北京市密云县学龄前儿童视力状况分析

目的:了解密云县学龄前儿童视力状况,为学龄前儿童眼保健工作提供指导依据和可行性方法。方法:选择密云县具有代表性的三个区域部分学龄前儿童(4～6岁)进行常规远视力检查,对视力结果进行统计分析。结果:学龄前儿童4,5和6岁视力低常率分别为36.29%,24.43%和20.86%;城镇视力低常率为36.76%,城乡结合部为24.35%,农村为17.08%;视力低常者中,轻度84.38%,中度8.99%,重度6.63%。结论:学龄前儿童的视力低常率以4岁组最高,城镇视力低常率明显高于城乡结合部和农村,视力低常者中以轻度低常为主。学龄前儿童视力是儿童眼保健工作的重要内容,结果受多种因素影响,应正确分析对待。     

南京市雨花台区3岁在园儿童视力和屈光状态的调查分析

目的:了解南京市雨花台区3岁在园儿童的视觉状况,分别进行城区和郊区、性别、视觉检测方法比较。方法:统一筛查标准,对雨花台区22所幼儿园1519例3岁在园儿童进行裸眼远视力、SureSight屈光筛查仪检查,并进行比较。结果:儿童1406例接受远视力表检查视力,异常检出率为12.30%。其中男童视力低常检出率为6.97%,女童5.33%。1 501例儿童接受SureSight屈光筛查仪检查屈光状态,屈光异常检出率为12.92%。城区儿童屈光异常检出率6.86%,郊区6.06%。结论:屈光不正是造成3岁在园儿童视力异常最常见的眼病。早发现、早干预是我们进一步有待完善的工作。     

Visual acuity norms in young children

There are no universally accepted standards for visual acuity tests or norms in young (3-6-year-old) children, although acuity measurement is important in both clinical and screening settings. This review outlines the requirements for such standards. Although more research is needed, available data suggest that a standard test should meet the following requirements. It should utilize a letter optotype (tumbling E, Landolt C, or HOTV variant of the STYCAR), and single optotype with contour interaction bar surround. It should permit nonverbal pointing responses in younger children and verbal responses in older children. If an orientation-specifying method is followed, as with the E or Landolt C, the test should use a three-alternative choice--up, down, and sideways with a nondifferentiated left-right--rather than the traditional four alternative choice. A C-like O pseudo-optotype should be considered in a paired-comparison test format when the Landolt C is utilized, with a similar format for the tumbling E if a suitable pseudo-optotype can be derived. The optical grating test, which is widely used in infant testing, may underestimate acuity deficits and so is not a test of choice for determination of Snellen-equivalent acuity. A letter-based variant of the grating test may hold promise. Reduction in testing distance from 6 to 3 or 4 meters is recommended.     

学龄前儿童视力和屈光状态分析

目的:了解北京市通州区学龄前儿童的视力现况,并对其屈光状态进行分析。方法:横断面调查研究。于2021-12/2022-01采用整群随机抽样法选取北京市通州区9所幼儿园3～6岁儿童1 513人3 026眼,均进行视力和屈光度检查,并分析不同年龄段儿童视力和屈光度分布情况。结果:纳入儿童视力低常率为15.47%,屈光异常率为14.24%,且随着年龄增长,屈光异常检出率减少,而屈光异常类型以单纯近视性散光为主(11.46%),随着年龄增加,单纯性远视率逐渐降低,单纯性近视率逐渐增加。屈光度检查结果显示,纳入儿童球镜度为0.50(0.25,1.00)D,柱镜度为-0.25(-0.50,-0.25)D,等效球镜度为0.375(0,0.625)D。不同年龄段儿童球镜度和等效球镜度均无差异(P>0.05),但柱镜度有差异(P<0.001)。结论:3～5岁儿童视力低常率随年龄增加逐渐降低,6岁后又呈增加趋势。3～6岁儿童屈光异常以单纯近视性散光为主。学龄前儿童视力发育情况应重点关注,应定期进行视力和屈光状态检查。     

The measurement of visual acuity in children: an evidence‐based update

Over the past decade, a number of large clinical trials have provided important information relating to the reliability and repeatability of commonly used paediatric tests of vision and their role in the diagnosis and management of paediatric ocular diseases. The aim of this review is to summarise recent findings on the use of paediatric visual acuity tests in clinical practice and to discuss the validity and accuracy of visual acuity measurements in infants and young children. We provide a broad overview of the benefits and challenges of measuring visual acuity in children and then discuss age‐appropriate tests for measuring visual acuity in infants through to school‐age children. We also discuss normative values for visual acuity in each age group and, where possible, provide comparisons of results between tests with a particular focus on the importance of optotype design.     

