发生率逐年减少,中、重度近视发生率逐年增长。弱视的屈光类型以远视散光为主。结论:对处于生长发育期的少年儿童进行视力普查是发现并预防屈光不正的重要手段。屈光状态筛查、屈光不正矫正以及早期适当的治疗和正确科学的指导是阻止和延缓病情发生、发展及防治弱视的有效方法。对于3～15岁的视力低常者我们应采取积极有效的综合防治措施。     

Prevalence of eye diseases in primary school children in a rural area of Tanzania

AIMS: The study measured the prevalence of eye diseases in primary school children between 7 and 19 years of age in a rural area of Tanzania, and investigated whether teachers could successfully provide the first component of a school eye screening service. METHODS: Teachers from each of three primary schools in Mwanza Region tested visual acuity using a Snellen's E chart in 1438 pupils. 1386 of these pupils were then interviewed and underwent a full eye examination by an eye team. RESULTS: 10 pupils (0.7%) had bilateral poor eyesight (visual acuity worse than 6/12), and an additional 14 pupils (1.0%) had unilateral poor eyesight. Significant refractive errors causing visual acuity less than 6/12 (1.0%), strabismus (0. 5%), and amblyopia (0.2%) were uncommon. Overall, 76 pupils (5.5%) had active trachoma, though the prevalence was 15.5% in the poorest school. 73 pupils (5.3%) reported night blindness, eight (0.6%) had Bitot's spots, and 11 (0.8%) had corneal scars. Simple screening by teachers correctly identified 80% of the pupils who were found to have bilateral poor eyesight by the eye team, with 91% specificity. CONCLUSION: The prevalence of significant refractive errors was not high enough to justify a school eye screening programme solely for this purpose. However, a programme may be justified in areas where trachoma is common. Further research is needed to validate the frequent reports of night blindness and to establish the public health importance of vitamin A deficiency in this age group.     

兰州市中学生干眼症患病率及危险因素分析

目的　探讨甘肃省兰州市中学生干眼症的患病率和危险因素。方法　2018年7月对甘肃省兰州市5所中学的学生进行了横断面调查。通过随机整群抽样获得所选36个班级的1503名学生。使用Schaumberg干眼调查问卷进行调查访谈。由两位经验丰富的眼科医师于访谈后进行眼科检查（一位医师进行视敏度检查，另一位医师进行裂隙灯检查）。计算干眼症的患病率，并评估干眼症与性别、近视、配戴隐形眼镜、屈光矫正不足、经常使用滴眼液、睡眠质量和压力状态之间的相关性。采用χ²检验和Logistic回归分析评估与干眼症相关的危险因素。结果　兰州市中学生干眼症的患病率为24.5％（363/1482）。363例干眼症患者最常报告的眼部刺激症状是视疲劳（303例，83.5％），其次是疼痛（166例，45.7％），视力模糊（134例，36.9％），眼部瘙痒（129例，35.5％），以及砂砾感（96例，26.4％）。多因素Logistic回归分析结果显示，屈光矫正不足、经常使用滴眼液、睡眠质量差是干眼症的独立危险因素。结论　中学生干眼症患病率高且易被忽视，针对中学生干眼症危险因素的预防措施可能有助于降低干眼症患病率并对学生的眼健康产生积极影响。     

