美多丽对远视眼学龄儿童验光的实用性探讨

目的探讨美多丽能否用于学龄儿童远视眼散瞳验光.方法以自身对照法,比较美多丽与1%阿托品用于33例60眼,6～12岁远视性屈光不正儿童,散瞳验光的结果.球、柱镜相同或相差≤0.50D为符合,＞0.50D为不符合;散光轴相同或相差≤5.为符合,＞0.50D为不符合.以student's配对t检验进行统计学分析.结果美多丽与98.33%,无显著差异(P86.67%,差异显著(P＜0.05);柱镜值符合率为1%阿托品散瞳验光结果,球镜值符合率为＞0.05);散光轴符合率为95.00%,无显著差异(P＞0.05).结论美多丽可用于无内斜视的远视性屈光不正学龄儿童散瞳验光,特别是再次散瞳验光配镜者.     

学龄儿童近视的预防与控制

近视的低龄化,近视发展的速度加快,这可能预示着罹患高度近视的人数以及高度近视所导致的低视力和失明的人数会增加。由学龄期获得并逐渐加深的近视会造成高度近视的流行,从而影响人们的工作、学习和日常生活。学龄儿童近视不仅仅是一个公共卫生问题,还会加重社会经济负担。我国近视人群比例约占47%,近视已经成为我国的“国病”。我国学龄儿童近视发病率高。学龄儿童近视的危害大。近年来,学龄儿童近视的预防及控制措施成为研究的重点。现就学龄儿童近视的预防与控制措施进行综述,以期为学龄儿童近视的防控提供新的线索。     

低度近视戴镜与否对近视发展程度的影响

目的:观察早期真性低度近视者不戴眼镜与配戴合适的眼镜对近视发展程度的影响。方法:回顾性研究2007-12/2009-12年就诊于我院的8～12岁在校学生中有完整病例,近视在-0.50～-2.00DS之间的初诊患者,分为2组,两组患者均采用睫状肌麻痹剂散瞳医学验光。第1组:未配戴眼镜组24眼;第2组:戴框架眼镜组28眼。将两组患者2a近视增长结果进行比较。应用t检验方法比较两组患者近视增长的程度。结果:第1组患者近视增长-2.07±0.52D,第2组患者近视增长-1.49±0.48D,两组差异显著(P<0.01)。结论:对于未戴镜患者近视增长较快,近视-0.50D以上者看远应配戴眼镜,以提高视网膜成像质量,使家长走出近视后不愿戴眼镜的误区。     

山西省交城县学龄儿童近视流行现状及特征研究

目的：:了解山西省交城县学龄儿童近视状况,分析其流行特征,探讨其可能的影响因素,为构建当地的近视综合防控体系提供科学依据。方法：:横断面调查研究。于2019年3月采取整群随机抽样方法,随机抽取交城县3所小学、3所中学在校学生（每个年级随机抽取2个班级）进行视力和屈光度检查。通过卡方趋势检验,比较不同年龄段学龄儿童近视发...     

双光镜延缓近视学龄儿童近视进展的Meta分析

背景关于双光镜是否能够延缓学龄儿童近视的发展一直存在争议,应用循证医学的方法对双光镜的效果进行评估具有重要的临床意义。目的系统评价双光镜和单焦点眼镜在延缓近视学龄儿童近视进展中的效果。方法系统检索MEDLINE（1966-2010年10月）、EMBASE（1974-2010年10月）、Cochrane Library、中国生物医学文献数据库（1978-2010年10月）和中国临床试验注册中心中关于双光镜治疗近视的随机对照试验,辅以手工检索相关期刊书籍,对检索所得文献进行双人筛选、评估和数据提取,针对屈光度进展量和眼轴长度进展量对纳入的研究进行Meta分析。结果有3项符合标准的高质量随机对照试验被纳入。在最长随访期时,双光镜和单焦点眼镜延缓近视学龄儿童屈光度进展量的加权平均差为0．22D（95％CI：-0．24～0．67）,差异无统计学意义（P=0．35）,在6、12、18、24个月和〉30个月时的差异量分别为0．15（95％CI：-0．09～0．38）、0．17（95％CI：-0．05～0．39）、0．42（95％CI：-0．14～0．98）、0．23（95％CI：-0．21～0．66）和0．03（95％CI：-0．40～0．46）,差异均无统计学意义。二者延缓近视学龄儿童眼轴长度进展量的加权平均差为-0．17mm（95％CI：-0．26～0．08）,差异有统计学意义（P=0．0003）。结论基于现有研究,双光镜和单焦点眼镜相比在延缓近视学龄儿童的近视进展方面差异无统计学意义。由于目前的高质量研究数量较少,上述结果仍需更多大样本的研究讲一步证实．     

