郑州市金水区小学生视力状况调查

目的　调查郑州市金水区７～１２岁小学生视力状况及屈光不正的患病情况,为小学生视力保健工作提供科学依据。方法　横断面调查研究,分层整群抽样方法,以学校为单位,随机抽取郑州市金水区３所小学,对抽样学校内的１～６年级在校学生进行普查,共调查７８４５名学生。眼部检查包括裸眼视力、矫正视力、眼前节、眼底、眼压及眼位检查,并对任意一眼或双眼裸眼视力＜１．０且眼压正常的儿童进行睫状肌麻痹验光。结果　实际受检学生７６８１名,应答率为９７．９１％。裸眼视力在７～８岁呈现逐年增加趋势,两两比较差异有显著统计学意义（Ｐ＜０．０１）;９～１２岁时裸眼视力视力呈现逐年下降趋势,两两比较差异有显著统计学意义（Ｐ＜０．０１）。任一眼裸眼视力≤０．５者占总人数３７．３９％,并且随着年龄增长,视力低下人群所占比例逐渐加大（７岁１５．２５％、８岁１８．３５％、９岁３１．６７％、１０岁４２．９６％、１１岁５１．７３％、１２岁６０．０３％）。接受睫状肌麻痹后验光的小学生中,近视的总患病率为３８．５８％,远视的总患病率为４．８４％。Ｌｏｇｉｓｔｉｃ回归分析显示,近视眼的等效球镜度与年龄呈显著正相关（ｒ＝１．７６９,Ｐ＜０．０１）;远视眼的等效球镜度与年龄呈显著负相关（ｒ＝－０．９２３,Ｐ＜０．０１）。受检的视力损伤者中屈光不正占８６．４０％,弱视占１２．４０％,沙眼导致的角膜混浊占０．０３％,其他原因导致的角膜混浊占０．３１％,白内障占０．４４％,视网膜疾病占０．１９％,其他致病原因占０．２５％。结论　郑州市金水区７～１２岁小学生视力损害的主要原因是近视,９岁是正视向近视转变的高敏年龄。     

Zywave波前像差仪测量屈光不正的准确性研究

目的评价Zywave波前像差仪测量近视眼屈光不正的准确性。方法对56例行屈光不正矫正术的怠者（106只限）分别用电脑验光（睫状肌麻痹和非睫状肌麻痹下）、显然验光、Zywave波前像差仪法测量眼屈光不正，并将患者按屈光不正度数分为三组：低度近视组（-0．50～-3．00D），中度近视组（-3．25--6．00D），高度近视组（-6．25D-）。对测量的结果进行单因素方差分析（ANOVA）。结果四种验光方法测量的验光结果（球镜、拄镜、等效球镜）除低度近视组电脑验光和睫状肌麻痹状态下验光的球镜度数（P=0．029）及等效球镜度数之间的比较差异有显著性（P=0．024）外，余在低度近视组、中度近视组及高度近视组两两之间比较差异均无显著性（ANOVA，P〉0．05）。Zywave波前像差仪和显然验光及睫状肌麻痹状态下验光测量结果比较，随屈光不正度数增加，球镜相符率降低，柱镜相符率升高。结论Zywave波前像差仪测量屈光不正有较高的准确性，可以很好地用于Zyoptix系统个体化切削治疗使用，但与显然验光和睫状肌麻痹状态下验光比较仍有差异，可以作为以上两种验光方法的参考和补充。     

老年性白内障的屈光状态及矫正视力

本文对130例(251)眼老年性白内障患者作了屈光与视力矫正。发现93%的受检眼矫正后视力提高,提高0.3以上者占70.12%,提高0.5以上者占36.25%;裸眼视力≤0.3的107眼中,82眼(76%)矫正后视力≥0.4,皮质型白内障者远视较多,核型白内障者近视较多。混合型白内障者散光较多,白内障越重。屈光不正度数越高。     

