北京市怀柔城区和郊区学龄前儿童视觉调查

目的对2009年北京市怀柔区25个幼儿园(其中区中心15个,郊区10个)4～6岁学龄前儿童进行视觉状况的普查,比较城区和郊区儿童视觉状况及相关因素。方法分别对城区2150例儿童和郊区1679例儿童进行了视力检测,包括远近视力(裸眼和戴镜视力)、外眼检查、眼位及眼球运动。对视力低于0.8进行散瞳验光。结果怀柔区城区和郊区儿童视力低常率有显著性差异。视力低常率:城区占13.02%,其中4岁占9.39%,5岁15.29%,6岁14.95%;郊区占9.17%,其中4岁占7.59%,5岁13.16%,6岁8.08%。各年龄组视力低常率有统计学意义,(P<0.01)。视力低常率与年龄相关。视力低常儿童中,其中疾病包括屈光不正;斜视;先天眼病(先天上睑下垂和先天眼球震颤);眼外伤。视力低常屈光不正占96.31%。屈光不正分布:远视74.16%,其中4岁占75.22%,5岁84.47%,6岁51.51%;近视10.77%,其中4岁占4.42%,5岁4.85%,6岁30.30%;混合散光15.07%,其中4岁占20.35%,5岁10.67%,6岁18.18%。弱视患病率4.3%;对弱视相关因素调查显示,屈光参差性占36.36%,轻度65.00%,中度31.67%,重度3.33%;斜视性占15.15%,轻度28.00%,中度60.00%,重度12.00%;形觉剥夺性占2.43%,轻度0%,中度50.50%,重度50.50%。结论学龄前儿童视力低常率和地域有一定的关系。低常率随年龄增加而降低,表明视功能发育逐渐成熟。屈光不正中各组比例提示远视是4～6岁学龄前儿童视力低下的主要原因。近视、斜视、弱视等因素所占比例提示普查手段十分重要,可以早发现早治疗。

Investigation of vision in preschool children of rural and urban areas in Beijing HuaiRou

Objective To investigation the vision of children who aged from 4 to 6 in 25 kindergartens of 15 rural and 10 urban areas in Beijng HuaiRou District.To compare with vision and visual corrective factors of children between rural and urban areas.Methods 2150 children in urban and 1679 children in rural areas underwent eye examination,including distant and near visual acuity（VA）,best corrected VA,slit lamp biomicroscopy,eye location and eye movement.Those whose vision under 0.8 took dilated pupil examination.Results Significant difference was found in child＇s low vision rate between rural and urban areas.The low vision rate was 13.02% in urban and were 9.39% in aged 4,15.29% in aged 5 and 14.95% in aged 6 respectively.The low vision rate was 9.17% in rural and were 7.59% in aged 4,13.16% in aged 5 and 8.08% in aged 6 respectively,showing a statistically significant difference between these two groups（P0.01）.The low vision was caused mostly by refractive error（96.31%）.Among that,the prevalence of hyperopia was 74.16%,including 75.22% in aged 4,84.47% in aged 5 and 51.51% in aged 6;myopia was 10.77%,including 4.42% in aged 4,4.85% in aged 5,and 30.30% in aged 6;mixed astigmatism was 15.07%,including 20.35% in aged 4,10.67% in aged 5,18.18% in aged 6.amblyopia rate was 4.3%,including 36.36% of anisometropia,65.00% of slight,31.67% of moderate,3.33% of severe.Strabismus rate was 15.15%,including 28.00% of slight,60.00% of moderate,12.00% of severe.Form deprivation rate was 2.43 %,including 0% of slight,50.5% of moderate,50.5 % of severe.Conclusions The prevalence rates of low vision are higher in rural areas and the rates decreased with increased ages.Hyperopia is the major cause of low vision in refractive error child aged 4 to 6.Morbidity of myopia,strabismus and amblyopia suggested that survey is a key method for early detect and treatment.