Visual acuity in an Australian Aboriginal population

Background: Australia is a developed country, However; Aboriginal Australians have rates of blindness comparable to Third World countries. There have been well-funded eye health programs for 15 years in Central Australia. This paper examines if there has been an improvement in visual disability of one traditional group of Aboriginal Australians. Methods: Results from an eye health survey of the Anangu Pitjantjatjara of South Australia in 1990 are presented. These data are compared with results for ‘blindness’ and ‘poor vision’ from a national survey undertaken in 1976. The two surveys were comparable in design, both were cross-sectional population-based prevalence surveys. Prevalence rates were adjusted for the size of the source population. Results: Young rural Aboriginal Australians have good visual acuity. Low vision and blindness (WHO definitions) occur in 19.6% and 10.4% of 60+ year olds, respectively. Women were more likely than men to be blind or have low vision (OR= 1.93; 1.06-3.58). There was a decline in ‘poor vision’ between surveys (OR=2.86; 1.86-4.75) but not in ‘blindness’. Conclusion: Although there has been a reduction in the prevalence of visual disability in rural Aboriginal Australians, improvements in the provision of eye care for the elderly need to occur.     

学龄前儿童视觉发育的研究进展

了解学龄前儿童视觉发育特点及视功能检查方法，及时发现患儿视功能障碍，掌握最佳治疗时机。视功能检测大体可分为两类：一种为心理物理方法，另一种为客观检查法。①学龄前儿童视力检测分为定性和定量检查或电生理方法[如视觉诱发电位（visual evoked potential，VEP）]等。②对立体视的检查方法有Titmus偏振光立体图、颜少明立体视脸查图及随机点立体图、计算机立体觉检测和视差诱发电位（disparity evoked potentials，DEP）检测法等。③分析综述国内外常见眼病如斜视、弱视的最新动向和研究现状。学龄前儿童视觉发育具有规律性和特殊性，采用适合于各年龄段视觉功能检测手段进行筛查和检查，才能真正落实早期发现和早期干预，提高儿童眼病的防治水平。     

Visual acuity of urban and rural adults in a coastal province of southern China: the Fujian Eye Study

AIM: To evaluate the vision status and sociodemographic associations of visual acuity (VA) in an urban and rural population in a coastal province of southern China. METHODS: The Fujian Eye Study, a population-based cross-sectional study, was performed from May 2018 to October 2019. Totally 10 044 participants over 50 years old from all nine cities in Fujian Province were enrolled, and underwent a questionnaire and a series of standard physical and ocular examinations. VA was measured by E Standard Logarithmic Visual Acuity Chart (GB 11533-1989). Data was double entered with EpiData v3.1 for data collation and Stata/SE statistical software v15.1 was used to analyze the data. RESULTS: Totally 8211 (81.8%) participants were finally included and were divided into urban populations (4678 subjects), rural populations (n=3533), coastal residents (n=6434), and inland residents (1777 subjects); 4836 participants were female. The mean age was 64.39±8.87y (median 64y; range 50-98y). The mean presenting VA was 0.61±0.30 (0.23±0.27 logMAR), and the mean best corrected visual acuity (BCVA) was 0.82±0.28 (0.08±0.19 logMAR). In the multiple regression analysis, BCVA was significantly correlated with several socioeconomic and biologic factors, including age (P<0.001), education level (P<0.001), income (P=0.005), rural residency (P<0.001), inland residency (P=0.001) and refractive error (P<0.001), while sex (P=0.194) was independent with BCVA. CONCLUSION: Accessible services and eye health policies targeting the elderly, people with high myopia and people living in rural or inland areas are needed.     

学龄前儿童的条栅视力观察

目的了解婴幼儿条栅视力的发育情况。方法采用电脑控制的闭路式强化优先注视（COPL）系统,以普查的形式进行条栅视力检查,分析本系统与方法的可靠性、成功率及599例2～72个月的正常婴幼儿及学龄前儿童的视力发育趋势。结果所有年龄组2次检测结果均表现出良好的可重复性;此检查方法成功率较高,可达90％以上,体现了COPL系统的强化优先注视的优势。检查中2～12个月和42～72个月的幼儿配合较好,12～42个月的幼儿处于好动状态,配合率略低,但也远高于以往文献报道;随幼儿年龄增加,其条栅视力亦逐渐增加。通过散点图估计发育趋势线图,可见出生后12个月的幼儿视力提高显著,之后条栅视力稳步上升,30～36个月视力变化相对趋于平缓,36个月之后的条栅视力发育进入平台期。结论应用电脑控制的COPL视力检测系统对学龄前幼儿条栅视力检查有较好的临床效果,可有效地应用于学龄前婴幼儿视力发育的研究,了解不同年龄段条栅视力发育的快慢及其发育成熟的年龄和可以发育的最高程度。     

