Effects of persistent viewing of 3 D TV on human visual function

目的:研究持续观看3D电视对视功能的影响,以及探索不同视功能参数之间的关系.方法:本研究录入19位受试者,每位受试者观看90分钟的2 D电视或90分钟的3 D电视,两部电视观看间隔时间为一周,顺序随机.每次观看电视前及观看后15 min内都做相关视功能检查,检查包括以下四种视功能参数:调节功能(调节反应、调节微波动、调节灵敏度、正相对调节、负相对调节、AC/A),融像性聚散功能(远距负融像性聚散功能、远距正融像性聚散功能、近距负融像性聚散功能、近距正融像性聚散功能),隐斜量(远距隐斜量、近距隐斜量),立体视.结果:无论是与观看前的基础值比较,还是与观看2D电视后的数据比较,观看3D电视后近距离调节反应增加,汇聚减少,远距隐斜量向外隐斜改变(P<0.05).结论:持续观看3D电视会对人们的视功能有一定影响,主要是打破了调节和聚散系统的平衡.厂家和公众应该引起重视,将调节功能、融像性聚散功能、隐斜量等参数作为评估3D电视安全性的指标.     

非斜视性双眼视觉异常临床分析

目的 对5例不同的非斜视性双眼视觉异常的视功能检测结果进行综合分析.方法 对2012年4月至2013年4月在南昌大学附属眼科医院在验光基础上,应用综合验光仪测量集合幅度、调节幅度以及正负相对调节,用Von Graefe法测量在远近距离的隐斜方向和隐斜度、调节集合/调节值(AC/A)比率(调节性集合与调节量之比),用Risley可变棱镜测量远近水平正负融像聚散,用Worth4点灯和R.D.S立体视觉图测量立体视觉.参照Morgan分析法加以分析并采取相应视觉训练.结果 (1)1例集合不足的特征是远距隐斜在正常范围而近距高度外隐斜,且近距正相对聚散(PRC)低、AC/A低.(2)1例集合过度是近距内隐斜、远距隐斜在正常范围、负相对聚散(NRC)低、AC/A高.(3)1例散开过度是远距高度外隐斜、近距隐斜在正常范围、高AC/A.(4)1例融像性聚散减低是远、近距隐斜均在正常范围,AC/A正常、但正负融像性聚散均下降.(5)1例单纯内隐斜是远、近距内隐斜均超过正常范围,负相对聚散下降、AC/A正常.结论 5例都属于非斜视性双眼视觉异常,临床症状虽相似,检查结果却不同,诊断和治疗也不尽相同.     

儿童青少年配戴多焦软性角膜接触镜对调节聚散功能的影响

目的：比较儿童青少年近视患者配戴单光框架眼镜和多焦软性角膜接触镜（简称多焦软镜）对调节和聚散功能的影响。方法：系列病例研究。选取2017 年7 ─10 月在温州医科大学附属眼视光医院视光门诊就诊的46 例近视患者参加本研究,分别在配戴单光框架眼镜和多焦软镜时测量其调节参数和聚散参数,包括调节幅度、调节反应、调节微波动、相对调节、远近隐斜以及远近BI/BO破裂点。采用配对t检验对数据进行分析。结果：同一受检者配戴单光框架眼镜和多焦软镜时在33 cm处的调节反应无明显差异,多焦软镜配戴后的调节微波动高于单光框架眼镜（t=-5.155,P<0.001）,近距隐斜向外隐斜方向偏移（单光框架眼镜：-0.83△±7.03△,多焦软镜：-2.46△±6.29△,t=-2.647,P=0.011）,远距BO破裂点变小（t=-3.023,P=0.004）,近距BI破裂点变大（t=2.575,P=0.013）。结论：青少年近视患者配戴多焦软镜后近距调节微波动增大,近距外隐斜增大,近距发散范围变大,提示多焦软镜的周边离焦设计会对配戴者的双眼视功能产生一定的影响,儿童青少年近视患者选择多焦软镜作为近视防控手段时需评估其双眼视功能。     

