单眼视力下降对双眼对比敏感度的影响

目的 研究单眼视力下降时双眼对比敏感度（CS）的变化规律,初步探讨单眼视力下降对双眼视功能及双眼相互作用的影响,并且探讨其在司法鉴定中的运用价值。方法 实验研究。于2016年3月至2017年8月选择司法鉴定科学研究院志愿者46例（男24例,女22例）。单眼矫正视力或裸眼视力均达4.9以上,主导眼前放置试验透镜,用插片法诱导实验性单眼视力不同程度下降。分别测试其左眼、右眼及双眼的视力、CS,计算对比敏感度双眼总和比（BSR）。数据进行球形检验、方差分析及秩和检验。结果 单眼视力下降可引起双眼视力一定程度下降,但是双眼视力仍优于单眼。当视力下降至轻度损害水平时,全频段正常倒“U”形CS曲线形态已破坏,且相较低空间频率而言,中、高空间频率时CS下降程度更为明显;在高频区且两眼视力均正常时,出现最大的BSR,为1.48。当单眼视力逐渐下降时,出现双眼平均及抑制（BSR<1）。提示双眼相互作用的形式存在一定程度的容忍性及空间依赖性。结论 单眼视力下降对双眼CS、双眼相互作用的形式及程度具有一定程度的影响。运用双眼CS检测,能够反映单眼视力的损害程度,具有临床及司法鉴定运用价值。     

单眼严重白内障伴外斜视患者临床疗效观察

目的：观察单眼严重白内障合并外斜视患者术后临床效果。 方法：回顾我院2010-03/2012-12单眼严重白内障合并外斜视行白内障摘除联合人工晶状体植入手术的患者资料45例。术前44例较差眼视力均〈0.05,1例2岁患儿无法配合视力检查。随诊观察术后6mo患者的最佳矫正视力、眼底、斜视度、双眼单视功能及复视情况。 结果：先天性白内障患者2例中有1例患儿2岁,无法配合视力及复视检查,眼底正常;另1例患儿术后无同时知觉,无复视。5例不明原因中青年单眼白内障患者中,有3例患者术后视力〉0.6,眼底正常,术后眼位正,有双眼单视;2例患者术后视力为指数,眼底有异常,术后斜视度与术前无变化,无同时知觉,无复视。38例老年性白内障患者中,有31例患者术后有双眼单视;3例患者术后斜视度与术前无差异,无同时知觉,无复视;3例患者术后斜视度与术前无差异,有复视,6mo内复视均自行消除;1例患者外斜10o,术后出现复视,且6mo内无改善,可用12？矫正,建议戴镜治疗。 结论：单眼严重视力障碍合并外斜视的成年患者多数术后可自行纠正眼位,获得一定的双眼单视功能。     

近视眼患者诱导屈光参差对视功能的影响

目的通过观察实验性屈光参差对40岁以上近视眼患者双眼视功能的影响,探讨老视患者的屈光手术治疗。方法对40岁以上近视患者48例用综合验光仪完全矫正其屈光不正后,在单眼前加不同度数正球镜,诱导单纯近视性( 0.5D、 1.0D、 1.5D、 2.0D、 2.5D和 3.0D)屈光参差。测定诱导屈光参差后的远视力、双眼同时视、融像功能、立体视情况。结果诱导的屈光参差超过 1.5D时,欠矫眼的远视力、立体视、融像功能和同时视随着屈光参差度数的增加逐渐下降。结论近视性屈光参差可引起中年近视患者双眼视功能异常,当屈光参差超过 1.5D时可引起双眼视功能急剧下降。大于40岁近视患者行屈光手术可留有小于 1.5D的近视性屈光参差,利于视近,且对高级视功能的影响不明显。     

