26例复视患者的双眼视觉

目的了解复视患者双眼视觉的特点。方法采用同视机及立体视觉检查图检测复视患者的双眼视觉,记录结果并进行统计学分析。结果复视患者都可以查到异常的重合点,水平复视和垂直复视的水平融合范围均小于正常的融合范围,差异均有显著性意义(P<0.05);复视患者都可以查到周边立体视:用同视机检查可以查出三级功能而用立体视觉检查图则查不到近立体视。结论复视患者可能存在有三级双眼单视功能。     

斜视弱视患者的双眼视觉状况及其矫治

本文在复习正常双眼视觉的概念及检查双眼视觉的常用方法和双眼视觉正常范围的基础上,介绍了单眼深度感知和双眼立体视觉近年来神经生理学及神经解剖学的研究进展,即单眼深度线索和双眼深度线索获得的深度感知在顶叶皮层的CIP区（顶尾侧）被整合,强调了单眼及双眼均可感知立体视觉。重点阐述斜视、弱视患者双眼单视及双眼立体视觉受到损害的状况,以及应用脱抑制训练、融合训练、立体视训练等方法矫治双眼视觉缺陷的结果。     

Binocular vision in concomitant strabismus

It was discovered that in a small angle concomitant squint there occurs a kind of binocular vision maintained by abnormal retinal correspondence. This phenomenon may be discovered by a campimetric examination, by VEP and by other psychophysical tests. There appear accomodational movements which tend to maintain a stable angle of deviation which enables a binocular vision. Analysis of these movements is presented.     

不同年龄组的间歇性外斜视术后双眼视觉恢复

目的:探讨间歇性外斜视患者手术前后双眼视功能的临床早期变化规律,对选择合理的手术时机和双眼视功能预后做出合理的判断提供帮助。方法:选择在斜视矫正术后获得眼正位90例间歇性外斜视患者作为研究对象,双眼裸眼视力或矫正视力均≥0.9,无明显屈光参差者。按接受手术年龄分为三组:A(3～5岁),B(6～8岁),C(≥9岁)3组,每组30例。三组平均发病年龄分别为3.20±1.20,3.80±1.50和4.08±1.78岁;病程分别为2.15±1.45,3.42±2.42和6.80±5.10a;斜视度分别为30.50±5.50,47.50±12.56和63.25±13.80。采用三棱镜加遮盖法检查6m及33cm的远近斜视度,以三棱镜度记录;颜少明《立体视觉检查图》检查近立体视;同视机检查远立体视。术后2,4,6wk随访。结果:三组术前平均发病年龄的差异无显著性意义(P>0.05),病程、斜视度数的差异有显著性意义(P<0.01)。术后观察6wk,双眼视觉功能与术前比较,差异均有显著意义(P<0.01)。结论:间歇性外斜视患者的发病年龄、手术年龄、病程与术后双眼视觉的恢复、重建及功能治愈有密切关系,发病年龄越早,病程越长,对双眼视觉损害就越大,术后恢复越差,双眼视觉的恢复和重建及功能治愈所需时间长。视觉发育成熟后(≥9岁)行斜视手术,术后双眼视觉恢复慢,所需时间长。     

Intractable diplopia after vision restoration in unilateral cataract

Twenty-four patients lost their ability to fuse when their binocular function was disrupted for at least 2 1/2 years by a unilateral traumatic cataract or a unilateral traumatic cataract followed by uncorrected aphakia. Three patients were 6 years old, one was 8 years old, and the remaining 20 patients were aged 10 years or older at the time of the injury. All patients had intractable diplopia when the cataract was removed and the aphakia corrected. Aniseikonia was not the cause of this inability to fuse and the insertion of an intraocular lens provided no relief. The prognosis for the elimination of diplopia, other than by occlusion of one eye, was poor.     

Binocular vision following posterior chamber lens implantation

Binocular vision was tested in 106 pseudophakic patients 1 week after unilateral implantation of a Simcoe posterior chamber lens with 10 degrees angled haptics. Binocular functions are resumed immediately after surgery. Visual acuity, or rather the difference in visual acuity between the right and left eyes is mainly responsible for the quality of binocular vision. Heterophoria, anisometropia, and aniseikonia are less important.     

Results of diplopia and strabismus in patients with severe thyroid ophthalmopathy after orbital decompression

Purpose:

It has been frequently stated that the orbital decompression, in patients with thyroid ophthalmopathy, does not usually improve extraocular muscles function and that after the operation there is often a deterioration of these functions. The purpose of this article is evaluation of extraocular muscles function after applying personal method of 3 wall orbital decompression.

Materials And Methods:

Retrospective review of case records of 119 patients with severe thyroid ophthalmopathy seen and treated by the author between December 1986 and December 2010. All patents underwent 3 wall orbital decompression combined with removal of the periorbital, intraorbital and retrobulbar fat. Correction of coexistent eyelid retraction and deformities were also performed.

Results:

Comparison of preoperative and postoperative results was conducted in 65 patients three months after 3 wall decompression. All patients showed a significant reduction of exophthalmos [5-11 mm, 7.2 mm on average], reduction of intraocular pressure, marked improvement in ocular muscle function as well as considerable reduction in or disappearance of subjective symptoms. There were no cases of subsequent impairment of ocular motility. Strabismus surgery was performed in 6 patients with residual diplopia. There was an improvement in vision in 68% patients who had impaired vision before the operation. Less evident relapse of exophthalmos was recorded in 3 cases only and only one patient required unilateral reoperation.

Conclusion:

It can be concluded that this method of orbital decompression is logical, based on an understanding of the pathology, has less complication rates, is relatively easy to perform, gives very good functional and aesthetic long term results and allows rapid recovery.     

The role of vergence adaptation in recovery of binocular single vision (BSV) following sensory strabismus

Vergence adaptation is an important element of comfortable binocular single vision and probably contributes to the high incidence of orthophoria or small angles of heterophoria in the normal population. Where binocular single vision has been absent for a period of time, restoration of good visual acuity appears to enable the vergence adaptation mechanism to become active again. A case is presented in which a moderate to large angle of deviation rapidly `disappeared' once good visual acuity was restored and the disparate images could be fused. Known factors concerning vergence adaptation are discussed in relation to such clinical cases.     

The role of vergence adaptation in recovery of binocular single vision (BSV) following sensory strabismus

Vergence adaptation is an important element of comfortable binocular single vision and probably contributes to the high incidence of orthophoria or small angles of heterophoria in the normal population. Where binocular single vision has been absent for a period of time, restoration of good visual acuity appears to enable the vergence adaptation mechanism to become active again. A case is presented in which a moderate to large angle of deviation rapidly 'disappeared' once good visual acuity was restored and the disparate images could be fused. Known factors concerning vergence adaptation are discussed in relation to such clinical cases.     

后天性共同性内斜视手术治愈后的双眼视觉

目的：探讨后天性共同性内斜视手术治愈后双眼视觉的恢复规律。方法：对40例后天性共同性内斜视经手术治愈后患者的临床资料进行分析。结果：40例后天性共同性内斜视患者术前36例(90％)无双眼视觉。术后40例(100％)具有同时知觉能力，40例(100％)可获得融合功能，但融合范围低于正常人群，26例(65％)获得远立体视，18例(45％)获得不同程度的近立体视。结论：后天性共同性内斜视患者黄斑中心凹立体视损害最严重，对于后天性共同性内斜视的临床处理应更加积极，树立婴幼儿期的持续性内斜应急诊处理的观念，使更多患儿获得良好的立体视觉。