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.     

天津市健康幼儿173例图形视力分析

目的　探讨 2～ 4岁健康幼儿的视力发育状况和LEA SCREENER图形视力表对检查中国幼儿视力的适用情况。方法　用LEA SCREENER图形视力表测定 1 73例保育院幼儿视力 ,并对有关因素进行统计分析。结果　双眼平均近视力为 0 58,远视力 0 4 8;右眼近视力 0 53,远视力 0 4 5;左眼近视力 0 52 ,远视力 0 4 4。男女幼儿的双眼远、近视力无显著性差异。不同月龄幼儿的平均视力均随月龄增加而增长。对其中 4 9名幼儿在 6个月后行第 2次检查 ,平均视力有不同程度升高。结论　LEA SCREENER图形视力表是一种方便、快捷和准确的幼儿视力检查方法。幼儿视力随月龄增长而增长     

先天性白内障一家系

先证者 ,女 ,1 2岁。 7岁发现患儿双眼视力下降 ,本地医院诊断为“白内障”。于 1 998年 1 2月 1 6日来诊。体检 :发育及智力正常 ,全身体检未见异常。视力 ,右 0 1 2 ,左 0 1 5。双眼结膜无充血 ,角膜透明 ,ＫＰ (一 ) ,前房深度正常 ,瞳孔光反应灵敏 ,晶状体呈核性混浊。散瞳后眼底未见异常。诊断 :双眼先天性核性白内障 ,弱视。分别于 1 2月 1 9日、 2 2日行右眼与左眼前后囊环形撕囊白内障囊外摘除 ,并局限性前玻璃体切割 ,与人工晶体囊袋内植入术 ,术后视力左 0 8,右 0 6。家系调查 (图 1 ) :三代人共累及 1 1人 ,发病时间均在 1 0…     

儿童人工晶体植入术后双眼视觉

目的　研究儿童人工晶体术后视力和双眼视功能恢复情况 ,探讨其相关因素。方法　对46例 (5 4眼 )儿童人工晶体植入术后远近视力、双眼视功能、眼位、屈光状态等情况进行 6～ 3 6个月随访。结果　术后视力恢复 :矫正远视力 2 6眼 (4 8 1 5 % )≤ 0 3 ,1 7眼 (3 1 48% )≥ 0 6,近视力 44眼 (81 48% )≤ 0 5 ,1 0眼 (1 8 5 2 % ) >0 5。双眼视功能 :2 8例具有不同程度的双眼视功能 ,其中 1 2例具有远立体视 ,7例用Titmus查有近立体视。结论　儿童白内障手术疗效与发病年龄、手术时机选择、术后光学矫正、系统正规的术后管理、弱视及双眼视功能训练有关。光学矫正时适当增加远视度数 ,将有利于视力提高及看近立体视的恢复。     

颅咽管瘤致双眼视神经萎缩一例

1　病例报告患者女 ,12岁 ,两年前在学校体检发现右眼视力差 ,曾在当地医院按弱视治疗 ,后因视力渐进性减退 ,于 2 0 0 2年 8月 4日来我院弱视门诊就诊。发育较同年正常儿童矮小、消瘦。视力 :右眼手动 ;左眼 0 5。双外眼检查正常 ,眼底检查见右眼视神经萎缩 ;左眼视神经部分萎缩。双眼散瞳验光 ,右眼 +1 5 0DS =手动 ;左眼 +1 0 0DC× 75° =0 6。视野双眼颞侧偏盲。眼科临床诊断 :双眼视神经萎缩 ;偏盲原因待查。进一步行CT检查 ,显示鞍上低密度囊性肿块。诊断为颅咽管瘤。遂转北京天坛医院 ,经核磁检查确诊为鞍上型囊性颅咽管瘤 ,2 …     

高度近视眼准分子激光原位角膜磨镶术后眼底出血一例

患者女 ,5 2岁。因双眼视力下降、左眼前正中黑影遮挡1个月 ,于 1999年 7月 8日来我院就诊。既往因双眼高度近视 (- 13 0 0ＤＳ)于 1999年 4月 9日在外院行双眼准分子激光原位角膜磨镶术 (ｌａｓｅｒａｓｓｉｓｔｅｄｉｎｓｉｔｕｋｅｒａｔｏｍｉｌｅｕｓｉｓ ,ＬＡＳＩＫ) ,术后 10ｄ视力右眼 1 0 ,左眼 1 2。本次就诊全身检查无异常。眼部检查 :右眼裸眼视力 0 0 6 ,矫正视力 0 5 (- 6 5 0ＤＳ) ,左眼裸眼视力 0 0 2 ,不能矫正 ;双眼外眼和前节均正常 ;双眼呈高度近视眼底改变 ,视盘周围及黄斑颞侧可见地图状脉络膜萎缩斑 ,右眼黄斑…     