上海市宝山区大场镇老年人屈光矫正前后视力损伤情况调查

目的 分析上海市宝山区大场镇60岁及以上人群中屈光矫正前后的视力损伤情况.方法 流行病学调查.2009年11～12月采取整群抽样的方法对上海市宝山区大场镇目标人群进行盲和视力损伤的流行病学调查.主要包括视力及裂隙灯检查、小瞳验光、问卷调查等.视力损伤按照WHO的标准进行分析.同时也分析了与可矫正的视力损伤有关的人群特征.对不同性别、不同年龄组可矫正的视力损伤患病率进行比较时采用卡方检验,各独立变量与可矫正视力损伤患病率之间的相关性采用单因素比值比(OR)方法.结果 本调查共纳入5199人,实际受检4545人,受检率为87.42％.日常生活视力中盲与视力损伤的患病率分别为0.86％和8.82％;屈光矫正后,盲与视力损伤患病率分别为0.66％和3.01％;可矫正视力损伤率为5.81％(264/4545).年龄与性别是可矫正视力损伤的主要危险因素.通过对264例可矫正的视力损伤的病因分析,发现单纯屈光不正为114例(43.18％),合并白内障121例(45.83％),合并黄斑变性21例(7.95％),合并糖尿病视网膜病变4例(1.52％),合并青光眼3例(1.14％),合并角膜病1例(0.38％).眼镜覆盖率为44.12％.随着年龄的增大,眼镜覆盖率下降,男性眼镜覆盖率高于女性.结论 屈光不正是老年人视力损伤的重要因素,屈光矫正是诊断盲和视力损伤的必不可少的步骤.     

两种睫状肌麻痹剂验光效果比较

屈光不正是影响视力最常见的原因。目前 ,矫正屈光不正的主要方法是验光配镜。麻痹睫状肌后进行客观检影验光 ,是目前准确测定屈光不正度数的主要方法。然而 ,由于不同睫状肌麻痹剂对睫状肌麻痹程度不同会影响验光结果的准确性 [1 ] 。我们对目前最常用的复方托品酰胺和阿托品 2种不同睫状肌麻痹剂进行临床验光效果比较 ,现报告如下。1　资料与方法1.1　一般资料　 1999～ 2 0 0 1年因幼儿园、小学等体检发现视力差来我科就诊者。由于怕影响学习 ,暂用复方托品酰胺散瞳验光检查 ,明确视力下降原因 ,或者由于家属怀疑复方托品酰胺验光欠准确 …     

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。     

便携式电脑验光仪筛查屈光不正的可行性探讨

目的 探讨便携式电脑验光仪的准确性及用其筛查屈光不正的可行性.设计诊断试验.研究对象2008年6月至9月南通大学附属医院眼科就诊的屈光不正患者65例（130眼）.方法 对所有病例分别行SHIN-NIPPON SRH-2000便携式电脑验光仪验光及视网膜检影.主要指标屈光值（球镜度数、柱镜度数及轴向）的差异性检验、相关分析及受试者工作特征（ROC）曲线分析.结果 以视网膜检影为金标准,电脑验光的球镜度数轻度偏正,其中睫状肌麻痹后电脑验光与检影的差值为（＋0.33±0.56）D,呈高度正相关（r=0.98,P〈0.01）,差异有统计学意义（t=6.87,P〈0.01） 电脑验光的柱镜度数轻度偏负,其中睫状肌麻痹后电脑验光与检影的差值为（-0.23±0.45）D,呈中度正相关（r=0.81,P〈0.01）,差异有统计学意义（t=-5.85,P〈0.01）.电脑验光在睫状肌麻痹前后比较无统计学差异（球镜度数t=1.31,P=0.26 柱镜度数t=-0.28,P=0.78）.电脑验光对散光的检出率高,但主要是≤0.75D的低度散光,且与视网膜检影的轴向差值多数≤150.以视网膜检影的等效球镜为参考指标,电脑验光的ROC曲线下面积〉0.95（睫状肌麻痹后为0.984,睫状肌麻痹前为0.979）.结论 便携式电脑验光仪筛查屈光不正的准确性与视网膜检影一致,可用在群体眼病流行病学调查中筛查屈光不正.     