学龄前儿童常用视力表的研究进展

学龄前期(3-6岁)是视觉发育的关键时期，及早发现并治疗学龄前儿童视觉问题至关重要。视力表是筛查儿童视觉问题的重要工具，国内常采用标准对数视力表和儿童图形视力表，而国外则常用Lea、HOTV和ETDRS视力表。已经有很多研究报道了这三种视力表在儿童视力检查中的可测性、可重复性及诊断视觉相关问题的敏感性。然而，在国内这三种视力表的应用较为有限，本文就这三种视力表的设计原理、临床中的应用及各自的特点进行综述，以便更好地了解它们在学龄前儿童中的适用性和局限性，从而为未来视力检查方法的选择和改进提供参考。     

孟加拉吉大港区学龄前儿童眼病发生率研究

目的:研究吉大港区学龄前儿童的眼病发生率情况.方法:随机横断面抽样调查,研究孟加拉吉大港区学龄前儿童的眼病发生率.对60所托儿所4～6岁学龄前儿童进行记录,走访且检查眼睛.根据性别、年龄、视力障碍和眼部疾病的诱因,分析所获得的数据.结果:对60所托儿所共计900例学龄前儿童进行检查,其中男性儿童占52.6％,女性儿童占47.4％.年龄范围为4～6岁不等.平均年龄为5.47 ±0.64.在学龄前儿童中,眼病发生率为16.89％,通常疾病为7.66％儿童存在屈光不正,其次3.66％患结膜炎,2.77％患睑缘炎,1.66％患鼻泪管阻塞(NDO),0.88％患感染性结膜炎,0.33％患麦粒肿,0.44％患睑板腺囊肿.其中1.11％患弱视,0.77％患斜视,0.11％患发育性白内障,0.33％患角膜混浊,是一个值得关注的问题.结论:研究学龄前儿童的眼病发生率可以很容易地确定可持续视力筛查方案,如果及时采取治疗能够有效降低眼部疾病的患病率和视力障碍.目前的研究表明,未对屈光不正进行矫正是学龄前儿童视力障碍的主要原因.     

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。     

Visual acuity in 5–7-year-old children: individual variability and dependence on observation distance

Accurate measurements of uncorrected binocular and monocular visual acuity were performed in 65 children aged 5-7 years at five viewing distances in the range 0.5-5.0 m by means of the test charts containing widely spaced E stimuli in four orientations. It was found that, in most children of this age, visual acuity (V) changed with test distance, as had been reported previously with older subjects. Visual acuity could be considered as practically independent of observation distance (Vmax-Vmin相似文献   

武汉市新洲区学龄前儿童视力调查分析

目的:了解武汉市新洲区学龄前儿童视力发育状况及弱视患病率。方法:受检儿童3211例使用目前我国通用的国际标准视力表检查视力。3岁及以上视力低于0.5,4～5岁低于0.6,6～7岁低于0.7或双眼视力相差两行以上者,通知到医院门诊复诊。结果:受检儿童3211例视力异常检出率为7.51%。视力异常眼的屈光状态以远视为主;在屈光不正性弱视中,轻度弱视占比例最大,中度弱视次之,弱视患病率为6岁组3.68%,5岁组3.76%,4岁组7.93%,3岁组16.48%。各年龄组的视力随年龄增长而逐渐提高,各年龄组视力主要分布:3岁(0.5518±0.1910)、4岁(0.6444±0.1584)、5岁(0.6662±0.1544)、6岁(0.7601±0.1119)。视力异常率在3岁年龄组差异有统计学意义P<0.05,视力异常率在4～6岁年龄组差异无统计学意义,P>0.05。结论:儿童的视力呈动态发育过程,对弱视的诊断应考虑年龄因素。应加大弱视常识及危害性的宣传,提高家长、社会对弱视的认识和重视。     

Visual acuity assessment in infants and young children

The accurate and reliable assessment of visual function in infants and young children is important for ensuring optimal management of those at risk of abnormal visual development. Visual acuity is the aspect of visual function most commonly assessed by optometrists and can be measured in infants and children using appropriate techniques. Acuity measurements obtained using different techniques may show considerable disagreement and may mislead the optometrist when monitoring acuity development. It is important for the practitioner to appreciate these differences so that reasonable comparisons may be made between acuity estimates made using different techniques. With this in mind, we discuss methodological differences between some of the techniques used in visual assessment of very young patients and the effects those differences may have on acuity estimates.     