共同性外斜视手术疗效分析

共同性外斜视是共同性斜视的主要类型 ,它不仅影响外观 ,而且影响双眼视觉的正常发育。其手术效果受多种因素的影响 ,手术量不易掌握且术后复发率较高。为探讨不同年龄阶段共同性外斜视术后眼位变化、双眼视功能恢复情况及眼位回退的相关因素 ,我们将 70例记录完整、随诊 6个月以上患者的有关情况报告如下 :对象和方法1 一般资料 :本组 70例 ,男 3 2例 ,女3 8例 ;年龄 3～ 3 7岁 ,平均 1 2 5岁 ;随访时间 6～ 62月 ,平均 2 2月 ;恒定性外斜视 3 6例 ,间歇性外斜视 3 4例。2 检查及手术方法。检查方法 :( 1 )用国际标准视力表检查视力。 (…     

北京市顺义县50岁及以上人群中青光眼患病率和正常眼眼压的调查

目的　调查北京市顺义县≥ 5 0岁人群中青光眼的患病率和正常眼的眼压。方法　 1996年 9～ 11月 ,采用整群随机抽样法在顺义县调查了 5 5 5 5人 ,除进行视力和一般眼部检查外 ,还进行了有关青光眼的检查 ,如询问青光眼家族史和发作史 ,测量前房深度和眼压 ,眼底检查时观察视乳头有无青光眼性改变。结果　 4 880人完成了有关青光眼的检查 ,受检率为 87 85 %。青光眼的患病率为2 0 7% ,其中原发性闭角型青光眼患病率为 1 6 6 % ,原发性开角型青光眼患病率为 0 2 9% ,继发性青光眼患病率为 0 12 %。各种类型的青光眼患病率均随年龄增长而增加。 6 4 0 0 %的青光眼患者视功能有一定程度或严重损伤。双眼盲比例为 16 0 0 % ,均为≥ 6 0岁的患者。单眼盲、双眼低视力和单眼低视力的比例分别为 17 0 0 %、2 3 0 0 %和 8 0 0 %。正常眼的眼压均值为 (13 5 3± 2 2 0 )mmHg(1mmHg =0 133kPa) ,随着年龄增长 ,眼压有下降趋势。结论　就青光眼的患病率和青光眼患者的视功能而言 ,青光眼是严重的致盲眼病。≥ 5 0岁人群中 ,正常眼的眼压均值比预想值低。在这些人群中筛查青光眼时 ,应将正常眼压上限值降低至 18mmHg。     

产后原田病继发性青光眼失明1例

患者 ,女 ,3 2岁 ,农民。因“产后双眼胀痛、视物不见 2 2天”,于 1996年 11月 3 0日收住院。有原田氏病史 5年。患者于 1992年 8月因头痛、耳鸣、间歇性双眼视物模糊 1年来院初诊。全身体检正常。视力 :右眼 0 .4( - 2 .5 D→ 1.0 ) ,左眼0 .5 ( - 2 .5 D→ 1.2 )。眼前部正常 ,双眼视乳头及脉络膜广泛充血。诊断 :原田氏病。给予皮质类固醇激素治疗 5天后双眼视力 1.0 ,激素减量 ,半年后停药 ,随访 1年双眼视力正常。1996年 8月 3日因孕 6月 ,双眼视力逐渐下降半年就诊。诉近 2年眼不痛 ,眼及全身未用任何药 ,妊娠后双眼视力逐渐下降。产…     

优先注视法婴儿视力卡

优先注视法(Preferenthal Looking简称PL)。PL 是目前研究得比较深入的一种客观儿童视力检查方法。其理论根据是婴儿喜欢注视有图象的画面,而不喜欢注视均匀的空白画面。将各种不同宽度的黑白条纹与相对空白的画面交替呈现在婴儿眼前,根据婴儿的注视行为及头部运动情况即可测出婴儿的PL 视力。PL 视力值为婴儿所能观看的最窄条纹视角值的倒数(小数记录)或对数(五分记录)。近年来婴儿视力发育情况逐渐引起人们的重视,请求眼科医生检查婴儿视力者日益     