Wavescan波前像差仪测量屈光不正的准确性研究

目的:评价Wavescan波前像差仪测量近视眼屈光不正的准确性。方法:对33例66眼行屈光不正矫正术的患者分别用电脑验光(睫状肌麻痹和非睫状肌麻痹下)、显然验光、Wavescan波前像差仪法测量眼屈光不正,并将患者按屈光不正度数分为3组:低度近视组(-0.50～-3.00D)17眼,中度近视组(-3.00～-6.00D)27眼,高度近视组(-6.00～D)22眼。对测量的结果进行两两比较,采用配对t检验分析。结果:四种验光方法测量的验光结果(球镜、柱镜、等效球镜)显示,低度近视及高度近视组,显然验光与Wavescan波前像差仪验光球镜及柱镜度数比较没有统计学差异(P=0.289,P=0.814,P=0.057,P=0.246),睫状肌麻痹状态下验光与Wavescan波前像差仪验光在中高度近视组,球镜度数及柱镜度数之间的比较差异没有统计学意义(P=0.052,P=0.111,P=0.539,P=0.154),并且结果不随屈光状态的不同而不同,而等效球镜度数之间的差异具有统计学意义。Wavescan波前像差仪和显然验光及睫状肌麻痹状态下验光测量,结果比较,随屈光不正度数增加,球镜相符率降低,柱镜相符率升高。结论:Wavescan波前像差仪测量屈光不正有较高的准确性,可以很好地用于VISXSTARS4准分子激光治疗系统个体化切削治疗使用,但与显然验光和睫状肌麻痹状态下验光比较仍有差异,可以作为以上两种验光方法的参考和补充。     

手持自动验光仪筛查儿童屈光不正的可行性探讨

目的探讨NIDEKARK-30手持自动验光仪筛查学龄期儿童屈光不正的有效性与可行性，试确定在非睫状肌麻痹状态下筛查儿童屈光不正的阳性界值。方法样本来自人群为基础的流行病学调查资料，采用系统抽样方法，随机抽取7～16岁儿童300名，600只眼。用NIDEKARK-30手持自动验光仪分别在睫状肌麻痹前后测定其双眼屈光状态。分析睫状肌麻痹前后双眼屈光状态差异，计算不同筛查阳性界值的灵敏度、特异度、Youden指数和阳性预测值。结果睫状肌麻痹前后双眼等效球镜度变化差异有显著性，散瞳后近视度数减少、远视度数增加；柱镜度和散光轴向变化差异无显著性。比较各年龄组睫状肌麻痹前后等效球镜度数变化，发现7～8岁、9～10岁和11～12岁组差异无显著性，13～14岁和15～16岁组差异亦无显著性；而7～12岁与13～16岁组差异有显著性。在非睫状肌麻痹状态下设定不同的儿童屈光不正筛查界值，发现7～12岁组选用≥-2．50D，13～16岁组选用≥-2．0D作为筛查近视的阳性界值，具有较好的灵敏度、特异度、Youden指数和阳性预测值。结论利用NIDEKARK-30手持自动验光仪在非睫状肌麻痹状态下检查儿童屈光状态，可以作为筛查学龄期儿童屈光不正的有效手段之一。     

PR-2000型自动验光仪在儿童屈光筛查中的价值

目的探讨PR-2000型自动验光仪应用于儿童屈光检查中的准确性及特点。方法对260例（520眼）屈光不正患者,用PR-2000型自动验光仪,分别在非睫状肌麻痹状态和睫状肌麻痹状态下验光,并分别与视网膜检影法的验光结果进行比较。结果球镜度数：非睫状肌麻痹状态下和使用阿托品后,PR-2000型自动验光仪验出的结果与阿托品散瞳检影法验出的结果均呈高度正相关（r=0．922,r=0．946）。柱镜度数：非睫状肌麻痹状态下和使用阿托品后,PR-2000型自动验光仪验出的结果与阿托品散瞳检影法验出的结果呈高度正相关（r=0．888,r=0．890）。对于≤0．75D的低度散光,自动验光仪比检影验光法的检出率高。结论PR-2000自动验光仪用于婴幼儿屈光筛查较为可靠实用,也可用于大面积屈光普查和流行病学调查。     

