颈内动脉狭窄导致视力下降1例

目的:报道因颈内动脉严重狭窄致眼动脉缺血1例。方法:病历报道。结果:患者因左眼视力逐渐下降3a余,近2mo晨起视物模糊加剧,下半侧视物不见为重就诊,追问病史,有短暂黑矇发作病史,经颅多普勒超声检查,示双侧颈内动脉颅内段局限重度狭窄,左眼动脉流速低。行颈内动脉内膜剥除术,术后自觉症状改善。结论:青光眼视野的缺失除眼压的升高外,应注意眼动脉的缺血。     

原因不明视力下降一例

患者男性,9岁,主诉"双眼视物不清一个月"于2020年1月就诊,既往体健,父母及兄弟姐妹无屈光不正病史。眼科检查:视力右眼0.12,矫正:-3.50DS/+1.25DC×75°=0.16;左眼0.10,矫正:-2.75DS/+1.00DC×90°=0.15。右眼眼压13mmHg,左眼眼压16 mmHg。双眼轻度外隐斜,伴眼球震颤,无代偿头位;双眼眼前节未见明显异常;小瞳下视盘边界清,色淡红,视网膜血管走形及比例正常,中心凹反光不清。     

垂体腺瘤致视力下降一例

杜彩霞女 40岁已婚农民双眼视物模糊一周.于2006年2月12日就诊眼科.患者于3个月前出现双眼轻度视物模糊,未引起注意,最近一周内双眼视物模糊突然加重,伴头痛头晕,既往身体健康无眼疾.无原因停经已经8年.家族中无类似患者眼病史.入院后查体:RP110/70mmHg发育正常,神志清楚,全身检查无阳性体征,生理反射存在,病理反射均未引出.眼科检查:双眼裸眼视力:右0.2,左0.2,外眼检查无异常.眼底镜检查:晶状体、玻璃体均无混浊.双侧视神经乳头边界清楚,杯盘比不扩大,眼底血管纹理清楚,A:V=2:4动脉血管轻度迂曲,黄斑中心凹反光点变暗.压陷式眼压计测得眼压值:右5.5/3.5=22.38mmHg;左5.5/3=24.38mmHg.弧形视野计检查结果显示双眼颞侧偏盲.双眼A/B超声检查未见异常.头颅及眶骨拍片报告:未见异常.     

口服苯妥英钠后视力下降一例

口服苯妥英钠后视力下降一例罗湘蒙苯妥英钠又名大仑丁（Ｄｉｌａｎｔｉｎ），属于抗癫痫药，对癫痫大发作疗效好，列为首选药。若使用不当，其副作用较多。尤以小儿用药中多见，。笔者曾见１例小儿服用苯妥英钠后双眼视力一度下降，报道如下。患儿男性，８岁，因头痛，性...     

儿童癔症性双眼视力下降一例

癔症性眼病是以眼部症状为主而首诊于眼科的心理性疾病。该病多见于成年人,儿童期发病较少,但资料显示儿童癔症的发病率逐年上升[1、2]。因儿童语言表达能力较差,且癔症性眼病的临床表现复杂多变,易造成诊断延迟及误诊。故眼科医生应提高对该病的认识,给予及时治疗。现我院有儿童癔症性视力下降1例报道如下。     

急性中毒型细菌性痢疾导致视力丧失一例

5岁男性患儿，因急性腹痛6h，于2004年8月11日来本院儿科就诊。体检：患者呈嗜睡状，呼吸急促，面色苍白，口唇发绀，上肢湿冷，皮肤呈花纹状，体温高达40．6℃，心率137次／min，心音低钝，血压30／10mmHg（1mmHg=0．133kPa），左下腹稍压痛。眼科会诊：因患儿不合作未能检测视力；双眼角膜清亮，前房清，瞳孔等大、等圆，直径约4mm，对光反射迟钝；晶状体、玻璃体无混浊；眼底未见异常。实验室检查：白细胞总数23×10^9／L。肛拭粪便检查：白细胞27个／高倍视野。[第一段]     

调节异常所致视力下降的临床分析

目的：观察调节异常所致远或近视力下降的临床特点及临床疗效。方法：回顾性系列病例研究。收集2014年2月至2016年2月因视力下降在中国人民解放军武汉总医院眼科就诊,经验光和视功能检查确诊的因调节异常导致视力下降的25例患者的临床资料,在屈光矫正的基础上联合睫状肌麻痹剂并行反转拍、调节交替训练和Brock线等视功能训练,分析其临床特点及治疗效果。采用配对t检验和Wilcoxon秩和检验进行统计分析。结果：①25例患者初诊时年龄6～24岁。4例外院诊断为“球后视神经炎”,1例外院配戴角膜塑形镜后效果欠佳就诊,2例准分子激光治疗近视术后视力下降,11例用眼过度后视力下降,7例仅因视力下降就诊。②疗效：基线裸眼远视力为4.19±0.34、等效球镜度（SE）为（-7.95±3.10）D、最佳矫正视力（BCVA）为4.28±0.32;21例给予托吡卡胺后SE为（-0.06±0.86）D、BCVA为4.43±0.15;14例应用阿托品凝胶后SE为（+1.24±0.84）D、BCVA为4.93±0.14。给予视功能训练3个月12次后,视功能项目指标较前改善,负相对调节（NRA）训练前后分别是+1.76±0.61、+2.49±0.15（t=-3.780,P<0.001）,正相对调节（PRA）训练前后分别是-1.26±0.76、-2.43±0.34（t=3.977,P<0.001）,调节灵敏度（Flipper拍）训练前后分别是0周/分（cpm）（负片通过困难）和10.6 cpm（Z=-4.012,P<0.001）。随访中矫正视力及屈光度未见变化。结论：对于排除眼部器质性疾病的视力下降患者,要重视视功能检查;对调节异常所致视力下降患者,在传统治疗的基础上,加用视功能训练,可使视力恢复并稳定。     