Monocular acuity in normal infants: the acuity card procedure

An "acuity card" technique has been developed for rapid assessment of visual acuity in infants. In this procedure an adult observer shows the infant a series of cards that contain gratings of various spatial frequencies and estimates acuity as the highest spatial frequency that the infant is judged to see. The present paper shows that the acuity card procedure can be used in a laboratory setting to estimate both monocular and binocular acuity in infants 1 to 12 months of age. Four monocular and two binocular acuity estimates were obtained on 36 normal infants, six each at ages 4, 8, and 16 weeks and 6, 9, and 12 months. Acuity estimate means and SD's agreed well with previously established preferential looking (PL) norms for each of the test ages. Time required for a monocular or a binocular test averaged 3 to 6 min.     

Refractive error and preferential looking visual acuity in human infants: a pilot study

A clinical pilot study comparing refractive error and preferential looking (PL) visual acuity in infants 2 to 12 months of age is described. The PL visual acuity of 30 normal infants without significant visual disorders was assessed using the Acuity Card Procedure. Near retinoscopy was used to determine refractive error. Infants of this sample had monocular PL visual acuities similar to those established by McDonald et al. in a laboratory setting. Statistical analysis of the data for this sample of infants showed that refractive error did not change systematically from 2 to 12 months of age. We have found that results obtained with the Acuity Card Procedure in a clinical setting agree with infant visual acuity as described in the research literature. Refractive error did not correlate with changes in PL visual acuity in infants 2 to 12 months of age.     

Binocular visual form deprivation in human infants

Visual acuity was measured with a preferential looking technique in infants and toddlers with binocular form deprivation. Of the 10 children in the study, there were 5 with congenital cataracts and 5 with uncorrected high refractive errors. Infants with cataract surgery before 2 months of age showed normal early development of visual acuity. A 4 to 6 month delay before treatment resulted in reduced acuity but recovery subsequently occurred. Infants with high hyperopia or astigmatism showed no acuity deficits in the first year of life when tested with optical correction. One case of early meridional amblyopia was detected in the third year of life. The deficit was not permanent and, after a period of optical correction, there was recovery of visual acuity to normal levels.     

Development of visual acuity in infants with congenital cataracts.

The visual acuity of 4 infants with congenital cataracts was measured serially during the first year of life by a preferential looking technique. Two infants with bilateral cataracts and no measurable acuity before surgery showed rapid development of acuity to normal levels for age after surgery and optical correction. In an infant with a unilateral cataract and an infant with a cataract and persistent hyperplastic primary vitreous marked differences in monocular acuities were found after surgery. Acuities became equal in the latter case after occlusion of the normal eye, while the other infant recovered acuity with 'bi-ocular' viewing. These acuity measurements demonstrate the sensitivity of the human visual system to binocular and monouclar visual form deprivation in the first year of life.     

Measurement of visual acuity in infants in 6 minutes: Teller's Acuity Cards

Most of the development of infant visual function occurs during the first year of life. Early pathological symptoms affecting visual or oculomotor processes, particularly ocular misalignment or amblyopia, should be detected and treated at the earliest age. Orthoptic and ophthalmological tests have been available for a long time but there remained a need for a convenient test for measuring visual acuity. Preferential looking techniques fulfill this demand and have been proven reliable and convenient to estimate visual acuity in preverbal infants. A new commercial presentation of the test, called Teller Acuity Cards, is described. Testing an infant was rapid, 5 to 6 minutes for a normal child, and easy because the child enjoys the convivality of the situation. Space requirement is reduced. Measures were taken from a population of 50 normal children aged 4 to 12 months. All children responded in the three situations, binocular and monocular (there was no blind eye in the group). Grating acuity values were higher than those obtained by projection preferential looking techniques. Binocular acuity was 6.5 cycles/deg (approximately 2.5/10) at 4 months of age, 9.8 cycles/deg (approximately 3.3/10) at 9 months and up to 13 cycles/deg (approximately 5/10) around 12 months. Acuities were found to be half an octave lower in monocular condition as compared to binocular. Orthoptic and ophthalmological check-up of infants is important, especially in case of children at risk of visual disorder. In most instances acuity can be preserved by therapeutic action provided it is initiated during the first year of life, when sensitivity to appropriate stimulation is at its peak.(ABSTRACT TRUNCATED AT 250 WORDS)     

Modulation of amblyopia therapy following early surgery for unilateral congenital cataracts.