The Prevalence of Refractive Errors and Visual Impairment among School Children in Brčko District,Bosnia and Herzegovina

In this study we investigate the prevalence of refractive errors and visual impairment among primary school children in the urban population of Br?ko District, Bosnia and Herzegovina. A cross-sectional study included 40 randomly selected classes of children aged 7–16 years attending five different primary schools in Br?ko District. The examination included visual acuity testing, ocular motility evaluation, retinoscopy and autorefraction under cycloplegia, examination of the external eye, anterior segment, media and fundus. A total of 1,005 children were enumerated, and 997 (99.2%) were examined. The prevalence of uncorrected, baseline (presenting), and best corrected visual acuity of 20/40 or worse in the better eye was 9.9%, 5.9% and 0.5%, respectively. The prevalence of myopia and hyperopia measured with retinoscopy was 17.3% and 3.0% eyes, and measured with autorefraction 20.4% and 3.3% eyes, respectively. Astigmatism was found in 12.9% eyes with retinoscopy and in 18.1% with autorefraction.     

小学一、五年级学生视力及屈光状态构成对比分析

目的了解小学一、五年级学生视力及屈光状态的构成情况,为儿童近视的预防矫治工作提供参考。方法对上海市川沙学区小学一年级学生447人,共计894只眼,五年级学生269人,共计538只眼进行眼科普查,先检查其裸眼视力、最佳矫正视力及小瞳屈光状态,后给予睫状肌麻痹剂散瞳,检查其基础屈光状态。结果近视是小学生视力低常的主要原因。小学五年级学生的视力低常率(54.3%)和近视患病率(53.2%)明显高于一年级(7.4%,6.2%),一年级的散光患病率(64.7%)高于五年级(59.5%)。两个年级各种屈光状态构成存在差异;五年级整体屈光状态偏近视,一年级偏远视。两个年级男女生屈光发育存在显著性差异。结论小学五年期间,是儿童屈光发育变化较快的年龄阶段,也是儿童屈光异常预防矫治的关键时期,应该作为儿童近视预防的重要阶段。     

Refractive error in children in an urban population in New Delhi

PURPOSE: To assess the prevalence of refractive error and related visual impairment in school-aged children in an urban population in New Delhi, India. METHODS: Random selection of geographically defined clusters was used to identify a sample of children 5 to 15 years of age. From December 2000 through March 2001, children in 22 selected clusters were enumerated through a door-to-door survey and examined at a local facility. The examination included visual acuity measurements, ocular motility evaluation, retinoscopy and autorefraction under cycloplegia, and examination of the anterior segment, media, and fundus. Myopia was defined as spherical equivalent refractive error of at least -0.50 D and hyperopia as +2.00 D or more. Children with reduced vision and a sample of those with normal vision underwent independent replicate examinations for quality assurance in four of the clusters. RESULTS: A total of 7008 children from 3426 households were enumerated, and 6447 (92.0%) examined. The prevalence of uncorrected, baseline (presenting), and best corrected visual acuity of 20/40 or worse in the better eye was 6.4%, 4.9%, and 0.81%, respectively. Refractive error was the cause in 81.7% of eyes with vision impairment, amblyopia in 4.4%, retinal disorders in 4.7%, other causes in 3.3%, and unexplained causes in the remaining 5.9%. There was an age-related shift in refractive error from hyperopia in young children (15.6% in 5-year-olds) toward myopia in older children (10.8% in 15-year-olds). Overall, hyperopia was present in 7.7% of children and myopia in 7.4%. Hyperopia was associated with female gender. Myopia was more common in children of fathers with higher levels of education. CONCLUSIONS: Reduced vision because of uncorrected refractive error is a major public health problem in urban school-aged children in India. Cost-effective strategies are needed to eliminate this easily treated cause of vision impairment.     