配戴单焦点与多焦点硬性角膜接触镜近视患者视觉质量对比分析

目的　探讨多焦点设计的硬性角膜接触镜对近视患者视觉质量的影响。方法　选取川北医学院近视学生15例（30眼）,分别定制单焦点硬性角膜接触镜（SVRGP）与多焦点硬性角膜接触镜（MFRGP）。受试者先配戴SVRGP,停戴一周后配戴MFRGP,每种镜片配戴两周后分别进行视力、对比敏感度、波前像差、光学函数和散射检查,并完成主观视觉质量调查问卷。采用配对t检验比较受试者配戴两种镜片两周后视觉质量的差异。结果　配戴两种镜片后受试者最佳矫正视力差异无统计学意义（P=0.268)。在3 cpd、6 cpd、12 cpd空间频率下,配戴两种镜片后受试者对比敏感度差异均无统计学意义（均为P>0.05);在18 cpd空间频率下,配戴MFRGP后对比敏感度较配戴SVRGP后下降,差异有统计学意义（P=0.015）。配戴MFRGP后受试者角膜总高阶像差、球差、彗差、三叶草像差均较配戴SVRGP后增加,差异均有统计学意义（均为P<0.05）。配戴MFRGP后受试者客观散射指数较配戴SVRGP后增大,差异有统计学意义（P<0.001）;4 mm和6 mm瞳孔直径下,配戴两种镜片后受试者调制传递函数截止频率、斯特列尔比和3种模拟对比度视力（OV100%、OV20%、OV9%）差异均无统计学意义（均为P>0.05)。主观视觉质量问卷调查中,配戴两种镜片后受试者视觉清晰度、白天视力波动、近视力、远视力、对矫正视力的满意度5个项目评分差异均无统计学意义（均为P>0.05);配戴MFRGP后受试者眩光、症状2个项目评分较配戴SVRGP后下降,差异均有统计学意义（均为P<0.05）。结论　MFRGP可以为近视患者提供良好的矫正视力、对比敏感度和光学函数,但患者的高阶像差、散射和眩光有所增加。     

配戴减少周边远视离焦眼镜对近视儿童眼部参数的影响

目的：通过比较配戴减少周边远视离焦设计的框架眼镜(AMSPL)和普通球柱镜框架眼镜(SPL)对近视儿童眼部各参数的影响,确定AMSPL安全性和有效性。

方法：随机抽取2017-07/2018-02于我院眼科中心配戴AMSPL的8～14岁近视儿童50例作为AMSPL组,同样抽取年龄、近视程度及配镜时间相当的SPL配戴者资料50例作为SPL组。检查两组患者眼压、睫状肌麻痹下的屈光状态、远距水平隐斜、近距水平隐斜、AC/A等双眼协动参数。

结果：AMSPL组儿童配戴初期舒适程度略低于SPL组,主要为周边视物模糊,但1mo后两者无差异; AMSPL组屈光不正度数年平均增长-0.62±0.50D,SPL组年平均增长-0.77±0.48D(P=0.072); 对于8～10岁近视儿童AMSPL组屈光不正度数年平均增长(-0.71±0.41D)低于SPL组(-1.05±0.39D),差异具有统计学意义(t=2.164,P=0.041); AMSPL组和SPL组远距水平隐斜、近距水平隐斜、AC/A等双眼协动参数无差异(P>0.05)。

结论：配戴AMSPL能在一定程度上延缓近视发展,尤其对于低龄近视儿童(8～10岁)效果较明显。配戴AMSPL与SPL相比眼部参数无明显变化,这表明近视儿童配戴AMSPL与SPL同样安全。     

不同程度近视青少年儿童双眼视功能的差异

目的通过比较不同程度近视儿童双眼协动参数的差异性及其与近视程度相关性,进一步探索近视发展的原理。方法横断面研究。研究对象包括128例7～14岁近视青少年儿童,根据等效球镜度分为低度近视组（-0.50～-3.00 D）、中度近视组（-3.25～-6.00 D）和高度近视组（>-6.00 D）。双眼协动参数测量包括远距及近距水平聚散力,远距及近距水平隐斜,梯度性调节性集合与调节的比率（AC/A比率）。采用单因素方差分析和卡方检验对3组数据进行分析。结果在融像性聚散范围中,远距散开力的破裂点、近距散开力的恢复点、远距集合力的恢复点、近距集合力的模糊点及破裂点随近视程度加深而减小（F=3.271、3.579、4.931、6.507、4.887,P<0.05）,其余参数的差异无明显统计学意义（P>0.05）;在隐斜视类型的构成比中,远距及近距隐斜类型构成比例的差异在3组中无明显统计学意义（P>0.05）,总体上近距内隐斜构成比例高于远距内隐斜（χ²=6.609,P<0.05）;梯度性AC/A随近视程度的增加而增加（F=3.625,P<0.05）,其中高度近视组明显高于低度近视组（P<0.05）。结论随着青少年儿童近视程度的增加,融像性聚散范围减少,梯度性AC/A比率增高。近视儿童表现出的近距内隐斜可能与近视发展相关。     