磁共振成像检查致视力突发下降一例

患者男,44岁。因慢性头痛行磁共振成像(MRI)检查期间左眼突发视力下降至光感到中山大学中山眼科中心就诊。眼部检查:右眼视力0.8,左眼视力光感。右眼眼压20 mmHg(1 mmHg=0.133 kPa),左眼眼压14 mmHg。裂隙灯显微镜检查,左眼8点时钟位虹膜组织缺损,为陈旧虹膜穿通伤,同时伴有晶状体局部混浊(图1A)。右眼眼前节及眼底检查未见异常。眼底检查,左眼可见大量玻璃体积血。右眼眼底检查未见异常体征。追问病史,患者诉2年前驾驶摩托车穿越工地时被沙土飞溅至脸上,未行任何诊治。CT检查,左眼视盘旁结节状高密度影(图1B)。     

注射流脑疫苗后双眼视力下降一例

曾××,男性,11岁。1986年4月17日左臂注射流脑疫苗后,次日出现低热,伴全身大关节红、肿、热、痛,活动轻度受限。第三天双眼明显视物模糊,经当地医院治疗10天无好转,于5月2日转来我院。首诊儿科,疑“小儿风湿性关节炎,急性风湿热?”实验室检查血尿常规:正常。血沉     

儿童辐辏功能不足一例

辐辏功能不足是两眼视线的平行运动正常,但内直肌同时收缩的有关运动表现功能不足[1]。它不是一种独立的临床疾病,可伴有或完全不合并各种斜视。临床检查,近点后退远移(10ｃｍ以外),且随视标移近外斜倾向增加。同视机检查,辐辏范围很小。主要症状,轻者有眼肌疲劳、眼胀、头痛,特别是近距离工作感到困难;严重者1米以内视物成双,丧失工作学习能力,日常生活亦感困难。其发病原因不完全明了,可能与解剖因素、视力与屈光因素、全身因素等有关。因而在治疗上,一般应积极寻找与发病有关因素,如屈光矫正,全身病的治疗,眼肌训练等,手术效果多不理想。…     

The effect of decreased visual acuity on clinical color vision testing

PURPOSE: Evaluate the effect of visual acuity on color vision testing. DESIGN: University based clinical experimental study. METHODS: Right eyes of 12 healthy subjects were fogged with plus lenses to logMAR 1.88 and assessed with D-15 panel, Ishihara, and Hardy-Rand-Rittler (HRR) plates. Subjects were tested at lesser degrees of fogging, 0.1 logMAR intervals. The acuity at which 5% of the population tests abnormally was estimated as follows. The average acuity at which a 10% reduction in correct responses occurred was determined. From this, two standard deviations were subtracted. Examination devices were compared using repeated measures analysis of variance. RESULTS: Color vision testing did not significantly differ from baseline up to logMAR 1.40 (D-15 panel), 1.10 (HRR plates), and 0.72 (Ishihara plates). Testing devices were significantly different (P < .005). CONCLUSIONS: Color vision testing is accurate up to logMAR 1.40 (20/501) with D-15 panel, 1.10 (20/252) with HRR plates, and 0.72 (20/106) with Ishihara plates.     

Contralateral decreased visual acuity and extraocular muscle palsies following retrobulbar anesthesia

Numerous complications resulting from retrobulbar injections in the injected eye and orbit have been reported. A rare complication of retrobulbar anesthesia is the occurrence of decreased visual acuity and extraocular muscle palsies in the contralateral eye. We report three cases of contralateral dysfunction of cranial nerves II and III, following retrobulbar anesthesia. None of the patients suffered permanent sequelae. Several methods of decreasing the probability of such an occurrence are discussed.     

Influence of corneal astigmatism in final visual acuity after implantation of AcrySof ReSTOR: case report

Currently, new types of intraocular lenses have been developed aiming to eliminate presbyopia and the use has become more popular. The authors report the case of a patient with bilateral cataract and corneal irregularities and astigmatism higher than 2D in the corneal topography, in which AcrySof ReSTOR intraocular lens was implanted in the left eye associated to relaxing limbal incisions trying to reduce corneal astigmatism. The near and distance postoperative visual acuity were worse than expected, with no improvement with refraction. Apparently, no other reason apart from irregular astigmatism/multifocal lens justified the low vision. After 45 days, with no visual acuity improvement, the intraocular lens was explanted and a monofocal one was implanted. The final corrected visual acuity improved. Thus, the present case emphasizes the need of a correct preoperative selection of patients to implant this type of multifocal lens, with special attention to corneal topography data.     

Congenital retinal macrovessels: a low visual acuity case report with a 14-year follow-up.

We report a rare case of congenital retinal macrovessel with decreased visual acuity, with a 14-year follow-up. Both the clinical findings and the visual acuity remained unchanged throughout the follow-up period.     

Potential acuity meter to predict postoperative visual acuity

Thirty-three eyes were examined with the potential acuity meter (PAM) to determine preoperatively the expected visual acuity for patients undergoing cataract surgery. The preoperative visual acuity was compared to the best postoperative visual acuity. Although several patients had moderate macular degeneration as well as cataracts, there was an overall accuracy to within two lines of the best visual acuity in 96% of patients. There was a tendency to underestimate rather than overestimate postoperative visual acuity when these readings were in error. The instrument was only used if the cataract examined had some clarity. Older patients who were unsteady had difficulty performing the test.