The prevalence of refractive errors among schoolchildren in Dezful, Iran

AIM: To determine the prevalence of refractive errors among schoolchildren in urban and rural areas of Dezful County, Iran. METHODS: In a cross-sectional study, using random cluster sampling, 5721 Dezful schoolchildren were selected from 39 clusters. The participants in the study totalled 5544; 3673 elementary and middle school students and 1871 high school students. For the former group, cycloplegic refraction and for the latter, non-cycloplegic refraction was tested. In all participants, uncorrected visual acuity and best corrected visual acuity were determined, and those with a visual acuity of 20/40 or worse, underwent a complete ophthalmic examination to determine the cause of visual impairment. A spherical equivalent of -0.5 diopter (D) or worse was defined as myopia, +2.0 D or more was defined as hyperopia, and a cylinder refraction greater than 0.75 D was considered astigmatism. RESULTS: The uncorrected visual acuity was 20/40 or worse in the better eye of 224 schoolchildren (3.8% of participants). This figure (percentage) was 14 (0.03%) based on their best corrected visual acuity and 96 (1.7%) with their presenting vision. According to results of cycloplegic refraction, 3.4% (95% confidence interval (CI), 2.5 to 4.4) of the primary and middle school students were myopic and 16.6% (95% CI, 13.6 to 19.7) were hyperopic. For high school students, these rates were 2.1% (95% CI, 0.7 to 3.5) and 33.0% (95% CI, 24.9 to 41.1), respectively, with non-cycloplegic refraction. In the multivariate logistic regression for primary and middle school students, myopia was correlated with age (p = 0.030), and hyperopia was correlated with age (p<0.001) and area of residence (p = 0.007). In high school students, hyperopia again showed a correlation with their area of residence (p = 0.029). CONCLUSION: The present study reveals the considerable prevalence rates of refractive errors among schoolchildren in Dezful County and the high rate of an unmet need for their correction. Although myopia is not very prevalent, the high rate of hyperopia in the studied population emphasises its need for attention.     

温州市区小学生弱视的筛选及屈光状态分析

目的 研究弱视在小学生中的发病率、屈光状态分布和主要影响因素。方法 在全市视力 小学生中,用列镜筛选,再用扩瞳检影验光进行屈光测定,选择矫正视力≤４．９;眼科检查无器质性病变的弱视患者,分别检查注视性质,眼位、单视功能及询问填写调查表。并分别作统计学处理。结果 在受检６３６００眼中,确诊弱视１２０５人,２２６６只眼,患病为３．７８％;以屈光不正弱视为主,其中远视性弱视最高。弱视程度与屈光度、注视性     

Pattern of eye diseases and visual impairment among students in southwestern Nigeria

Purpose The aim of the study was to determine the prevalence and causes of eye diseases and visual impairment in students in the Ilesa East local government area of Osun state, Nigeria. Methods A cross-sectional survey that utilised a multistage random sampling method to select 1,144 primary and secondary school students. Results A total of 1,144 students (504 males and 640 females) were involved in the study. Their ages ranged from 4 to 24 years. The majority (97.8%) of them were below 18 years of age. A total of 177 (15.5%) of the school children were found to have eye diseases. The major ocular disorders were in the following order: conjunctiva 91 (51.4%), refractive error 66 (37.3%), lid 7 (4.0%), corneal, including staphyloma and keratoconus 5 (2.8%) and then others. These included conjunctival diseases 91 (8%) constituted mainly by allergic/vernal conjunctivitis 85 (7.4%), refractive error 66 (5.8%), lid disorders 6 (0.6%), squint 3 (0.3%), corneal scarring 3 (0.3%) and cataract 2 (0.2%). A total of 15 students were visually impaired, with a prevalence of 1.26%. Only two students were blind, with a prevalence of 0.17%. Causes of visual impairment were refractive error 10 (0.87%), bilateral immature cataract 1 (0.08%), corneal opacities 2 (0.2%), amblyopia leading to squint 1 (0.08%) and cataract 1 (0.08%). The causes of blindness in students were bilateral corneal scars presumed to be due to vitamin A deficiency in one (0.08%) student and complicated bilateral keratoconus with complicated vernal ulcers in another (0.08%). Conclusions Eye diseases are common amongst Nigerian students. Eye examination for all new intakes and regular screening in both public and private primary and secondary schools is advocated. Wearing of corrective glasses should be emphasised for children with refractive error. Causes of blindness and visual impairment in children attending regular schools in Nigeria were avoidable.