小学生近视筛查中常用指标的准确性比较

目的 比较几种常用小学生近视筛查方法（裸眼远视力、小瞳孔电脑验光、轴率比、散瞳验光）评估近视的准确性,提出适合于群体近视筛查的视觉指标。设计 以人群为基础的横断面研究。研究对象 以河北省肃宁县学区小学生为研究对象,发放《散瞳验光知情同意书》,签字同意并排除眼病后共计232例学生,年龄6～12岁,男性123例,女性109例。方法 采用标准对数视力表测量裸眼远视力（UCDVA）,低于1.0为视力不良;采用电脑验光仪（日产RM-8000）进行小瞳孔验光,≤-0.50 D为近视阳性界值;相干光生物测量仪（IOL Master）测量眼轴及角膜曲率,计算轴率比（眼轴/平均角膜曲率半径,AL/CR）,>3为可疑近视。采用1%盐酸环喷脱酯点眼行睫状肌麻痹,瞳孔充分散大后行电脑验光,以等效球镜≤-0.50 D为近视诊断标准,并与散瞳验光结果比较,分析各方法在群体近视筛查中的灵敏度、特异度和Youden指数,评估其诊断近视的准确性。主要指标 UCDVA、小瞳孔下屈光度、AL/CR与散瞳后屈光度相比对诊断近视的灵敏度、特异度、Youden指数。结果  裸眼远视力筛查近视的灵敏度为86.8%,特异度为59.3%,Youden指数为0.46;小瞳孔验光筛查近视的灵敏度为94.3%,特异度为66.6%,Youden指数为0.61。 轴率比筛查近视的灵敏度为90.6%,特异度为81.3%,Youden指数为0.72。结论 在散瞳验光难以实施的大规模小学生近视筛查中,轴率比是一个相对客观、准确的评估指标。（眼科, 2012, 21: 327-330）     

A comparative clinical survey of the prevalence of refractive errors and eye diseases in urban and rural school children

Objective: To assess the prevalence of refractive error and common ocular diseases in school-aged children in urban and rural populations in and around Hyderabad, India.Design: Population-based, cross-sectional study. Participants: A total of 3314 school children, 1789 from urban areas and 1525 from rural areas.Methods: The examination included visual acuity measurements, retinoscopy and autorefraction under cycloplegia, examination of the anterior segment and external eye, and ocular motility evaluation.Results: In the urban group the prevalence of uncorrected presenting and best-corrected visual impairment (≤20/40 in the better eye) was 9.8%, which dropped to 7.1% with presenting vision and was further reduced to 1.1% with best-corrected visual acuity. Uncorrected visual acuity in the rural group was 6.6%, which dropped to 3.3% with presenting vision and was further reduced to 2.5% with best-corrected visual acuity. The prevalence of refractive error was greater (25.2%) in the urban than the rural group (8%). Myopia measured with autorefraction was observed in 51.4% of urban children and 16.7% in rural children. Increased literacy rate, duration of study hours, and older age of the child were found to have contributed more to the prevalence of myopia in the urban group. Hyperopia with autorefraction was found to be 3.3% in the urban and 3.1% in the rural group. Hyperopia was associated with younger age in the study group. Trachoma was the leading cause of ocular morbidity in the rural group (3.5%) compared with the urban group (0.16%). Night blindness was reported in 3.2% of children in the rural group and 0.33% in the urban group. Vitamin A deficiency, low socio-economic status, and poor personal and environmental hygienic practice were found to have a positive correlation with ocular morbidity among rural group children.Conclusions: Provision of health education, periodic visual screening programs, and primary eye care by trained health care personnel in the elementary schools will prevent the prevalence of refractive errors and common ocular diseases in school children.     

