和谐及企图和谐异常视网膜对应共同性内斜视患者生活质量和心理状况的临床研究

目的评价和谐及企图和谐异常视网膜对应共同性内斜视患者生活质量和心理状况,分析斜视手术对其影响。方法通过前瞻性随机临床对照的方法,对和谐及企图和谐异常视网膜对应共同性内斜视患者36例分别采用《国家眼科研究视功能问卷》和《综合医院焦虑抑郁量表》中文译本评定患者最近1个月的视觉生活质量和焦虑、抑郁评分,手术后1个月再次评定患者焦虑、抑郁情况及视觉生活质量,36例健康志愿者作为对照,比较两组患者生活质量和心理状况的差异。结果和谐及企图和谐异常视网膜对应共同性内斜视患者焦虑、抑郁及共患患者发生率分别为22.2%、25.0%、27.8%。《国家眼科研究视功能问卷》评分显示术前共同性内斜视患者在视觉健康相关生活质量部分亚功能(7/12)如一般健康、总体视觉、驾驶、社会功能、心理问题、周边视野和依赖性等均有不同程度的损害(均为P<0.05)。通过斜视手术干预,患者视觉生活质量和心理状态均有明显好转(均为P<0.05)。通过斜视手术干预,患者焦虑、抑郁评分明显好转(均为P<0.05),视觉健康相关生活质量的样本中位数差值[43.3(一般健康)、38.2(社会功能)、12.4(心理问题)、17.5(社会活动)、16.4(依赖性)、12.4(周边视野)],均较手术前明显改善[8.6(一般健康)、7.3(社会功能)、3.5(心理问题)、3.6(社会活动)、2.8(依赖性)、5.6(周边视野),均为P<0.05]。结论斜视手术可使和谐及企图和谐异常视网膜对应共同性内斜视患者心理状况和视觉健康相关生活质量得到明显改善。斜视手术有助于患者视觉生活质量和心理康复。     

斜视对心理的影响

斜视不但影响患者的视功能、容貌,对患者的心理影响也是明显的.主要表现在斜视患者普遍存在抑郁、低自尊、社交焦虑和就业方面.另外,斜视患儿父母也因其孩子的影响而存在抑郁、紧张、焦虑.对年幼患儿斜视手术可以有效地改变他们的视功能,提高其适应社会的能力.对青少年和成年人斜视手术可改善其容貌,提高自尊水平,减少受到的社会歧视,减轻社交焦虑,更好的获得就业.     

成人斜视患者生存质量的研究

目的：研究成人斜视患者生存质量的现状及治疗对生存质量的改善效果。
　　方法：本课题为前瞻性研究。征集2013-10/2014-05就诊于我院的符合入选和排除标准的斜视患者共45例作为试验组,另外选择最佳矫正视力及眼位正常的成人45例作为对照组。采用中文版成人斜视生存质量量表进行问卷调查,比较斜视患者与正常成人以及斜视患者术前与术后6 mo的生存质量差异。
　　结果：对照组正常成人的CAS-20社会心理评分及视功能评分都明显高于试验组斜视患者,差异均有统计学意义(P<0.01)。试验组斜视患者在术后6mo时较术前相比CAS-20社会心理评分及视功能评分都明显升高,差异均有统计学意义(P<0.01)。试验组斜视患者在术后6mo时社会心理评分及视功能评分仍显著低于对照组正常成人,差异均有统计学意义(P<0.01)。
　　结论：斜视在社会心理和视功能方面均影响了成人患者的生存质量,而斜视矫正手术有助于改善斜视患者的生存质量。     