近视矫正眼镜对青少年儿童近视的影响

我科对青少年儿童轻度近视戴镜与不戴镜对视力的影响进行观察,现报告如下。     

低度近视戴镜足矫与欠矫对近视发展的影响

目的：观察早期真性低度近视者戴镜足矫或欠矫对近视发展程度的影响。 方法：回顾研究2010-07/2011-08来院就诊的50例100眼8~12岁在校学生,近视度-1.00~-2.00D。分为两组,均用睫状肌麻痹剂作医学验光,第1组50眼患者近视度-1.55±0.37D,戴镜足矫;第2组50眼患者近视度-1.50±0.48D,戴镜欠矫。将两组患者1.5a后的近视增长结果进行比较,应用t检验方法比较两组患者近视增加的程度。 结果：第1组患者近视增加-0.75±0.43D,第2组患者近视增加-1.55±0.27D,两组差异有显著统计学意义(P＜001)。 结论：对于欠矫的患者近视增长较快,近视在-1.00D以上者看远应戴足矫眼镜,以提高视网膜上成像质量,其近视程度的发展也较戴镜欠矫者减少。     

握笔姿势对学龄儿童近视病情影响的初步研究

目的研究不同的握笔姿势对学龄儿童近视的发病及近视严重程度的影响.方法在上海市2所定点中学中进行视力普查,收集300名正视学生的资料.记录其握笔姿势.同时收集300名于2003.7.1～2003.8.15至我院门诊就诊的学龄近视患儿的资料.根据屈光度(＜-3.00D,-3.00D～-6.00D,＞-6.00D)分为3组,每组100人,分别记录握笔姿势.对所得资料进行统计分析.结果握笔姿势分为三种:拇指于食指不相碰(姿势1),拇指与食指相碰(姿势2),拇指与食指交叉(姿势3).正视组儿童握尾姿势为姿势1者68人,屈光不正组儿童握笔姿势为姿势1者37人,x2=11.09＞x2(0.01)P＜0.01差异有显著意义.分别比较3组不同屈光度的儿童的握笔姿势.其差别的x2=19.2＞x20.01P＜0.01.结论近视的发病与采用不同的握笔姿势有关.屈光度的加深与采用不同的握笔姿势也有关.从本次调查结果来看,姿势1,即拇指与食指不相碰,有利于学龄儿童防治近视,保护视力.     

角膜塑形镜矫正近视的临床研究

目的 评价新一代角膜塑形技术（ｏｔｈｏｒｋｅｒａｔｏｌｏｇｙ）矫正青少年近视的有效性、预测性及安全性。方法 应用美国视康公司提供的ＯＫ近视矫正镜,对２２１例（４４２只眼）近视患者进行矫治。结果 ＯＫ镜矫治３ｍｏ后,视力在０．５及０．８以上分别为９３％及７２％。矫正偏中心的占９．５％,未见角膜明显损伤。结论 角膜塑形技术可有效矫治青少年近视,并具有矫正迅速,安全可靠等特点。对矫正后视力的巩固及提高矫     

