颜色视功能检查及其进展

颜色视功能检查主要分为视觉心理物理学检查(主观检查)和视觉电生理检查(客观检查)两种。目前临床使用的多为主观检查,客观检查尚处于应用研究阶段。本文主要介绍假同色图测验、色相排列测验、色盲镜、视网膜电图和颜色视诱发电位等色觉检查法各自的特点、适用范围及色觉检查的一些进展。     

颜色视功能检查及其进展

颜色视功能检查主要分为视觉心理物理学检查（主观检查）和视觉电生理检查（客观检查）两种。目前临床使用的多为主观检查，客观检查尚处于应用研究阶段。本文主要介绍假同色图测验、色相排列测验、色盲镜、视网膜电图和颜色视诱发电位等色觉检查法各自的特点、适用范围及色觉检查的一些进展。     

Panel D-15检查法在招收飞行学员中的应用

目的:探讨PanelD-15检查法在招收飞行学员中的应用。方法:随机选取2012-12-01/12-10南航招收飞行学员400例为测试对象,应用俞自萍色盲检查图和PanelD-15对学生的色觉能力进行评估,以俞自萍色盲检查图判断色盲、色弱和正常学生;用PanelD-15比较学生色相子排列的次序,以正常、小错和按跨线判断学生对不同色调的辨色能力。结果:色盲本检查,正常386例,全色盲4例,红绿色盲5例,红绿色弱5例;PanelD-15检查,正常384例,小错5例,跨线11例。结论:PanelD-15能够客观评价招飞学生的色觉能力,可减少漏诊率,保证招飞质量,保证飞行安全。     

角膜接触镜配戴者眼部及系列用品微生物学调查

１９９１年～１９９３年期间，对软质角膜接触配戴者眼部及系列用品污染微生物进行调查。结膜囊带菌阳性率戴镜前为３３．６％，戴镜后为２２．５％。Ｐ〈０．００５。戴镜前结膜囊细菌以革兰氏阳性菌为主，戴镜后菌群发生了变化，革兰氏阴性菌所占比率与革兰氏阳性菌接近，戴镜者系列用品２８．２％～４０．６％，被微生物污染，戴镜前，后结膜囊菌群变化与接触镜系列用品污染密切相关，检查了３２例戴镜并发角膜感染病例，从眼病变     

软性与透气性硬性角膜接触镜配戴者角膜地形图及前房深度对比分析

目的　比较配戴软性及硬性角膜接触镜对角膜形态及前房深度的影响。方法　选取屈光不正患者６０例（１２０眼）,分别予以配戴软性角膜接触镜（ｓｏｆｔｃｏｎｔａｃｔｌｅｎｓ,ＳＣＬ）及透气性硬性角膜接触镜（ｒｉｇｉｄｇａｓｐｅｒｍｅａｂｌｅｃｏｎｔａｃｔｌｅｎｓ,ＲＧＰＣＬ）,其中ＳＣＬ组３０例（６０眼）,ＲＧＰＣＬ组３０例（６０眼）,ＯｂｓｃａｎⅡ角膜地形图观察戴镜前及戴镜后１ａ、２ａ角膜屈光力、角膜前后表面Ｄｉｆｆ值、中央角膜厚度、前房深度的变化。结果　戴镜前ＲＧＰＣＬ组角膜上下表面屈光力差值为（０．９８±０．４９）Ｄ,戴镜后１ａ为（０．６６±０．４３）Ｄ,戴镜后２ａ为（０．５９±０．３７）Ｄ,均较戴镜前减小（Ｐ＜０．０５）;戴镜后１ａ、２ａ角膜前表面屈光力均较戴镜前降低,差异均有统计学意义（均为Ｐ＜０．０５）。ＳＣＬ组戴镜后１ａ、２ａ角膜前后表面屈光力、Ｉ－Ｓ值、前后表面Ｄｉｆｆ值、前房深度与戴镜前比较,差异均无统计学意义（均为Ｐ＞０．０５）;戴镜前中央角膜厚度为（５４９±２６）μｍ,戴镜后１ａ为（５２７±２９）μｍ,与戴镜前比较差异无统计学意义（Ｐ＞０．０５）,戴镜后２ａ为（５０９±３１）μｍ,与戴镜前比较差异有统计学意义（Ｐ＜０．０５）。结论　长期配戴ＲＧＰＣＬ对角膜代谢和功能影响不明显,且能够提供更好的光学矫正效果。     

