儿童彩色视力表的研制及应用

目的:研制一种儿童彩色视力表,并探讨其应用效果。方法:视力表设计采用视角原理,用彩色图形视标,各行视标间增率以几何级数(10槡10),即1.2589增加。11个彩色图形,共8行,检查距离3m,视力记录为五分记录和小数记录。以标准对数视力表为对照,用新的儿童彩色视力表检查4~6岁儿童100眼。结果:儿童彩色视力表和E字对数视力表检查,两组视力检查结果差异无统计学意义(t=1.2671,P>0.05),两组视力数据存在正相关(r=0.924,P<0.01)。合作率100%,对视标的识别率90%以上。结论:儿童彩色视力表儿童容易接受,具有可靠性,适用于儿童视力的检查。     

低视力对数视力表的研制

目的 :研制一种适合我国眼科临床使用的低视力对数视力表。方法 :根据Baily Lovie的LogMAR视力表和我国标准对数视力表的设计标准和原理设计 ,1分视角为 1.0视力 ,视标的增率为 10 10 ,视标的间距和行距与我国标准视力表相同 ,E字母设备 ,每行视标个数与Baily Lovie的视力表一致。为了与低视力分级标准一致 ,采用小数记录。结果和结论 :低视力对数视力表 ,设计合理 ,检查低视力的范围大 ,将应用于我国眼科临床     

三种视力表视力测量差异研究

目的:探讨mc-3投影式视力表(A)、普通箱式视力表(B)以及综合验光仪(C)对不同年龄段人的裸眼视力及校正视力的测量结果是否有差异.方法:志愿者206人(395眼),根据患者年龄分为3组:青年组:25～45岁,共116眼;中年组:46～70岁,共102眼;老年组:71～90岁,共177眼.用视力表投影仪、普通箱式视力表以及综合验光仪分别测量各志愿者的裸眼视力及矫正视力.结果:矫正视力:3组中均无差别.裸眼视力:青年组、中年组中无差别.老年组中综合验光仪的视力测量结果要好于视力表投影仪和视力了表箱,差别具有显著性意义(秩和检验P＜0.05).结论:在老年组的裸眼视力测量结果中,综合验光仪好于视力表投影仪和视力表箱,这种视力测量的差异可能足由于不同背景亮度及视标照度下视标的对比度不同所引起.     

Lea图形与HOTV字母视力表对3～4.5岁儿童视力检查的比较

目的:比较分析Lea图形与HOTV字母视力表在3~4.5岁学龄前儿童视力检查中的适用情况及视力发育情况。方法:采用调查研究,以随机顺序先后应用两种视力表对广州地区两所幼儿园共133例266眼进行视力检查,视力值及其差异均用logM AR记录方法表示。结果:Lea视力较HOTV视力总体可测率高(96.24%vs92.48%),但差异无统计学意义(P>0.05)。儿童单眼两种视力差异均无统计学意义(右眼t=0.517,P=0.606;左眼t=-0.618,P=0.538)。儿童左右眼之间的视力差异均无统计学意义(Lea视力表:t=0.638,P=0.525;HOTV视力表:t=-0.897,P=0.372)。男性儿童的两种视力均优于女性儿童,但差异无统计学意义(均P>0.05)。3岁、3.5岁、4岁、4.5岁四个年龄组单眼的两种视力检查结果显示,儿童的视力随年龄增长逐渐提高,但四个年龄组间Lea视力差异无统计学意义(右眼:F=2.662,P=0.052;左眼:F=1.850,P=0.143),HOTV视力差异具有统计学意义(右眼:F=4.518,P=0.005;左眼:F=3.893,P=0.011)。结论:两种视力表都适合于3~4.5岁学龄前儿童的视力筛查;3~4.5岁儿童单眼的两种视力结果相似;视力发育与眼别、性别均无关;年龄大于3岁的儿童基本都可以接受主观视力检查,且在学龄前早期主观视力发育较快。     