青少年和成人斜视患者社会心理障碍的调查研究

目的 探讨水平斜视对青少年和成人患者社会心理健康的影响及斜视矫正术对其的改善作用.方法 调查研究.参考国外相关资料,制作斜视患者社会心理健康评价调查问卷表,对56例斜视患者（男23例,女33例）于术前和术后2-3个月分别采用术前和术后社会心理健康问卷表进行调查;同时记录患者一般资料和斜视专科情况.采用独立样本t检验.单因素方差分析和Pearson相关分析进行统计学分析.结果 总共56例斜视患者接受了问卷调查,其中内斜视17例,外斜视39例（其中间歇性外斜视15例）：56例患者均存在一定程度的社会心理障碍,其中64%患者因斜视影响其结交朋友等社交活动,61%患者与异性朋友相处受影响,82%患者的自信心和93%患者与他人对视能力受影响;74%的患者因斜视而回避公众场合和活动.64%的患者手术治疗的目的为恢复双眼视功能.在斜视对患者个人生活和社会生活影响的得分中,患者性别、斜视类型、婚否、受教育程度、工作与否的影响差异无统计学意义,手术年龄、斜视程度与得分无明显相关性.斜视手术后2-3个月,患者的社会心理健康状况明显改善,自我评价、自信心和人际关系明显改善.患者对斜视诊疗的建议是希望能获得更舒适的斜视治疗过程和获取更多的号业知识.结论 斜视对青少年和成年斜视患者的社会心理健康有明显影响,主要体现在自我评价低、自信心和社会活动受影响;斜视矫正手术能显著改善其社会心理健康状况.     

斜弱视及其治疗与儿童心理健康关系的研究进展

斜弱视是儿童期常见的视觉发育相关性眼病,斜弱视及其治疗与患儿的社会心理健康密切相关。目前研究发现,斜视患儿容易受到疏远和歧视,社会心理问题发生率较正常儿童高,严重者可出现精神障碍,及时的斜视治疗能给患儿带来积极的社会心理影响。弱视对儿童心理影响的已有研究结论尚不一致,但是大多数研究表明弱视治疗可能给患儿社会心理健康带来负面影响,有效的心理干预措施可以提高弱视治疗的依从性,使治疗过程对心理健康的影响最小化。随着研究的深入,斜弱视患儿在社会生活、学习及治疗中面临的社会心理健康问题将逐步得以阐明,可为心理干预治疗提供更多理论依据。     

共同性斜视围手术期护理

目的 探讨共同性斜视围手术期的护理方法.方法 对45例共同性斜视患者围手术期运用护理程序进行护理.结果 通过对共同性斜视患者围手术期的精心护理,患者眼位偏斜得到满意的矫正,复视症状消失,无明显并发症.结论 通过对共同性斜视患者有针对性的心理护理,克服了心理障碍,安抚了不安情绪,以健康心态接受治疗,并有利于减轻斜视术后眼部不适及胃肠道症状,心理护理和术后眼部护理对患者的治疗、顺利康复同等重要.     

斜视矫正术后屈光状态变化的研究进展

近年来随着儿童电子化设备的广泛应用以及不良用眼习惯,斜视发病率逐年升高.斜视不仅影响患者外观,更重要的是,会影响良好双眼视觉的建立.越来越多的患者及家属选择手术矫正斜视,随着学者们对手术患者深入地跟踪随访,发现了斜视矫正术后屈光状态的变化并进行研究.本文对斜视矫正术后眼屈光状态的变化情况、可能的影响因素及发生机制进行综...     

共同性外斜视术后患者的生存质量的变化

目的：评估共同性外斜视患者斜视手术前后的生存质量变化。

方法：通过采用回顾性队列研究方法,随访18～30岁的恒定性的共同性外斜视患者65例。采用成人斜视生活质量评估量表AS-20和健康调查简表SF-36评估共同性外斜视患者术前和术后3mo时的生存质量状态。

结果：共同性外斜视患者术后3mo的AS-20社会心理评分及视功能评分都明显提高,差异均有统计学意义(P<0.01)。共同性外斜视术后3mo的SF-36评分中生理功能评分、生理功能对角色功能的影响评分、健康总体评分、活力评分、社会功能评分、情绪对角色功能的影响评分、精神健康评分及总体评分与术前相比均有明显改善,差异均有统计学意义(P<0.01),而躯体疼痛评分与术前相比,差异无统计学意义(P>0.05)。