长期配戴角膜接触镜对角膜形态的影响

目的 比较分析长期配戴软性角膜接触镜（SCL）及硬性透气性角膜接触镜（RGPCL）患者的中央角膜厚度（CCT）、角膜曲率及角膜内皮细胞形态之间的差别.方法 选取有角膜接触镜配戴适应证的屈光不正患者共172例（300眼）,除屈光不正外无其他任何眼病.根据患者的主观要求及眼部情况分为SCL配戴组（59例102眼）和RGPCL配戴组（113例198眼）.配戴方法均为日戴型连续配戴,即每日戴镜时间不少于6 h.随访时间为3年.分别于配戴前、配戴后6个月和3年进行检查,采用非接触式角膜内皮镜测量CCT、角膜内皮细胞计数、六角形比例及变异系数,采用电脑验光仪测量角膜曲率.对两组戴镜前后的各参数进行配对t检验,组间比较采用两独立样本t检验.结果 中央角膜厚度：戴镜后3年,SCL组CCT较戴镜前减少（27.1±0.8）mm,差异有统计学意义（P＜0.05）;RGPCL组CCT较戴镜前减少（3.1±2.2）mm,差异无统计学意义（P＞0.05）;两组间比较,戴镜前和戴镜后6个月时CCT差异无统计学意义,但在戴镜后3年时RGPCL组CTT较SCL组厚,两组差异有统计学意义（P＜0.05）.角膜曲率：SCL组戴镜后各时间点水平曲率和垂直曲率与术前比较,差异均无统计学意义;RGPCL组戴镜后各时间点与戴镜前比较,差异均有统计学意义（P＜0.05）;两组间比较,戴镜后3年RGPCL组角膜曲率较SCL组小,两组差异有统计学意义（P＜0.05）.角膜内皮细胞密度：SCL组和RGPCL组戴镜后角膜内皮细胞密度较戴镜前均有降低,差异均有统计学意义.戴镜后3年,SCL组和RGPCL组角膜内皮细胞密度分别降低了（368.5±31.5）个/mm^2和（140.2±5.6）个/mm^2,差异有统计学意义（P＜0.05）.六角形比例和变异系数：SCL组戴镜后3年与戴镜前比较,差异有统计学意义（P＜0.05）;RGPCL组戴镜前后变化不明显;两组间比较,戴镜后3年两组差异有统计学意义（P＜0.05）.结论 长期配戴RGPCL对患者角膜形态及功能的影响较小,同长期配戴SCL相比具有更高的安全性.     

色觉测定仪的研制及临床应用

色盲是一种常见的眼病。检查色觉的方法很多,平常一般采用假同色版测验法,即色盲表定性检查。目前,广泛采用假同色表主要有三种。至于临床上检查,各图表中何者为优,     

同一家庭3个姐妹色觉障碍

目的:评价我校医学生和她的家庭成员先天色觉障碍的遗传特征,以建立其遗传模式.方法:运用Ishihara(石原)假同色图试验测定色觉障碍,用FW100色调试验评估其类型.并进行眼科检查和遗传学研究,建立色盲家谱,并对她的家庭给予遗传学咨询.结果:眼科检测结果显示双眼最佳矫正视力为20/20(1.0),近视矫正屈光度-2D,裂隙灯检测和眼压测量结果在正常范围,眼底镜检查视神经、黄斑和周边视网膜均正常,其它外眼评估和神经学检测正常,先证者的姐妹和她父母的眼科检测也正常,3姐妹和父亲的IPPT试验错误得分为19～20/25,结果和红绿色盲中绿色觉异常者一致.染色体分析和卵巢周期均正常.结论:根据她家谱,她的色盲是伴X染色体的隐性外显率模式的遗传特征.     