角膜塑形镜矫正近视对角膜形态的变化及影响

目的：探讨配戴角膜塑形镜矫正近视对角膜形态的变化及影响。

方法：选择2015-01/2016-12期间在我院接受配戴角膜塑形镜矫正近视的90例患者为研究对象,根据配戴方式不同分为观察组(夜戴)45例90眼和对照组(日戴)45例90眼,观察比较两组患者配戴角膜塑形镜前、配戴后1wk,1、3、6mo时的等效球镜度(spherical equivalent,SE)、裸眼视力(uncorrected visual acuity,UCVA)、角膜曲率及角膜中央厚度。

结果：两组患者在戴镜后1wk,1、3、6mo时测量角膜中央厚度均明显低于戴镜前,差异有统计学意义(P<0.05); 观察组在戴镜后1、3、6mo时测量角膜中央厚度均明显低于对照组,差异有统计学意义(P<0.05); 两组患者配戴角膜塑形镜后1wk,1、3、6mo时的角膜曲率值均明显低于本组配戴角膜塑形镜前,且配戴前后差异具有统计学意义(P<0.05)。观察组配戴角膜塑形镜6mo时的角膜曲率(40.0±0.5D)明显低于对照组配戴角膜塑形镜6mo时的角膜曲率(41.3±0.9D),且组间差异具有统计学意义(P<0.05); 在戴镜3mo时观察角膜上皮染色率,观察组上皮染色率阳性占49%(44/90),对照组上皮染色率阳性占29%(26/90),两组均以0级、1级为主; 随着角膜塑形镜配戴时间延长,两组患者的SE水平都呈下降趋势,且均明显低于配戴之前。配戴6mo时观察组SE水平(-0.42±0.20D)明显低于对照组SE水平(-0.52±0.19D),差异具有统计学意义(P<0.05); 两组患者配戴角膜塑形镜后UCVA值明显升高,且与配戴前相比差异具有统计学意义(P<0.05)。

结论：配戴角膜塑形镜可降低近视度数,提高视力,且夜间配戴效果相对优于白天配戴。     

Tendency for Evolution of High Myopia in 308 Chinese School Children from Xi’an City

 Purpose: To observe the refractive status, and especially the tendency for evolution of high myopia, in eyes of Chinese school children from Xi’an city. Methods: The study was conducted in 11514 eyes of the 5757 students whose ages were between 7~18 years in Xi’an city primary and high schools. The inclusion criterion was >-6D of the spherical equivalent refraction. The object ophthalmic examinations were done, included non-cycloplegic objective refraction, visual acuity, intraocular pressure, fundus evaluation by ophthalmologists and nurses with professional training. Specially designed questionnaires were filled in and the data were statistically analyzed with SPSS10.0. Results: 1. Of 11514 eyes, the detected rate was 81.4% (9376 eyes) for myopia and 5.3% (615 eyes) for high myopia. High myopia was found in 2.6% (300 eyes) of right eyes, 2.7% (315 eyes) in left eyes, and 2.4% (275 eyes) were in boys and 2.9% (340 eyes) in girls. Among 12 school grades, the detected rates of high myopia increased significantly with student age, with 0.9% in the 1st grade of primary school and 12.5% in the 3rd year of senior middle school. 2. The average refractive error of spherical equivalent refraction was (-7.43±1.29) D with 95% confidence interval (-7.54, -7.33). No significant differences were found between the right and left eyes or both genders. 3. The distribution of myopic severity was lowest (-6D) in primary school students younger than 12 years, was higher (-8D) in junior middle school students older than 13 years, and highest (-13D) in senior middle school students. Conclusion: A continuous growth was evident in the severity of high myopia throughout 12 years of primary and middle school except for the first year of primary school, with growth occurring in two transitional stages between the senior primary and junior middle school years, and between the junior and senior middle school years. The distribution of high myopia was lowest, at -6D, in primary school, increased to -8D in junior middle school, and progressed to -10D in senior middle school, indicating a high risk of development of pathologic myopia during the students’ later lifespan. The adolescent period of 13 to 18 years of age in middle school is a critical period for the development of pathological myopia over -8D.     