Refractive error and visual impairment in urban children in southern china

PURPOSE: To assess the prevalence of refractive error and visual impairment in school-age children in a metropolitan area of southern China. METHODS: Random selection of geographically defined clusters was used to identify children 5 to 15 years of age in Guangzhou. Children in 22 clusters were enumerated through a door-to-door survey and examined in 71 schools and 19 community facilities from October 2002 to January 2003. The examination included visual acuity measurements, ocular motility evaluation, retinoscopy, and autorefraction under cycloplegia and examination of the external eye, anterior segment, media, and fundus. RESULTS: A total of 5053 children living in 4814 households were enumerated, and 4364 (86.4%) were examined. The prevalence of uncorrected, presenting, and best-corrected visual acuity 20/40 or worse in the better eye was 22.3%, 10.3%, and 0.62%, respectively. Refractive error was the cause in 94.9% of the 2335 eyes with reduced vision, amblyopia in 1.9%, other causes in 0.4%, and unexplained causes in the remaining 2.8%. External and anterior segment abnormalities were seen in 1496 (34.3%) children, mainly minor conjunctival abnormalities. Media and fundus abnormalities were observed in 32 (0.73%) children. Myopia (spherical equivalent of at least -0.50 D in either eye) measured with retinoscopy affected 73.1% of children 15 years of age, 78.4% with autorefraction. The prevalence of myopia was 3.3% in 5-year-olds with retinoscopy and 5.7% with autorefraction. Females had a significantly higher risk of myopia. Hyperopia (+2.00 D or more) measured with retinoscopy was present in 16.7% of 5-year-olds, 17.0% with autorefraction. The prevalence of hyperopia was below 1% in 15-year-olds, with both methods. Astigmatism (cylinder of > or = 0.75 D) was present in 33.6% of children with retinoscopy and in 42.7% with autorefraction. CONCLUSIONS: The prevalence of reduced vision because of myopia is high in school-age children living in metropolitan Guangzhou, representing an important public health problem. One third of these children do not have the necessary corrective spectacles. Effective strategies are needed to eliminate this easily treated cause of significant visual impairment.     

Refractive error and visual impairment in African children in South Africa

PURPOSE: To assess the prevalence of refractive error and visual impairment in school-aged African children in South Africa. METHODS: Random selection of geographically defined clusters was used to identify a sample of children 5 to 15 years of age in the Durban area. From January to August 2002, children in 35 clusters were enumerated through a door-to-door survey and examined in temporary facilities. The examination included visual acuity measurements, ocular motility evaluation, retinoscopy and autorefraction under cycloplegia, and examination of the anterior segment, media, and fundus. In nine clusters, children with reduced vision and a sample of those with normal vision underwent independent replicate examinations for quality assurance. RESULTS: A total of 5599 children living in 2712 households were enumerated, and 4890 (87.3%) were examined. The prevalence of uncorrected, presenting, and best-corrected visual acuity of 20/40 or worse in the better eye was 1.4%, 1.2%, and 0.32%, respectively. Refractive error was the cause in 63.6% of the 191 eyes with reduced vision, amblyopia in 7.3%, retinal disorders in 9.9%, corneal opacity in 3.7%, other causes in 3.1%, and unexplained causes in the remaining 12.0%. Exterior and anterior segment abnormalities were observed in 528 (10.8%) children, mainly corneal and conjunctival. Myopia (at least -0.50 D) in one or both eyes was present in 2.9% of children when measured with retinoscopy and in 4.0% measured with autorefraction. Beginning with an upward trend at age 14, myopia prevalence with autorefraction reached 9.6% at age 15. Myopia was also associated with increased parental education. Hyperopia (+2.00 D or more) in at least one eye was present in 1.8% of children when measured with retinoscopy and in 2.6% measured with autorefraction, with no significant predictors of hyperopia risk. CONCLUSIONS: The prevalence of reduced vision is low in school-age African children, most of it because of uncorrected refractive error. The high prevalence of corneal and other anterior segment abnormalities is a reflection of the inadequacy of primary eye care services in this area.     