色觉异常疾病的视觉电生理评价

色觉是视觉功能的一个基本而重要的组成部分,是人类视网膜锥体细胞的特殊感觉功能。一般先天性色盲多无自觉症状,通常在体检中进行常规色觉检查时被发现。继发性色觉障碍更需要及早明确原发疾病对色觉是否产生影响。色觉检查方法的特异性、敏感性及发现疾病早期特有的表现尤为重要。色觉检查的方法很多,但大多数属于主观检查法,包括假同色图测验、色相排列测验和色盲镜等;客观检查以视觉电生理检查为主,其中荧光素眼底血管造影（FFA）、视网膜密度检测、CT扫描等有助于明确视神经、视网膜及黄斑病变的形态学评估。临床视觉电生理检查属于客观的功能学检查方法,对于一些特殊人群色觉的评定及对某些继发性色觉改变的早期诊断显示了一定的优势。就临床电生理在继发性色觉障碍疾病中的特征性表现及早期诊断价值进行综述。     

硬性透气性角膜接触镜与软性角膜接触镜对中低度近视患者角膜形态的影响

目的　探讨屈光不正患者长期配戴软性角膜接触镜（soft contact lens,SCL）和硬性透气性角膜接触镜（rigid gas permeable contact lense,RGPCL）对角膜形态参数的影响。方法　收集视光学中心验配角膜接触镜的屈光不正患者60例(120眼),按照患者配戴SCL或RGPCL分为SCL组和RGPCL组（两组均为30例60眼）,在戴镜前及戴镜后1 a、2 a测量2组患者中央角膜厚度、内皮细胞密度、六角形细胞比例及变异系数,并对2组数据进行对比。结果　SCL组:戴镜后2 a,中央角膜厚度(509±31)μm较戴镜前(549±26)μm明显下降（P<0.05）;角膜内皮细胞密度为(2819.3±169.2）个·mm^-2,较戴镜前密度(3182.6±162.3）个·mm^-2减少;六角形细胞比例（51.52±4.69）%较戴镜前（61.45±4.58）%降低（P<0.05）;内皮细胞变异系数（39.14±3.15）较戴镜前（33.47±2.83）增加（P<0.05）。RGPCL组戴镜前后中央角膜厚度、角膜内皮细胞密度、六角形细胞比例及内皮细胞变异系数比较,差异均无统计学意义（均为P>0.05）。结论　与配戴SCL相比,配戴RGPCL对屈光不正患者的角膜形态和功能影响不明显,更适合长期配戴。     

Soft tinted contact lenses and color discrimination

A preliminary investigation concerning the effects of tinted soft contact lenses on color discrimination was conducted. The effects of blue, green, aqua, and brown shades were evaluated using the Farnsworth-Munsell 100 Hue Color Test, the Lanthony Desaturated Panel D-15, and the Nagel anomaloscope. Results on the 100 Hue and Desaturated D-15 were unremarkable in all cases. The anomaloscope results showed a consistent shift in the amount of red/green wavelengths needed to match the yellow field, particularly for the brown and green shades.     

Colour vision and tinted contact lenses

The effect of tinted soft contact lenses on colour discrimination was studied using Ciba Softcolor^TM dark tinted lenses and the Lanthony New Colour Test for twenty subjects with normal colour vision. Blue, green, aqua and amber tinted lenses were used. We found no significant difference between test performance with the various tinted lenses and the clear lens which was used as a control. This result verifies, for a range of saturations, the conclusion drawn in a related study that tinted soft contact lenses do not affect the colour discrimination performance of persons with normal colour vision.     

软性红色角膜接触镜矫正红绿色盲初探

目的 探讨以软性角膜接触镜矫正红绿色盲的可行性,方法 通过志愿者试戴研制能矫正红绿色盲的色盲镜片。结果 同一种镜片对各红绿色盲患者的矫正作用有明显差异;镜片颜色的细微改变即可对红绿色盲矫正效果产生明显影响。通过反复探索,研制出了一种对大多数红绿色盲患者都能满足矫正的色盲镜片。结论 适宜的红色角膜接触镜可以显著改善红绿色盲患者的辨色能力。     

Variable tinted spectacle lenses: a comparison of aesthetics and visual preference.