5至24个月婴幼儿条栅视力发育规律的初步研究

目的 对5至24个月龄正常婴幼儿条栅视力发育规律进行初步研究.方法 使用以优先注视原理设计的Teller acuity cardsⅡ检测5至24个月龄正常婴幼儿的双眼及单眼视力.应用方差分析进行差异性比较,月龄组间两两比较使用Dunnett's方法,单眼与双眼及两侧单眼间的差异用配对t检验.视力水平与月龄的关系用Spearman曲线回归分析.结果 Teller acuity cards检查双眼视力完成率98.77％,单眼检查完成率89.2％.平均检查时间2～5 min.分别测得5至24个月龄婴幼儿双眼及单眼视力均值.单眼视力略低于双眼视力,差异小于或等于1个倍频;两眼间视力差异无统计学意义.正常婴幼儿双眼及单眼视力随年龄增长而提高,5月龄至14月龄视力增长平缓,平均视力由0.17(5.1 cpd)增长到0.32(9.6 cpd),提高约1倍频,15月龄以后视力水平提高速度加快,2岁时达到略低于成人视力水平0.833( 26 cpd),视力水平与12月龄时相比增加1.5倍频.结论 Teller acuity cards TMⅡ可以有效地检测2岁以内婴幼儿的双眼及单眼视力.正常婴幼儿双眼及单眼条栅视力随年龄增长而不断提高.不同时期,婴幼儿视力发育具有不同的增长速率.单眼视力等于或略低于双眼视力水平,两眼视力发育比较平衡.     

单眼与双眼老年性白内障摘除人工晶状体植入术后的双眼视觉比较分析

目的　比较分析单眼与双眼老年性白内障摘除人工晶状体植入术后双眼视功能恢复状况。方法　对单眼和双眼人工晶状体手术患者各 6 0例分别检测矫正视力、屈光状态、双眼影像 ,以及用同视机等方法检查双眼视功能。结果　两组患者的双眼同时视功能、融合功能无显著差异。双眼手术组患者的远近立体视功能显著优于单眼组。影响单眼手术患者双眼视功能恢复的主要原因是另侧非手术眼的白内障所导致的视力低下和两眼屈光参差。结论　双眼视功能恢复水平是评价人工晶状体术后视觉质量和生活能力改善的重要指标。单眼手术和双眼手术者双眼视觉的差异主要体现在立体视功能上     

儿童间歇性外斜视术后单眼注视综合征

目的探讨评价儿童间歇性外斜视矫正术后的双眼视觉改变,以讨论发生单眼注视综合征的可能性。方法对35例儿童间歇性外斜视矫正术前后双眼注视状态及双眼单视功能的改变进行分析。结果在部分间歇性外斜视术后过矫的儿童中,其双眼单视功能有改变并发生单眼注视、立体视降低,有少数病例术后视力下降并不能矫正。结论在视力尚未发育成熟的间歇性外斜视的儿童中,由于手术过矫,术后存在出现抑制性暗点的可能性,故尔有发生单眼注视综合征的危险。手术过矫的原则取决于儿童的年龄及视功能发育成熟程度。     

老年人视力异常及增龄性眼病

目的调查老年人日常生活视力及矫正视力,分析老年人视力异常原因及常见增龄性眼病。方法常规检查957例60岁及以上老年人的日常生活视力、眼前节、眼底和眼压。对日常生活视力<1.0的患者验光矫正视力。并对可疑眼病辅助相应的检查。采用SPSS1.0软件包进行统计。按年龄分组进行比较视力状况和眼病分析。结果957例老年人随增龄其生活视力逐渐下降,60岁组平均1.04,70岁组平均0.83,80岁组及≥90岁组分别为0.61和0.39;平均每增长10岁视力下降约0.2,各年龄组间差异有极显著性(P<0.001)。验光检查93.37%的眼有屈光不正。老年人常见眼病前3位的是白内障、黄斑病变和青光眼。白内障患病率最高,黄斑病变和青光眼是严重影响视力的主要眼病。高龄老年人眼病患病率显著高于其他年龄人群。结论老年人随增龄视力显著下降。屈光不正是视力损害的普遍原因。黄斑病变、白内障及青光眼等老年人常见眼病高龄老年人患病率显著增多。     