Screening for amblyopia in preschool children: Results of a population-based,randomised controlled trial

INTRODUCTION The rationale for preschool vision screening programmes has recently been questioned. Evidence about the effects of early treatment is needed, but it is not known how early the target conditions can reliably be detected. In this study, an intensive programme comprising several different screening methods, used at different ages up to 37 months, was compared with the usual practice of visual surveillance and ad hoc referrals.

METHODS Two groups were randomly selected from children in a population birth cohort study. The control group (n = 1461) received visual surveillance only. The intervention group (n = 2029) was offered in addition a programme of regular visual assessments by orthoptists testing visual acuity, ocular alignment, stereopsis and non-cycloplegic photorefraction.

RESULTS The intervention group programme yielded more children with amblyopia (1.6% vs. 0.5%, p < 0.01), and was more specific (95% vs. 92%, p < 0.01), than the control programme. The individual components of the intervention programme were compared. The cover test and visual acuity tests were poorly sensitive until the children were 37 months, but were always >99% specific. Photorefraction was more sensitive than acuity testing at all ages below 37 months, with specificity >95% at 31 and 37 months.

CONCLUSIONS Photorefraction would have detected more children less than 37 months of age with straight-eyed amblyopia than did visual acuity testing, but with more false positives. At 37 months, photore-fraction plus a cover test would have been comparable in effectiveness to visual acuity testing plus a cover test.     

弱视患者远、近视力差异的临床观察

目的  了解弱视儿童近视力和远视力是否存在差异。设计 回顾性病例系列。研究对象 弱视儿童81例（139眼）。方法 对81例初次就诊的弱视患者进行屈光矫正,分别运用标准对数远视力表和标准对数近视力表进行矫正后远、近视力的测量及分析。对所有接受检查的弱视儿童分别按年龄、屈光度和病因进行分组统计分析。主要指标 近视力,远视力。结果 不同病因弱视患者的远近视力比较：屈光不正性弱视、屈光参差性弱视、斜视性弱视患者的平均近视力分别为0.48±0.27、0.47±0.28、0.45±0.30,平均远视力分别为0.46±0.22、0.40±0.20、0.43±0.30,各组的远近视力差异均无统计学意义（P均＞0.05）。不同年龄弱视患者的远近视力比较：3岁～≤5岁组、＞5岁～≤7岁组、＞7岁～12岁组的平均近视力分别为0.41±0.23、0.56±0.29、0.46±0.31,平均远视力分别为0.39±0.18、0.52±0.22、0.42±0.23,各年龄组患者的远近视力差异均无统计学意义（P均＞0.05）。不同屈光度弱视患者的远近视力比较：≤+4.00 D组和＞+4.00 D组平均近视力分别为0.45±0.26、0.48±0.28,平均远视力为0.40±0.30、0.46±0.21,两组屈光度患者的近视力与远视力平均值差异均无统计学意义（P均＞0.05）。结论 本研究结果显示,不同病因、不同年龄段、不同屈光度的弱视患者其远、近视力无明显差异。 （眼科,2013,22： 266-268）     

Habitual visual acuity in a large urban cohort of Western India and factors influencing poor habitual vision

Purpose:The aim of this study was to determine habitual visual acuity (HVA) in a large urban cohort in western India and identify factors associated with poor HVA.Methods:This was a prospective study conducted over 10 days in September 2018 to assess the HVA in individuals attending a 10-day festival in Western India. Participants who volunteered to undergo vision screening and also filled the questionnaire form pertaining to demographic information including their age, gender, address, income, and educational status were included in this study. HVA was recorded with the distance correction that the participants were wearing when they attended the screening. The study evaluated the prevalence of visual acuity 6/6 or <6/6, 6/12, and 6/18 and the factors associated with lower visual acuity.Results:Of the 6300 participants, 1660 (26.3%) were females. Majority of the participants were from urban background (6084, 96.6%) and were of younger age group (18–40 years––3786, 60.1%; 41–60 years––2187, 34.7%; >60 years––327, 5.2%). HVA was recorded as 6/6 both eyes in 4136 (65.6%), at least 6/12 both eyes in 5691 (90.3%), and at least 6/18 both eyes in 5974 (94.8%) individuals. Only 11 patients (0.17%) had VA worse than 6/60 with only 3 patients (0.003%) having bilateral VA <6/60. Older age, female sex, lower education status, and low annual income were significant risk factors for poor HVA.Conclusion:Poor education, lower income, female gender, and old age are significantly associated with poor HVA even in urban Western India despite relatively easy access to affordable eye care facilities.