PURPOSE: To determine the correlation between the aesthetics of lens tints preferred for cosmesis and lens tints preferred for viewing. METHODS: Thirty-five subjects (mean age: 25; 49% male, 51% female) with no significant ocular pathology participated in the study. Median visual acuity was 20/20. Color vision testing was performed on each subject using Ishihara plates, and those with abnormal scores were excluded from the study. Subjects were shown nine pre-selected tinted lenses (50% transmittance) of variable wavelengths. These lenses were mounted on two separate color backgrounds, one white and the other approximating their skin tone. Subjects were asked to choose from each background which tinted lens they would most prefer to wear and which lens they would least prefer to wear. The subjects were then shown a series of eight pictures (four nature photographs and four paintings) with different dominant wavelengths. Subjects were asked to grade the aesthetic effect of a clear lens and each of the nine tinted lenses on the appearance of the pictures. Chromaticity coordinates were calculated for each lens and picture. RESULTS: The blue lens was the most frequently chosen preferred lens to wear, followed by green, purple, and gray. The least preferred lenses were yellow, brown, and pink. For viewing the nature photographs, the clear lens was preferred over any of the tinted lenses. For viewing the paintings, the purple lens was most preferred. The yellow lens was least preferred for both photographs and paintings. CONCLUSIONS: Younger individuals with no significant ocular pathology preferred viewing both nature photographs and paintings through tinted lenses that did not, or only slightly, altered the chromaticity of the image. Whereas a clear lens was favored over the tinted lenses for viewing the photographs, some tinted lenses (purple and pink) were preferred for viewing paintings. There was no correlation between the most favored lens tint chosen based purely on cosmesis and the most favored lens tint based on viewing preference. However, the least preferred lens tint for cosmesis and viewing was yellow.     

Influence of the luminance level on visual performance with a disposable soft cosmetic tinted contact lens

The purpose of the present work was to study the effect on visual performance of wearing disposable soft tinted contact lenses for cosmetic purposes. Parameters such as contrast sensitivity (Vistech 6000), colour vision (Farnsworth-Munsell 100-Hue colour test), visual fields (static Goldmann perimetry) and subjective vision (what the wearer feels while wearing the lenses) were studied under different illumination levels in order to check for possible vision losses while wearing these contact lenses at low illumination levels. Sixteen emmetropic subjects were fitted consecutively with seven pairs of different colour lenses (Optima Colors lenses by Bausch & Lomb), and the experimental parameters were measured under four different illumination levels (60, 6, 1, and 0.1 cd/m2; but 15 and 0.3 cd/m2 for the static perimetry) The results obtained showed no statistically significant differences in visual performance between wearing the lenses and not wearing them (p > 0.01), except for the static perimetry, in which statistically significant differences (p < 0.01) occur at eccentricities greater than 30 degrees.     

Effect of variable tinted spectacle lenses on visual performance in control subjects.

PURPOSE: To evaluate quantitatively the effects of tinted spectacle lenses on visual performance in individuals without visual pathology. METHODS: Twenty-five subjects were assessed by measuring contrast sensitivity with and without glare. Gray, brown, yellow, green, purple, and blue lens tints were evaluated. Measurements were repeated with each lens tint and with a clear lens, and the order was counterbalanced within and between subjects. Glare was induced with a modified brightness acuity tester. RESULTS: All subjects demonstrated an increase in contrast thresholds under glare conditions for all lens tints. However, purple and blue lens tints resulted in the least amount of contrast threshold increase; the yellow lens tint resulted in the largest contrast threshold increase. CONCLUSIONS: Purple and blue lens tints may improve contrast sensitivity in control subjects under glare conditions.     

Optical and visual performance of aspheric soft contact lenses.