山东省冠县4～18岁学生屈光不正横断面研究

目的 调查山东省冠县4～18岁在校（园）学生屈光不正患病状况.方法 横断面调查研究.通过随机整群抽样从冠县幼儿园、小学、初中和高中随机抽取学生进行屈光不正现况调查.所有学生接受裸眼视力、矫正视力、散瞳验光、眼内压、眼前节、眼后节等检查.屈光不正与性别、年龄的关系采用二元Logistic回归模型进行分析.结果 共3 112例4～18岁在校（园）学生接受检查,其中完成散瞳验光检查3 111例,完成视力检查3 094例.近视患病率为31.3％ （95％CI：29.7％～33.0％）,年龄较大[OR：1.49 （95％CI：1.45～1.54）,P＜0.01]、女性[OR：1.31 （95％CI：1.09～1.57）,P＜0.01]和城镇学生[OR：2.54（95％CI：2.11～3.07）,P＜0.01]的近视患病率较高.高度近视总体患病率为1.4％ （95％CI：1.0％～1.8％）,散光的总体患病率为32.4％（95％CI：30.8％～34.0％）,屈光参差的总体患病率为6.2％（95％CI：5.4％～7.1％）,高度近视、散光和屈光参差患病率均呈现随年龄增长而上升的趋势（P＜0.01）,其中散光和屈光参差的患病率与居住地有关（P＜0.01）,但均与性别无关（P＞0.05）;远视患病率为8.2％（95％CI：7.2％～9.2％）,并随年龄增加而下降[OR：0.72（95％CI：0.68～0.76）;P＜0.01].较好眼裸眼视力≤20/40和≤20/200者分别有675例（21.8％）和85例（2.7％）.单眼或双眼裸眼视力≤20/40的880人中,837人（95.1％）是由于屈光不正导致的.结论 山东省冠县4～18岁在校（园）学生的视力损害主要由以近视为主的屈光不正导致,且呈现出随随年龄增加而上升的趋势.     

Refractive error in children in a rural population in India

PURPOSE: To assess the prevalence of refractive error and related visual impairment in school-aged children in the rural population of the Mahabubnagar district in the southern Indian state of Andhra Pradesh. METHODS: Random selection of village-based clusters was used to identify a sample of children 7 to 15 years of age. From April 2000 through February 2001, children in the 25 selected clusters were enumerated in a door-to-door survey and examined at a rural eye center in the district. The examination included visual acuity measurements, ocular motility evaluation, retinoscopy and autorefraction under cycloplegia, and examination of the anterior segment, media, and fundus. Myopia was defined as spherical equivalent refractive error of at least -0.50 D and hyperopia as +2.00 D or more. Children with reduced vision and a sample of those with normal vision underwent independent replicate examinations for quality assurance in seven clusters. RESULTS: A total of 4414 children from 4876 households was enumerated, and 4074 (92.3%) were examined. The prevalence of uncorrected, baseline (presenting), and best corrected visual acuity of 20/40 or worse in the better eye was 2.7%, 2.6%, and 0.78%, respectively. Refractive error was the cause in 61% of eyes with vision impairment, amblyopia in 12%, other causes in 15%, and unexplained causes in the remaining 13%. A gradual shift toward less-positive values of refractive error occurred with increasing age in both boys and girls. Myopia in one or both eyes was present in 4.1% of the children. Myopia risk was associated with female gender and having a father with a higher level of schooling. Higher risk of myopia in children of older age was of borderline statistical significance (P = 0.069). Hyperopia in at least one eye was present in 0.8% of children, with no significant predictors. CONCLUSIONS: Refractive error was the main cause of visual impairment in children aged between 7 and 15 years in rural India. There was a benefit of spectacles in 70% of those who had visual acuity of 20/40 or worse in the better eye at baseline examination. Because visual impairment can have a significant impact on a child's life in terms of education and development, it is important that effective strategies be developed to eliminate this easily treated cause of visual impairment.