结论：斜视手术有助于改善共同性外斜视的生存质量。临床上,应重视运用生存质量评估指导斜视的治疗。     

共同性斜视再手术原因分析

目的探讨共同性斜视再次手术原因及手术方式。方法对近5年来在我院住院手术的1329例共同性斜视患者进行回顾性分析,其中42例因各种原因再次手术。结果 22例患者因手术欠矫或术后眼位回退再次手术,其中内斜视4例,外斜视18例2;0例因过矫再次手术,其中内斜视12例,外斜视8例。结论共同性斜视患者双眼视功能是否正常、是否伴有弱视、术前斜视度测定是否准确、斜视类型、手术者临床经验等都是斜视再次手术影响因素。     

间歇性外斜视诊室检查技术

<正>间歇性外斜视是临床最常见的外斜视类型。该病发病早,由于融合功能的减退,患者会逐渐丧失双眼视功能并有发展为恒定性斜视的可能;随着年龄增长,间歇性外斜视对患者及其父母生活质量的负面影响将逐渐增大,患者的日常生活及社会活动因此不同程度受限,进而导致一系列社会心理问题。间歇性外斜视是介于外隐斜与恒定性外斜视之间的一种斜视,视轴常常分开,当看远时,融合性散开幅度超过融合性集合幅度,即产生外斜;而看近视时可保持正位,     

关注斜视对患者生存质量的影响

斜视患者的生存质量状况越来越受到重视,研究发现儿童和成年斜视患者均伴有不同程度的社会心理障碍、视功能异常等显著影响生存质量状况的因素。目前临床上已有经过评估的专用于斜视患者的生存质量评估量表,通过量表评估发现手术后患者生存质量显著改善,量表得分与手术效果显著相关,有研究建议生存质量评估可作为手术后效果的评价手段之一。临床上应更重视患者的生存质量评估,来指导斜视治疗,提高患者满意度。     

Quality of life and cost-utility assessment after strabismus surgery in adults

Purpose  

To understand the functional and psychosocial aspects of strabismus surgery, an evaluation based on the patient’s perspective is essential. In this study, we assessed quality of life and utility in adult patients who had undergone strabismus surgery, and we modeled the cost of providing this intervention in order to calculate the cost-utility of strabismus surgery in adults.     

Adults with strabismus seek surgery for pyschosocial benefits

Background/PurposeThe goal of strabismus surgery is to align the eyes, help eliminate diplopia, and restore and/or expand binocular visual function. Adults with strabismus are subjected to psychosocial prejudices, and many patients seek strabismus correction for these reasons.MethodsA surgical audit was performed on 91 adult patients, by a singular surgeon. The type of strabismus, preoperative measurements, and indications for surgery were obtained from the patient notes, as were all final outcomes. Final measurements, on average, were taken at 16 weeks postoperatively, and patients were asked to comment subjectively on their outcome.ResultsThe majority of patients were seeking surgery for combined psychosocial and cosmetic reasons (78.4%), or combined psychosocial and functional indications (9.6%), whereas the remainder were seeking surgery for functional indications only. Eighty-three percent of patients reached the desired surgical outcome of <10 prism dioptres; 97.6% were satisfied or very satisfied with their surgery, with the remaining patients having a neutral standpoint, and none were dissatisfied.ConclusionAdult strabismus surgery is highly successful and provides patients with a good level of satisfaction. Many patients seek surgical correction for cosmesis and psychosocial benefits.     

Social and emotional impact of strabismus surgery on quality of life in children.

PURPOSE: Improved quality of life after strabismus surgery has been demonstrated in adults, but has not been extensively studied in children. The purpose of this study was to evaluate the psychosocial effects of childhood strabismus surgery. METHODS: This was a prospective interventional study. A modified version of the RAND Health Insurance Study quality of life instrument was administered to parents or guardians of children with strabismus. The questionnaire was administered by telephone interviews conducted by trained staff before and 2 months after corrective surgery. RESULTS: Ninety-eight children with a mean age of 4.5 (+/-3.3) years were studied. Reliability measures (Cronbach's alpha coefficients) indicate that the questionnaire has good internal consistency (alpha > 0.7 in most subscales). Compared with before surgery, significant improvements were noted after surgery, especially within the functional limitations (paired Student's t -test, P = 0.01), social relations ( P < 0.01), general health perceptions ( P < 0.01), and developmental satisfaction ( P < 0.01) subscales. CONCLUSIONS: Parental proxies can provide meaningful measures of children's response to strabismus surgery. Statistically significant improvements were observed in social, emotional, and functional measures of the children's health status. As previously documented for adults, this study shows that psychosocial benefits afforded by strabismus surgery also contribute to an improvement in quality of life for children.     