PURPOSE: This study was conducted to investigate whether aspheric design soft contact lenses reduce ocular aberrations and result in better visual acuity and subjective appreciation of clinical performance compared with spherical soft contact lenses. METHODS: A unilateral, double-masked, randomized and controlled study was undertaken in which ocular aberrations and high and low contrast logMAR visual acuity were measured on myopic subjects who wore aspheric design (Biomedics 55 Evolution, CooperVision) and spherical design (Biomedics 55, CooperVision) soft contact lenses. Ten subjects who had about -2.00 D myopia wore -2.00 D lenses and 10 subjects who had about -5.00 D myopia wore -5.00 D lenses. Measurements were made under photopic and mesopic lighting conditions. Subjects were invited to grade comfort, vision in photopic and mesopic conditions, and overall impression with the two lens types on 100 unit visual analogue scales. RESULTS: There was no significant difference in high contrast or low contrast visual acuity between the two lens designs of either power under photopic or mesopic conditions. Both lens designs displayed lower levels of spherical aberration compared with the "no lens" condition under photopic and mesopic light levels (p < 0.0001); however, there were no differences in aberrations between aspheric and spherical lens designs. There were no statistically significant differences in subjective appreciation of clinical performance between lens designs or lens powers. CONCLUSIONS: At least with respect to the brand of lenses tested, the fitting of aspheric design soft contact lenses does not result in superior visual acuity, aberration control, or subjective appreciation compared with equivalent spherical design soft contact lenses.     

Do tinted lenses or filters improve visual performance in low vision? A review of the literature

This is a review of studies that have investigated the proposed rehabilitative benefit of tinted lenses and filters for people with low vision. Currently, eye care practitioners have to rely on marketing literature and anecdotal reports from users when making recommendations for tinted lens or filter use in low vision. Our main aim was to locate a prescribing protocol that was scientifically based and could assist low vision specialists with tinted lens prescribing decisions. We also wanted to determine if previous work had found any tinted lens/task or tinted lens/ocular condition relationships, i.e. were certain tints or filters of use for specific tasks or for specific eye conditions. Another aim was to provide a review of previous research in order to stimulate new work using modern experimental designs. Past studies of tinted lenses and low vision have assessed effects on visual acuity (VA), grating acuity, contrast sensitivity (CS), visual field, adaptation time, glare, photophobia and TV viewing. Objective and subjective outcome measures have been used. However, very little objective evidence has been provided to support anecdotal reports of improvements in visual performance. Many studies are flawed in that they lack controls for investigator bias, and placebo, learning and fatigue effects. Therefore, the use of tinted lenses in low vision remains controversial and eye care practitioners will have to continue to rely on anecdotal evidence to assist them in their prescribing decisions. Suggestions for future research, avoiding some of these experimental shortcomings, are made.     

Color discrimination of deutan and protan observers through tinted soft contact lenses

The effects of tinted soft contact lenses on the color discrimination of nine red-green color deficient subjects was assessed with two different clinical tests. Relative to the no-tint trials, individual differences on the Farnsworth-Munsell 100-Hue^TM test occurred; however, the results were inconsistent across subjects. These erratic differences were probably attributable to fatigue and motivation. The tinted lenses did not affect performance on the Ishihara Plate Test.^TM     

Benefit of coloured lenses for age-related macular degeneration

PURPOSE: To evaluate and compare the functional and perceived benefits of wearing coloured lenses by patients with age-related macular degeneration (ARMD). METHOD: Ten subjects with early ARMD and five elderly controls wore a selection of NoIR wrap-around coloured lenses (yellow 29.7% light transmission, orange 22.9%, red 16.8% and grey 10.3%), each for a duration of 7 days. Contrast sensitivity, colour vision, visual acuity, the effect of glare and peripheral sensitivity were measured for each lens and compared with a control (no lens) condition. Subjective ratings of visual performance were also scored. RESULTS: Compared with the no filter condition, red and grey lenses reduced contrast sensitivity whereas yellow and orange lenses increased contrast sensitivity. These objective changes were supported by subjective ratings in subjects with ARMD. Grey lenses reduced the loss of contrast sensitivity usually suffered in the presence of glare, whereas visual acuity and peripheral sensitivity decreased with red lenses. Colour vision became distorted with red lenses in control subjects, but was relatively unaffected by the use of coloured lenses in subjects with ARMD. CONCLUSIONS: The subjective benefit of coloured lenses appears to be due to a minor enhancement of contrast sensitivity.