近视性和远视性弱视视功能发育临床观察

目的：：了解近视性弱视和远视性弱视对双眼视功能发育的影响。方法：对50例经治疗后双眼矫正视力均达0.9以上的弱视患儿行双眼视功能检查。测量同时视、融合范围及远近立体视。根据患儿的屈光状态将患儿分为A组(近视组)20例、B组(远视组)30例。比较A、B两组同时视、融合和立体视差异。结果：近视组中存在同时视的15例(75％),集合融合范围正常的6例(30％),分开融合范围正常的16例(80％),有正常远立体视的7例(35％),有正常近立体视的6例(30％)。远视组中存在同时视的26例(87％),集合融合范围正常的7例(23％),分开融合范围正常的20例(67％),有正常远立体视的15例(50％),有正常近立体视的7例(23％)。50例患儿中存在正常远立体视的为22例(44％),正常近立体视13例(26％)。同时视在两组患儿之间的差异无统计学意义(χ2=0.454,P>0.05);集合性融合和分开性融合在两组患儿之间的差异也无统计学意义(χ2=0.565,P>0.05;χ2=0.740,P>0.05);远近立体视两组患儿差异也均无统计学意义(χ2=0.195,P>0.05;χ2=0.295, P>0.05)。结论：近视及远视因素对弱视患儿双眼视功能发育影响的差异不显著。弱视治疗后矫正视力正常的患儿短期内双眼视功能仍未完全恢复正常。     

Treatment modalities in Duane’s Retraction Syndrome

AIM: To assess the influence of near work, time outdoor and parental myopia on the prevalence of myopia in school children in Aba, Nigeria.METHODS: Primary and secondary school children aged between 8 and 15y were randomly recruited from 12 schools in Aba. Information on family history, near work and outdoor activity was obtained using myopia risk factor questionnaire. Cycloplegic refraction was performed using autorefraction technique. Myopia was defined as spherical equivalent refraction (SER) ≤-0.50 D in the poorer eye. Data were analysed for 1197 (male: 538 and female: 659) children with full relevant data.RESULTS: Risk of developing myopia was positively associated with parental myopia [Odds ratio (OR): 6.80; 95%CI, 2.76-16.74; P<0.001) for one myopic parent and (OR: 9.47; 95%CI, 3.88-23.13; P<0.001) for two myopic parents, longer daily reading hour (OR: 1.21; 95%CI, 1.03-1.42; P<0.020) and less time outdoors (OR: 0.8; 95%CI, 0.74-0.87; P<0.001). CONCLUSION: Parental history of myopia was the most important risk factor associated with myopia. In addition, children with both parents being myopic had increased odds of developing myopia than those with one myopic parent. It is recommended therefore, that children spend more time outdoors as this could reduce the prevalence and progression of myopia.     

电子产品对学龄前及学龄初期儿童近视的相关性分析

目的：探索电子产品对学龄前及学龄初期儿童近视的影响及发生发展规律,并制定合理的用眼健康指导规范,为开展防治工作打下坚实的基础。方法：回顾性分析门诊就诊的3～12岁学龄前及学龄初期儿童900例,均建立个性化档案,记录裸眼视力、验光、裂隙灯、眼底镜、斜视检查结果;记录电视、电脑、手机、iPad、写作业、课外书用眼情况。统计分析各年龄组的屈光状态、不同年龄组电子产品使用时间及其与近视的相关性。结果：裸眼视力正常者学龄前儿童多于学龄初期儿童,差异有统计学意义（ P＜0．05）;视力低常者学龄前儿童各年龄组间比较,差异无统计学意义（ P＞0．05）;近视的例数7～12岁（学龄初期）多于3～6岁（学龄前）儿童,差异有统计学意义（ P＜0．05）。电子产品的应用在6岁、10岁儿童中用眼时间叠加最多,logistic回归模型显示玩手机时间、玩电脑时间、玩iPad时间是近视的危险因素。结论：对学龄前儿童行早期筛查,健康用眼指导、建立个性化就诊档案,进行一对一个性化用眼指导;避免学习任务繁重造成用眼时间叠加,争取近视延后发生、控制近视度数增长过快。因此,减少电子产品的使用已经成为一项值得深入研究的课题。     