The impact of strabismus on quality of life in adults with and without diplopia: a systematic review

Strabismus affects approximately 4% of the adult population and can cause substantial physical disturbance and changes to appearance. This article aims to examine the impact of strabismus in adults both with and without diplopia, focusing primarily on quality of life (QoL). We highlight the value of measuring QoL, assess the ways in which it can be measured, and the impact the disease, diplopia, and surgery have on the patient. QoL differs for strabismus patients based on their diplopia status. Patients with diplopia tend to have more concerns relating to functional QoL, whereas patients without diplopia have primarily psychosocial concerns. Two diplopia-specific questionnaires have been designed to assess QoL and the perceived severity of symptoms. Further research is needed to identify the variables which influence QoL so that appropriate support can be given to all patients with strabismus to improve their QoL.     

The impact of strabismus on psychosocial heath and quality of life: a systematic review

Strabismus can hinder an individual's ability to perform daily functions and negatively affect their well-being. I examine the impact strabismus has on psychosocial health and quality of life in children and adults and evaluate the challenges confronted by parents of children with strabismus. Numerous misconceptions exist regarding the impact strabismus has on overall health. Negative attitudes persist toward those affected, resulting in difficulties with self-image. Individuals with strabismus are at increased risk for both visual system and psychiatric disorders. Misinformation regarding available treatment options for children and adults with strabismus continues to exist, resulting in decreased access to care. Improved education of health care providers can increase appropriate referrals and initiation of treatment. Treatment of strabismus is not merely cosmetic and has the potential to improve psychosocial health and quality of life for children and adults with and without diplopia.     

Quality of life in adult intermittent exotropia and the risk factors

AIM: To study the quality of life of adult patients with intermittent exotropia(IXT) in China and analyze the factors affecting the quality of life in IXT patients.METHODS: Total y 109 cases of normal eye(control group), 77 cases of IXT(IXT group) and 115 cases of strabismus control group(except IXT) were collected. The quality of life of the patients was assessed by Chinese version of adult strabismus patient’s quality of life scale(CAS-20). The differences of general characteristics, visual function and quality of life were analyzed, and the effects of individual factors and visual function on quality of life of patients with IXT were analyzed.RESULTS: The IXT group had a high proportion of patients with family history, low proportion of patients with amblyopia compared with strabismus control group. The proportion with normal near and far stereopsis of IXT group were lower than that of normal control group. The best corrected visual acuity of IXT group was higher than that of strabismus control group, but lower than the control group. In addition, the median strabismus degree in IXT group was higher than that in other strabismus control group. The median psychosocial scores and median visual function scores of the IXT group was lower than that of the normal control group, but not different from strabismus control group. Occupation status, course of disease, far stereopsis and near stereopsis significantly affected the quality of life in IXT patients.CONCLUSION: Adult IXT patients in China have a certain proportion of family history and lower quality of life, The main factors affecting the quality of life of IXT patients is stereopsis, course of disease and occupation status.     

Comitant strabismus

A review of the literature on comitant strabismus of the period from April 1999 until April 2000 is presented. A rather new and increasingly important issue is the psychosocial aspect of strabismus. Two studies have demonstrated that strabismus creates a significant negative social prejudice on the patients and that it can significantly reduce an applicant's ability to obtain employment. Subsequently, strabismus surgery can no longer be called "cosmetic". Concerning the timing of surgery in congenital esotropia, it was reported that early surgery does not ensure continued alignment, but frequently requires additional operations. The increased risk of early-onset strabismus in prematurely born children was confirmed by several studies, and the importance of regular ophthalmologic controls of all preterm infants screened for retinopathy of prematurity was stressed. It was reported that risk factors are cicatricial retinopathy of prematurity, refractive error, family history of strabismus, and poor neurodevelopmental outcome, rather than low gestational age and regressed acute retinopathy of prematurity. A number of other aspects of interest concerning exotropia, esotropia, and dissociated vertical deviation are presented in this review.