近视患者准分子激光原位角膜磨镶术后隐斜和聚散功能变化

目的 探讨准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)前后患者隐斜和聚散功能变化.方法 von Grade法测定36例(72眼)近视患者LASIK前、后隐斜和正、负融像性储备,统计分析并比较各测定值差异.结果 术前戴镜远、近距隐斜分别为(-2.3871±2.0888)△、(-7.5161±4.5180)△,术后1个月裸眼远、近距隐斜分别为(-2.4355±1.4705)△、(-9.798 4±4.3867)△,术前戴镜与术后1个月裸眼近距隐斜差异有显著统计学意义(t=-3.822,P<0.01):而术前戴镜与术后1个月裸眼远距隐斜差异无统计学意义(t=0.142,P>0.05).手术前、术后1个月远距正融像性储备分别是(13.2581±7.5805)△、(10.6774±7.3184)△,负融像性储备分别为(9.8710±4.3030)△、(9.967 7±3.8777)△,近距正融像性储备分别是(21.2258±8.6283)△、(16.9032±6.9683)△,负融像性储备分别为(22.3871±5.4692).、(22.516 l±4.972 4).,手术前、术后1个月近距正融像性储备差异有显著统计学意义(t=2.937,P<0.01),其余指标变化差异均无统计学意义(均为P>0.05).结论 LAsIK术后1个月,近距外隐斜增大,正融像性储备减低,LASIK术前全面进行双眼视功能检查,评估用眼疲劳,必要时进行训练,可以提高手术后患者用眼舒适度.     

不同矫正方式对近视患者双眼视功能的影响

目前常用的近视矫正方式有框架眼镜、角膜接触镜以及屈光手术三种.框架眼镜安全廉价,可作为中低度近视且无屈光参差患者的首选,而高度近视或屈光参差近视患者配戴角膜接触镜(包括角膜塑形镜、硬性透气性角膜接触镜、软性角膜接触镜等)更易获得良好的双眼视功能.在减少屈光参差对近视者双眼视功能损害方面,屈光手术也能获得良好的效果.     

长期配戴硬性角膜接触镜对泪膜稳定性的影响

目的：探讨长期配戴硬性角膜接触镜对泪膜稳定性的影响,观察硬性角膜接触镜长期配戴的安全性。

方法：本组观察对象为2014-10/2016-01于我院进行配戴硬性角膜接触镜矫正的近视患者60例120眼以及无硬性角膜接触镜配戴史的低度近视患者30例60眼,将白天配戴RGP的患者26例52眼设为白天配戴组,只在夜间配戴OK镜的患者34例68眼设为夜间配戴组,无硬性角膜接触镜配戴史的低度近视患者30例60眼设为对照组。戴镜前、戴镜1、6mo,1、2a 进行泪液分泌试验(Schirmer I test,SⅠt)、泪膜羊齿状试验以及泪膜破裂时间(break-up time ,BUT)检测。

结果：白天配戴组与夜间配戴组戴镜后各时间点BUT、SⅠt均较戴镜前降低,且均显著低于对照组,差异有统计学意义(P<0.05),戴镜后6mo,1、2a白天配戴组BUT、SⅠt显著低于夜间配戴组,差异有统计学意义(P<0.05); 三组患者配镜前、配镜1、6mo后泪液羊齿状试验分级比较,差异无统计学意义(P>0.05); 配镜1、2a白天配戴组与夜间配戴组≥Ⅲ级眼数显著高于对照组,差异有统计学意义(P<0.05); 白天配戴组与夜间配戴组组间比较差异无统计学意义(P>0.05)。

结论：长期配戴硬性角膜接触镜可使泪液分泌量降低,泪膜稳定性下降。     

高度近视LASIK后早期AC/A值的变化研究

目的 观察高度近视患者准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)术后早期调节性集合(accommodative convergence,AC)与调节(accommodation,A)比值的变化.方法 用LASIK治疗高度近视患者38例76眼,按术前屈光矫正方式分为归为框架眼镜组17例和角膜接触镜组21例,采用VonGraefe法测量各组术前戴镜和术后裸眼1月及3月远距、近距水平隐斜,根据公式得到计算性AC/A值并进行统计学分析.结果 框架眼镜组术后1个月计算性AC/A值明显低于术前戴镜AC/A值(P<0.05),而术后3月计算性AC/A值与术前比较无统计学意义(P>0.05).角膜接触镜组术后1月和3月AC/A值与术前比较均无统计学意义(P>0.05).结论 配戴框架眼镜的高度近视患者LASIK术后早期AC/A值较配戴角膜接触镜明显减小,3月后逐渐恢复至术前水平.LASIK手术对高度近视患者计算性AC/A值无明显不良影响.     

Contact lenses vs spectacles in myopes: is there any difference in accommodative and binocular function?