Spot Vision Screener视力筛查仪在儿童视力筛查中的应用分析

目的：通过对Spot Vision Screener视力筛查仪在儿童视力筛查中的应用探讨,寻求一种新型、可靠、方便的儿童屈光状况筛查方法。方法：对我院门诊进行筛查的2~9岁儿童共87例174眼进行屈光检查,并将结果与电脑显然验光结果进行对比。结果：Spot Vision Screener视力筛查仪与电脑显然验光结果对比,除右眼球镜值存在统计学差异外,两种方法测量的左眼球镜值、双眼柱镜值及柱镜轴向、双眼等效球镜值均无统计学差异(P>0.05)。结论：Spot Vision Screener视力筛查仪操作简单易行,儿童配合度好,不失为临床对儿童进行视力筛查的一种新方法。     

中心性浆液性脉络膜视网膜病变患者远近立体视功能

目的 :比较“中浆”患者远近立体视功能损害的临床特点。方法 :对 48例 (5 1眼 )中浆患者按常规方法检查视力、屈光、Amsler方格卡、双眼影像、眼底FFA或OCT ;用同视机检查患者双眼同时知觉、融合范围及定性立体视 ;采用同视机随机点画片及《立体视觉检查图》检测患者的远近立体视功能及抑制性暗点。结果 :48例患者除中心视力下降、视物变形和有中心暗点等单眼视功能受损外 ,还有双眼影像不等及双眼视功能不同程度的损害。双眼视功能受损中 ,双眼同时视障碍为 2 .1% ,双眼融合视缺失为 4.3% ,而双眼定性立体视丢失为 16 .7%。采用随机点画片定量检测发现 ,远距离交叉视差锐度和非交叉视差锐度及近距离立体视锐度达到正常者分别为 2 8例 (占 5 8.3% )、2 4例 (占 5 0 .0 % )和 14例(占 2 9.2 % )。显示近立体视损害较远立体视更明显 ,差异有显著性 (P <0 .0 5 )。病愈后三项功能恢复中心立体视者分别为 47例 (占 97.9% )、46例 (占 95 .8% )和 45例 (占 93.8% )。病愈前后远近距离三项立体视锐度达到正常者的比例以及平均视锐度值 ,差异有显著性 (P <0 .0 1)。影响立体视功能的主要原因是两眼视力相差大 ,双眼同时视像差大及有抑制性中心暗点。结论 :中浆患者视功能受损表现是多方面的。双眼视功能受损特     

低视力儿童的视力特点

本文对１１５例低视力儿童的裸眼视力、矫正视力及戴用助视器后视力进行了分析，认为低视力儿童的视力特点是以一级低视力为主；虽然视力低下，但验光配用普通眼镜后仍可增进部分视力；戴用低倍数、简单的远用助视器就可使大部分人提高到有用视力（０．３）。患者的裸眼近视力相对较好，近一半人具备阅读视力（０．４），配用近用助视器的需求相对较少；使用双目助视器后，双眼远视力较单眼视力在视力表上有１行或１行以上提高者仅占３４．５％，说明并不是所有低视力儿童都适宜配用双目助视器。此外，通过随访还发现低视力儿童的另一特点是视力相对稳定。     

Binocular interactions in normal and anomalous binocular vision: effects of flicker.