BACKGROUND--Stimulus deprivation amblyopia is the principal cause of visual impairment in infants with unilateral congenital cataract. Even if lensectomy is undertaken at an early age, intensive postoperative occlusion of the phakic eye is essential for the development of useful vision in the aphakic eye. Despite this, the optimum method of regulating occlusion therapy is uncertain. METHODS--Interocular acuity differences identified using clinical preferential looking techniques (Keeler cards) were used to regulate target levels of phakic eye occlusion in a prospective evaluation of 10 systemically, metabolically, and neurologically normal infants in whom dense unilateral cataract was diagnosed before 8 weeks of age, and operated upon by 10 weeks. Actual occlusion levels were recorded each day by parents in a diary. The development of preferential looking acuity in the phakic and aphakic eye were compared with prediction intervals derived from observations on 43 normal children. RESULTS--Aphakic eye preferential looking acuities were within the normal range at last review in all but one infant. Interocular acuity differences were < or = 0.5 octave in all children older than 1 year of age at last review, and > or = 1 octave in three of four children less than 1 year old at last review (Fisher exact p = 0.033). Phakic eye acuities were within the normal range in all infants at all visits. CONCLUSION--Within the first 2 years of life, normal preferential looking acuity may be achieved in both eyes of infants undergoing early surgery for unilateral congenital cataract if occlusion therapy is modulated according to interocular acuity differences quantified by clinical preferential looking techniques.     

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。     

Visual acuity in human infants: a review and comparison of behavioral and electrophysiological studies.

Three techniques—optokinetic nystagmus (OKN), preferential looking (PL), and the visually evoked potential (VEP)—have been used to assess visual acuity in infants between birth and 6 months of age. All three techniques indicate that the visual acuity of infants increases during the first 6 months postnatal. The accumulating evidence strongly suggests that all three techniques give meaningful and reliable—if somewhat different—estimates of visual acuity in infants, and that variants of these techniques will eventually be useful for the assessment of infant vision in clinical settings.     

Preferential looking: Parameters and preliminary data of a new computerized version

A computerized version of preferential looking (CPL) was developed by the authors. Formal parameters (spatial frequency, luminance, contrast of the stimuli; randomized procedure; computerized statistical control) and preliminary binocular acuity results in 69 healthy children (6–36 months) are compared to those of OPL, FPL and ACP version. Low cost, standardized procedure, statistical control of visual acuity estimates and the need of one operator only are among CPL advantages.Abbreviations ACP Acuity cards procedure - PL Preferential looking - CPL Computerized preferential looking - FPL Forced-choice preferential looking - OPL Operant preferential looking - OKN Opto kinetic mystagmus - VEP Visually evoked potentials     

Infant grating acuity is temporally tuned

Studies of infant visual development have shown that acuity estimated with pattern visually evoked potential (VEP) techniques is higher than acuity estimated with preferential looking (PL) techniques. A major difference is that VEP stimuli are temporally modulated while PL stimuli are typically stationary. We measured PL acuity in 2-10-month-old infants for stationary gratings and for gratings phase alternating at 2.5, 7.5, 14 and 23 reversals/sec using a computer generated staircase method. The acuity functions were temporally tuned at 7.5 or 14 rev/sec for infants 3 months and older. Acuity for 7.5 and 14 rev/sec gratings was 0.5 to 1.0 octave higher than for stationary, 2.5 and 23 rev/sec gratings. When adults' grating acuity was measured foveally and 5 deg eccentrically, tuning occurred only for the eccentric targets, suggesting that the retinal area used by the infants to detect gratings acts like the adult perifovea. In a second experiment, VEP and PL acuity were both measured from the same infants using 14 reversals/sec gratings. The VEP/PL acuity difference was less for phase alternating gratings than for stationary gratings. The magnitude of the difference was age dependent, decreasing from 2 octaves at 2 months to 0.5 octave at 12 months. Even though the use of phase alternating gratings results in improved PL acuity, temporal modulation does not completely account for the difference between VEP and PL acuity.