Background  

Theoretically, the accommodative and vergence demands are different between single-vision contact lenses and spectacle lenses. The aim of the present study was to determine whether these differences exist when these two correction methods are used in clinical practice. For this, different visual parameters that characterize the accommodative (accommodation amplitude, accommodative facility, and accommodative response) and binocular function (near and distance horizontal and vertical dissociated phorias, near and vertical associated phorias, near and distance negative and positive fusional vergence, vergence facility, near point of convergence, negative and positive relative accommodation, stimulus AC:A ratio and stereoacuity) were evaluated in a student population when their myopia was corrected with either spectacles or soft contact lenses (SCL).     

近视的屈光矫正对近外周融合和水平位均衡的影响

目的 探讨青少年近视眼的屈光矫正与近外周融合功能的关系以及评价双眼水平位均衡状态.方法 利用综合验光仪检测97名青少年近隐斜、近外周融合力和双眼水平位均衡的情况,将近视青少年按照近视程度.矫正情况分类,分组为A组,0.50～1.50D;B组,-1.75～-3.00D;C组,-3.25～-4.50D,分别同正常青少年进行近外周融合力的比较和双眼水平位均衡的评估,分析屈光矫正对近外周融合范围和双眼水平位均衡的影响,以及近隐斜和近外周融合范围的关系.结果 未矫组与正视祖和足矫组在近隐斜度(f=33.43,P=0.000)和近正融像性集合(F=90.55,P=0.000)方面差异均有统计学意义,而近负融合像集合间均值差别无统计学意义(F=2.78,P=0.07).未矫近视青少年表现为近融合范围的变小,近融合范围的均值为(+11.22～-16.51).近正融像性集合与近隐斜存在负的直线关系(r=-0.785,P=0.00).正视组,足矫组.未矫组的双眼水平位均衡的异常率差别有统计学意义(x2=12.467,P=0.002).结论 近视如不矫正,双眼水平失衡率显著增高;对近融合范围的影响在低度近视就已经非常显著,主要表现为对近正融像性集合的影响.对近融合范围的影响是近视程度越高影响越大.     

Changes in accommodative and vergence responses when viewing through near addition lenses.

It has been proposed that near addition lenses reduce the lag of accommodation and may slow myopia progression. In this study, we investigated the differences in accommodative response and near phoria in subjects with and without near addition lenses. Fourteen subjects (7 emmetropic and 7 myopic) participated in the study. Monocular and binocular accommodative responses to a target at 40 cm were measured with and without +2.00 diopter (D) lenses using a Canon R-1 optometer (Canon Europe N.V., Amsterdam, The Netherlands). Near dissociated phoria was measured using 3 testing methods: Maddox rod, cover test, and Von Graefe technique. The differences in accommodative response and near phoria between the 2 viewing conditions with and without the near addition lens were significant (P < 0.0001). No significant differences were revealed in accommodative response and near phoria between refractive error groups. The average accommodative responses of all subjects were 2.03 +/- 0.06 (SE) D (without +2.00 D lens) and 0.60 +/- 0.07 D (with +2.00 D lens) under monocular viewing conditions and 2.11 +/- 0.06 D (without +2.00 D lenses) and 0.77 +/- 0.07 D (with +2.00 D lenses) under binocular viewing conditions. The average near phorias of all subjects were -2.08 +/- 0.69 prism diopters (PD, without +2.00 D lenses) and -7.90 +/- 0.68 PD (with +2.00 D lenses). We discuss the effect of near addition lenses on the defocus of the retinal image, accommodative response, and near phoria. In addition, we propose that the observed difference between binocular and monocular accommodation, when viewing through near addition lenses, is caused by an increased vergence accommodation.     

Effects of wearing yellow spectacles on visual skills, reading speed, and visual symptoms in children with reading difficulties

Background

Possible beneficial effects of yellow-tinted spectacle lenses on binocular vision, accommodation, oculomotor scanning, reading speed and visual symptoms were assessed in children with reading difficulties.

Methods

A longitudinal prospective study was performed in 82 non-dyslexic children with reading difficulties in grades 3–6 (aged 9–11 years) from 11 elementary schools in Madrid (Spain). The children were randomly assigned to two groups: a treatment (n?=?46) and a without-treatment group (n?=?36). Children in the treatment group wore yellow spectacle lenses with best correction if necessary over 3 months (in school and at home). The tests were first undertaken without the yellow filter. With best spectacle correction in each subject, measurements were made of: distance and near horizontal heterophoria, distance and near horizontal fusional vergence ranges, the accommodative convergence/accommodation (AC/A) ratio, near point of convergence (NPC), stereoacuity, negative relative accommodation (NRA) and positive relative accommodation (PRA), monocular accommodative amplitude (MAA), binocular accommodative facility (BAF), oculomotor scanning, and reading speed (words per minute). The Convergence Insufficiency Symptom Survey (CISS) questionnaire was completed by all children. After the 3-month period, measurements were repeated with the yellow lenses (treatment group) or without the yellow lenses (without-treatment group) but with refractive correction if needed.