低视力对数视力表在严重弱视儿童视力评价中的应用价值

目的 :应用低视力对数视力表评价严重弱视患儿的疗效。方法 :研究对象是初诊时矫正视力≤ 0 .1的 12例患儿 ,年龄 3～ 5岁 ,其中远视性屈光参差性弱视 11例 ,斜视性弱视 1例。采用由刘晓玲等设计的低视力对数视力表 ,进行矫正远视力评价。治疗采用以遮盖和矫正为主的综合治疗。结果 :12例患儿治疗前矫正视力为 0 .0 4～ 0 .0 8,视功能训练后视力提高 2行或 2行以上的有 10例 ,只有 3例 3眼视力超过 0 .1。但是 ,医师、患儿及家长由此得到了较大的鼓舞 ,积极参加进一步的训练。结论 :虽然严重弱视儿童的视力预后比较差 ,但是使用低视力对数视力表评价以后 ,低于 0 .1的视力也能够被精细测量 ,短时间的治疗已经证明多数儿童视力有 2行以上的提高 ,且得到家长的理解和儿童的配合     

ETDRS对数视力表在儿童视力检查中的可重复性分析

目的：探讨ETDRS对数视力表对儿童视力检查的可重复性及其影响的相关因素。方法：在流行病学调查的过程中，随机使用ETDRS对数视力表，为250位裸眼视力低于0．5和98位视力正常儿童进行裸眼视力重复检查。结果：两次视力测量之间差异的均数为0．004log±0．07；Kappa分析结果具有很好的一致性（k=0．71）；性别与视力检查一致性无明显相关（P=0．845）；年龄与视力检查一致性有显著相关性（P=0．019），年龄越小视力检查一致性越差；屈光不正与视力检查一致性也有显著相关性（P=0．000），近视度数在-1．00D—-5．00D之间的儿童视力检查一致性相对差．而正视眼的视力检查一致性较好。结论：结果提示ETDRS对数视力表适合儿童视力检查，建议推广使用。眼科学报2008；24：48-52．     

低视力儿童的视力特点

本文对１１５例低视力儿童的裸眼视力、矫正视力及戴用助视器后视力进行了分析，认为低视力儿童的视力特点是以一级低视力为主；虽然视力低下，但验光配用普通眼镜后仍可增进部分视力；戴用低倍数、简单的远用助视器就可使大部分人提高到有用视力（０．３）。患者的裸眼近视力相对较好，近一半人具备阅读视力（０．４），配用近用助视器的需求相对较少；使用双目助视器后，双眼远视力较单眼视力在视力表上有１行或１行以上提高者仅占３４．５％，说明并不是所有低视力儿童都适宜配用双目助视器。此外，通过随访还发现低视力儿童的另一特点是视力相对稳定。     

拥挤Kay图片视力表在学龄前儿童视力筛查中的应用

目的：采用拥挤Kay图片视力表检测学龄前儿童视力,并和标准对数视力表检测结果进行比较,探讨2种视力表检测结果是否具有一致性,以补充不能完成标准对数视力表检测的学龄前儿童的视力筛查。方法：前瞻性自身对照研究。于2021年1─5月随机选取济南市章丘区某幼儿园152名学龄前儿童进行全面眼科筛查,分别使用拥挤Kay图片视力表及标准对数视力表对其进行视力检测,并采用Wilcoxon检验进行2种视力差异性的比较,Spearman秩相关分析及Bland-Altman分析进行相关性及一致性分析。结果：152名儿童参与筛查,其中129名儿童屈光状态正常且能配合2种视力表检测。129名儿童中男74名,女55名,年龄为（52.3±7.0）个月;拥挤Kay图片测得LogMAR视力为0.10（0.09,0.10）,标准对数视力表视力为0.10（0.10,0.22）;2种视力检查方法有较好的相关性（r=0.436,P<0.001）,拥挤Kay视力表检测结果略高于标准视力表约0.04 LogMAR,差异有统计学意义（Z=-6.124,P<0.001）,Bland-Altman散点图显示98.4%的点均在一致性范围内;参与筛查儿童Kay图片视力检查配合度更高（χ2=18.007,P<0.001）。不同月龄拥挤Kay图片视力检测结果差异有统计学意义（H=13.791,P=0.003）,随年龄增长,视力呈递增趋势。结论：拥挤Kay图片视力表用于学龄前儿童视力检测,患儿配合程度高,其结果与标准对数视力表相比有较好的一致性,但Kay图片视力表所检查的视力结果高于标准视力表约0.04 LogMAR,在参考视力结果时应相应调整视力标准。     