Temporal modulation thresholds were determined for monocular viewing and for binocular viewing of stimuli presented in phase or in counterphase to each eye of observers with normal binocular vision and those lacking stereopsis. The results showed that in individuals with normal binocular vision sensitivity was much greater for in-phase than for counterphase stimulation at low temporal frequencies, but that this superiority declined at higher temporal frequencies. Averaged across frequencies, binocular sensitivity for in-phase stimulation was 40-50% higher than monocular sensitivity. In contrast, in the observers lacking stereopsis the ratios of binocular in-phase/monocular sensitivity averaged 1.02, and there were no significant differences in sensitivity to in-phase and counterphase stimulation. This failure of binocular integration at threshold does not result from differences in transmission time between the 2 eyes. However, while individuals lacking stereopsis showed an absence of binocular interaction for uniform-field flicker at threshold, they showed suprathreshold dichoptic temporal frequency masking which was similar to that found in normal persons.     

Binocular interactions in normal and anomalous binocular vision

Binocular interactions for grating patterns were investigated in humans with normal binocular vision and in humans with abnormal binocular visual experience due to strabismus and/or amblyopia via 1) comparison of monocular and binocular contrast thresholds; 2) interocular transfer of the threshold elevation aftereffect; and 3) dichoptic masking. Whereas the normal observers showed improved binocular over monocular contrast sensitivity (i.e., binocular summation) and substantial interocular transfer of the threshold elevation aftereffect, the abnormal observers showed an absence of binocular summation and no significant interocular transfer. The dichoptic masking experiments showed that a suprathreshold masking grating presented to one eye elevated the contrast threshold for gratings presented to the fellow eye, within a narrow range of spatial frequencies (about 1 octave wide at half height) and orientations, centered about the spatial frequency and orientation of the mask. The magnitude and bandwidth of this masking effect was similar in subjects with normal and abnormal binocular vision, occurring even when the masking grating was presented to the amblyopic eye. These effects depend upon the contrast of the masking grating. In individuals with normal binocular vision, a grating with subthreshold contrast presented to one eye reduces the contrast threshold for detection of gratings of similar spatial frequency and orientation presented to the fellow eye. No such subthreshold summation is evident in the amblyopic observers. We conclude that while strabismus and/or amblyopia disrupted the normal excitatory interactions between the two eyes, cortical inhibitory binocular connections were not disrupted.     

图形视觉诱发电位在猫双眼视觉研究中的作用

目的:通过建立猫不同种类的视觉破坏动物模型,探讨图形视觉诱发电位在双眼视觉研究中的作用。方法:健康家猫18只,于4周龄时随机建立正常、形觉剥夺性弱视及光学性斜视模型3组,每组动物各6只,分别在6周龄、10周龄和16周龄时记录各组动物的P波振幅和潜时。结果:随年龄增长,正常组P波潜时缩短,振幅增大,双眼振幅大于单眼反应之和;弱视组在10周龄时右眼振幅低于左眼,差异有统计学意义(P<0.05),潜时无统计学差异;16周龄时右眼(即弱视眼)振幅和潜时均低于左眼,双眼振幅表现为部分总和;光学性斜视组单眼间的P波潜时和振幅相比较以及与正常组相比无明显差异,双眼总和在10周龄和16周龄时小于单眼反应之和。结论:图形视觉诱发电位是评价动物双眼视觉的一种有效手段。     

Binocular optical instruments and binocular vision

Many visual optical instruments provide the facility for binocular viewing instead of restricting viewing to monocular vision. The main advantage of binocular viewing is the reduction in fatigue likely to occur if one eye is occluded while viewing monocular instruments. This is particularly important for prolonged viewing periods. Also, binocular systems have the potential for stereopsis with an increase in stereoscopic acuity in some cases; although not all binocular instruments provide stereoscopic imagery. In spite of these advantages, some observers have difficulty with binocular instruments. The problems arise when there are alignment errors in the optical components leading to displaced or rotated images. There may also be a conflict between the amount of convergence of the binocular tube axes and the AC/A ratio of the observer, and the amount of accommodation required under those viewing conditions. These factors are discussed in detail along with a case example.     