学龄期儿童近视初诊时屈光状态分布与生物学参数的相关性研究

目的:研究学龄期儿童初发并确诊为近视时的年龄、屈光分布的特点及其与眼轴、角膜散光的相关性。方法:采用简单随机抽样法选取2020-05/09于我院眼科门诊因视力下降就诊,并第一次诊断为近视的学龄期儿童196例391眼,排除患其它引起视力下降眼病的病例。按年龄分为6~8、9~10、11~12岁三组,按屈光度分为SE≤-1.00D、-1.00-3.00D四组。所有儿童均接受视力、眼压、裂隙灯显微镜、IOL Master、验光及眼底检查并记录结果,分析屈光度、年龄分布及与各屈光参数关系。结果:纳入病例中6~8、9~10、11~12岁年龄组分别有128眼(32.7%)、155眼(39.6%)、108眼(27.6%)。平均年龄9.29±1.64岁。各年龄组间等效球镜(SE)和眼轴(AL)均有差异(P<0.01)。SE≤-1.00D、-1.00-3.00D屈光度组分别有134眼(34.3%)、162眼(41.4%)、74眼(18.9%)、21眼(5.4%)。平均SE为-1.54±0.89D。各屈光度组AL有差异(P<0.01)。SE与AL间呈线性回归关系,回归方程为Y=12.373-0.577X,R²=0.286,β=-0.577,P<0.001。散光度与角膜散光间呈线性回归关系,回归方程为Y=0.084-0.502X,R²=0.389,β=-0.502,P<0.001。结论:6~12岁的学龄期儿童初次确诊近视性屈光不正的年龄集中在9~10岁,屈光度以低度近视为主。AL增长与年龄、SE相关,儿童散光性屈光不正与角膜散光相关。     

徐州市中小学生近视筛查与矫正情况分析

目的:了解江苏省徐州市6～18岁中小学生近视筛查与矫正情况。方法:横断面随机整群抽样研究,于2020-09/12以学校为单位抽取徐州市70所中小学校进行近视筛查。参与抽样63 488人,剔除不合格记录后,最终纳入6～18岁中小学生58 149人,并分析其不同年龄、性别、地区、近视程度下的近视及矫正情况。结果:徐州市6～18岁中小学生筛查性近视率为49.26%,近视患病率随年龄增长呈增加的趋势(P<0.01),近视程度随年龄增加逐渐加深,女生近视患病率高于男生(53.70%vs 45.67%,P<0.01),城市中小学生近视患病率高于乡镇(55.40%vs 45.10%,P<0.01)。框架眼镜矫正率为31.11%,足矫率为60.23%,同时矫正率随着年龄的增长逐渐增高(P<0.01),女生矫正率高于男生(32.45%vs 29.84%,P<0.01),但女生足矫率却低于男生(56.60%vs 63.98%,P<0.01)。城市中小学生矫正率和足矫率均高于乡镇(46.50%vs 18.33%,62.20%vs 56.07%,P<0.01)。结论:...     