Results

Over the 3 months, the two groups showed similar mean changes in the variables used to assess binocular vision, accommodation, oculomotor scanning, and reading speed. However, mean relative changes in convergence insufficiency symptoms differed significantly between the groups (p?=?0.01).

Conclusion

No effects of wearing yellow spectacles emerged on binocular vision, accommodation, oculomotor scanning, and reading speed in children with reading difficulties. The yellow filter had no effect even in children with low MAA and BAF. The reduction in visual symptoms observed in children with reading difficulties using the yellow filters was clinically insignificant.     

Binocular function in school children with reading difficulties

Introduction  

Prior findings suggest that poor readers tend to have poor binocular vision skills, but data on the binocular abilities of children with poor reading skills are lacking. Our aim was to characterize distance and near horizontal heterophoria, distance and near horizontal fusional vergence ranges, accommodative convergence/accommodation (AC/A) ratio, near point of convergence, and stereopsis in poor-reading school-age children without dyslexia selected from a non-clinical population.     

近视青少年配戴角膜塑形镜前后调节参数变化

目的：:观察近视青少年配戴角膜塑形镜前后调节参数及隐斜度的变化,探讨角膜塑形镜延缓近视进展的机制及近视发病病因。方法：:回顾性研究。收集2011年1月至2019年3月在中国医科大学附属第一医院眼科门诊进行角膜塑形镜配戴前后调节参数资料完整的患者51例（102眼）,比较角膜塑形镜配戴前、配戴后1、12个月或以上的正负相对...     

Vertical imbalance induced by prism-ballasted soft toric contact lenses fitted unilaterally.

Fitting a prism-ballasted soft toric contact lens unilaterally may potentially induce a vergence error that the subject cannot compensate. In the present study, a prism-ballasted (1.5Delta base down) soft toric contact lens was fitted in the right eye only of 10 subjects with normal binocular vision. The effect on binocular vision was evaluated by measuring vertical phoria adaptation and vertical fixation disparity adaptation. The results show that the vertical vergence error induced was well compensated and fully adapted to. However, care might be needed when fitting these lenses unilaterally in subjects with vertical phoria-related problems.     

Vergence and accommodation responses in the control of intermittent exotropia

Purpose

Individuals with different types of intermittent exotropia (IXT) may use neurally coupled accommodation and vergence responses differently from those without exotropia to achieve eye alignment. This study examined the relationship between simultaneously recorded accommodation and vergence responses in children and young adults with a range of types of IXT while aligned and deviated.

Methods

Responses of 29 participants with IXT (4–31 years) and 24 age-matched controls were recorded using simultaneous eye-tracking and eccentric photorefraction while they watched a movie in binocular or monocular viewing at varying viewing distances. Gradient response AC/A ratios and fusional vergence ranges were also assessed. Eight participants had divergence or pseudo-divergence excess type IXT, 5 had convergence insufficiency and 16 had basic IXT.

Results

Control and IXT participants accommodated similarly both in monocular and binocular-aligned conditions to visual targets at 80 and 33 cm. When deviated in binocular viewing, most participants with IXT exhibited changes in accommodation <0.5D relative to alignment. Gradient response AC/A ratios were similar for control [0.56 MA/D (IQR: 0.51 MA/D)] and IXT participants [0.42 MA/D (0.54 MA/D); p  = 0.60]. IXT participants showed larger vergence to accommodation ratios with changes from distance to near fixation [1.19 MA/D (1.45 MA/D)] than control participants [0.78 MA/D (0.60 MA/D); p = 0.02], especially among IXT participants with divergence or pseudo-divergence excess. Participants with IXT exhibited typical fusional divergence ranges beyond their dissociated position [8.86 Δ (7.10 Δ)] and typical fusional convergence ranges from alignment [18 Δ (15.75 Δ)].

Conclusions

This study suggests that control of IXT is typically neither driven by accommodative convergence alone nor associated with over-accommodation secondary to fusional convergence efforts. These simultaneous measurements confirmed that proximal vergence contributed significantly to IXT control, particularly for divergence or pseudo-divergence excess type IXT. For IXT participants in this study, achieving eye alignment did not conflict with having clear vision.