斜视弱视患者的双眼视觉状况及其矫治

本文在复习正常双眼视觉的概念及检查双眼视觉的常用方法和双眼视觉正常范围的基础上,介绍了单眼深度感知和双眼立体视觉近年来神经生理学及神经解剖学的研究进展,即单眼深度线索和双眼深度线索获得的深度感知在顶叶皮层的CIP区（顶尾侧）被整合,强调了单眼及双眼均可感知立体视觉。重点阐述斜视、弱视患者双眼单视及双眼立体视觉受到损害的状况,以及应用脱抑制训练、融合训练、立体视训练等方法矫治双眼视觉缺陷的结果。     

白内障人工晶状体植入术后多维立体视评估

目的 比较双眼白内障患者单眼及双眼不同类型人工晶状体（IOL）植入术后多维立体视的变化。方法 回顾性分析双眼白内障摘出联合IOL植入术患者的数据。比较不同类型IOL植入术后各阶立体视的差异,并比较单眼术后和双眼术后各阶立体视的变化。对影响各阶立体视的因素进行Logistic回归分析。结果 双眼白内障患者在行双眼手术后比单眼手术后各阶立体视均有改善,差异具有统计学意义。单眼术后立体视与患者年龄和双眼间最佳矫正视力（BCVA）差相关,年龄越小、双眼间BCVA差值越小,则立体视越好。IOL的不同类型对立体视无显著影响。结论 不同类型IOL植入术后均可获得良好的立体视,且差异无统计学意义。由于不同患者对立体视的需求不同,在单眼术后可依据双眼BCVA差值选择另眼手术的时机。     

The effect of binocular and monocular distractors on saccades in participants with normal binocular vision

We tested the effect of visual distractors presented monocularly and binocularly on saccade latency and accuracy to determine whether differences occur in saccadic planning with binocular or monocular visual input. For five participants with normal binocular single vision (BSV), saccade latency and accuracy were compared with distractors presented to the dominant eye, non-dominant eye or to both eyes. Eye movements of the dominant eye were recorded using a Skalar infra-red recorder. In the presence of normal BSV, the effect of distractors is significantly larger for saccade latency and accuracy with binocular distractor presentation than for monocular presentations, with no difference between distrators presented to the dominant or non-dominant eye. The implications of these results are discussed with regard to saccade programming.     

Functional effects of bilateral form deprivation in monkeys

Psychophysical methods were used to study the effects of binocular form deprivation, initiated at 1 month of age, on the visual sensitivities of young monkeys. All the monkeys reared with bilateral form deprivation for 7 weeks or longer had reduced spatial contrast sensitivity for both eyes. Although the contrast sensitivity deficits of the bilaterally form-deprived monkeys generally were larger for one eye than the other, the magnitudes of the deficits were small compared with those produced by similar periods of unilateral form deprivation. For other monocular vision functions investigated, temporal contrast sensitivity and increment-threshold spectral sensitivity, the data for the bilaterally form-deprived animals showed only minor variations from those of the control monkeys. However, none of the bilaterally form-deprived monkeys had binocular vision on either measures of binocular summation or stereodetection, even if the animal had normal monocular vision functions. Therefore, these results show that monocular sensory deficits caused by abnormal early visual experience as a result of bilateral form deprivation are much less severe than those caused by unilateral form deprivation. The differences in the severity of visual deficits may be attributed to the consequences of anomalous binocular competition associated with unilateral form deprivation that was minimized during bilateral form deprivation. Thus, these results illustrate that anomalous binocular competition is more detrimental to the developing visual system of infants than direct deprivation per se.     

近视儿童双眼视觉功能的研究进展

近视性屈光不正已日渐成为影响儿童视力及视觉发育的主要眼病。随着对近视发生发展机制的不断探索,其双眼视觉功能的研究显得尤其重要,研究表明,调节系统异常、辐辏参数及立体视功能均与儿童近视关系密切。提示我们在矫治儿童近视的同时,不仅要注意其单眼视力,还应同时关注并全面了解双眼视功能,在此基础上通过正确合理的视觉训练来改善双眼视觉状态。