Elementary school comprehensive intervention and myopia development: the Wenzhou Epidemiology of Refraction Error Study

AIM: To investigate the effects of school-based comprehensive intervention on myopia development in elementary school children. METHODS: As a part of the Wenzhou Epidemiology of Refraction Error Study, there were 1524 participating elementary students (730 girls, 47.9%) in grades 1 to 3 from three campuses of one school, aged 7.3±0.9y, who were examined twice every year for a 2.5y follow up period. Comprehensive intervention and other reminders were given at school every semester for the intervention group. The control group did not receive comprehensive intervention and did not have reminders of it. RESULTS: There were 651 students in the intervention group [mean age 7.3±0.9y; 294 (45.2%) girls] and 737 students in the control group [mean age 7.2±0.9y; 346 (46.9%) girls]. Overall mean myopia progression during the 2.5y follow-up was -0.49±1.04 diopters (D) in the intervention group and -0.65±1.08 D in the control group (P=0.004). The majority that not get myopia at baseline spherical equivalent (SE≤-1.0 D). Their mean myopia progression during the 2.5y follow-up was -0.37±0.89 D in the intervention group and -0.51±0.93 D in the control group (27.5% reduction, P=0.009); Overall, mean axial length elongation was less in the intervention group (0.56±0.32 mm) than in the control group (0.61±0.38 mm, 10.5% reduction, P=0.009). The percentage of close reading distance (<30 cm) in the intervention group was less than in the control group (73.4% vs 76.2%, P<0.001), the percentage of everyday perform eye exercises in the intervention group was more than in the control group (27.8% vs 20.7%, P<0.001) 30mo later. CONCLUSION: The comprehensive intervention program at elementary school has a significant alleviating effect on myopia progression for children during the 2.5y follow-up, especially for those non-myopia at baseline.     

Prevalence of myopia and hyperopia in a population of Polish schoolchildren

PURPOSE: The aim of this study was to determine the prevalence of myopia and hyperopia in a population of Polish schoolchildren. METHODS: A total of 4422 students were examined (2107 boys and 2315 girls, aged 6-18 years, mean age 11.1, S.D. 3.5). The examination included retinoscopy under cycloplegia induced with 1% tropicamide. Myopia was defined as a spherical equivalent (SE) of at least -0.5 dioptres (D), and hyperopia as a SE of at least +1.0 D. Data analysis was performed using Spearman's rank correlation coefficients and chi-squared test; p-values of <0.05 were considered statistically significant. RESULTS: It was observed that 13.3% of Polish students in the age group ranging from 6 to 18 years were myopic while 13.1% of students were hyperopic. Furthermore, a positive correlation was found between the prevalence of myopia and age (p < 0.001) and a negative correlation between prevalence of hyperopia and age (p < 0.001). It was observed that the prevalence of myopia increases substantially between 7 and 8 years of age (p < 0.01). Moreover, it was determined that with age the average refractive error among schoolchildren becomes more myopic (p < 0.001). CONCLUSIONS: The occurrence, degree and progress of myopia and hyperopia in Poland is similar to that in other European countries with a predominantly Caucasian population.     

成都市新都区小学生近视流行病学研究

目的：调查成都市新都区小学生近视现状,分析本地区小学生近视的流行病学特点及相关影响因素。

方法：采用分层整群随机抽样调查的方法,抽取成都市新都区4所小学的一年级到六年级学生,每个年级3个班,分别进行眼科检查和问卷调查,用SPSS21.0软件进行统计分析。

结果：共有3 324名学生参与本次调查,近视的学生1 124人,近视率33.81%。不同性别、不同年龄、不同年级、吃水果蔬菜和喝牛奶频次、父母监督和提醒学生用眼习惯频次、在家看书写字光线情况、每天连续家庭作业及看书时间、睡眠时间、每天课外活动时间、课间休息时去户外活动或做眼保健操频次、躺着看书或在晃动的车内看书频次、看书写字姿势以及父母双方患有近视情况的学生近视患病情况存在不同(P<0.05)。多因素回归分析发现：年级、性别、父母监督和提醒用眼习惯、在家看书写字的光线、每天连续家庭作业及看书时间、每天课外活动时间、躺着看书或在晃动的车内看书、看书写字姿势是否正确、父母近视情况均为近视的独立影响因素,其中父母监督和提醒用眼习惯为影响近视的保护因素,其余各指标均为危险因素。

结论：青少年近视与环境、遗传等多种因素有关,应尽早采取相应措施,延缓其发生发展。