使用计算机致调节不足伴假性近视一例

患者男性,10岁,因远近视力均下降2周、看书写字困难而就诊。近2周每天使用计算机约10小时。家族史:母亲近视1.00D。检查:右眼裸眼视力0.8,左眼0.7,近视力右眼0.5,左眼0.6(徐广第近视力表)。眼部检查无明显异常。验光:因患者要继续回学校上课,显然验光:右眼 0.25DS-0.5DC×170=1.0,近视力0.5;左眼 0.5DS-0.75DC×10=1.0,近视力0.6。单眼调节力测量:近视力表置于眼前33厘米处,当近用附加镜度增加至1.5D时,左右眼分别可以辨认0.9的视标,继续增加近附加镜度近视力不提高,即两眼调节幅度均为1.5D。采用Nidek公司ARK-730型调节测量仪(内置软…     

灯箱视力表与电脑视力表临床应用对比研究

目的:通过与灯箱视力表的对比研究了解电脑视力表的临床使用价值。方法:选取初三学生63例(126眼)同时用灯箱和电脑视力表进行远用视力检测,对视力检测值进行配对检验。结果:两种视力表检测值的t检验等于1.2671,P>0.20,两种视力表的检测在统计学上无显著性差异。结论:电脑视力表和灯箱视力表在临床上具有相同的应用价值,可以推广和普及。     

视力表的历史、现状与发展趋势

视觉是人类最重要的感觉之一。视锐度反映了视觉系统辨别空间细节的能力,是临床实践中最常用的视功能评估指标。视力表是使用最广的视锐度测量工具。笔者回顾了国内外视力表的发展历程,简述了早期糖尿病视网膜病变治疗研究视力表和标准对数视力表的设计原理和计分规则。由于传统视力表自身的精度限制,其在视力普查和儿童青少年近视防控工作中的局限性也日益凸显,电子视力表代替传统视力表正逐渐成为趋势。笔者分析了当前不同电子视力表的硬件特性、软件算法逻辑和测量结果,发现显示屏的分辨率和尺寸、程序的测量和计分规则等多种参数设置的不统一可能会造成不同设备测量视力的结果不具有可比性。研发规范化的新型电子视力表势在必行。     

Comparison of visual acuity estimates using three different letter charts under two ambient room illuminations

Background:

Visual acuity is an essential estimate to assess ability of the visual system and is used as an indicator of ocular health status.

Aim:

The aim of this study is to investigate the consistency of acuity estimates from three different clinical visual acuity charts under two levels of ambient room illumination.

Materials and Methods:

This study involved thirty Malay university students aged between 19 and 23 years old (7 males, 23 females), with their spherical refractive error ranging between plano and –7.75D, astigmatism ranging from plano to –1.75D, anisometropia less than 1.00D and with no history of ocular injury or pathology. Right eye visual acuity (recorded in logMAR unit) was measured with Snellen letter chart (Snellen), wall mounted letter chart (WM) and projected letter chart (PC) under two ambient room illuminations, room light on and room light off.

Results:

Visual acuity estimates showed no statistically significant difference when measured with the room light on and with the room light off (F_1,372 = 0.26, P = 0.61). Post-hoc analysis with Tukey showed that visual acuity estimates were significantly different between the Snellen and PC (P = 0.009) and between Snellen and WM (P = 0.002).

Conclusions:

Different levels of ambient room illumination had no significant effect on visual acuity estimates. However, the discrepancies in estimates of visual acuity noted in this study were purely due to the type of letter chart used.     

Habitual visual acuity in a large urban cohort of Western India and factors influencing poor habitual vision

Purpose:The aim of this study was to determine habitual visual acuity (HVA) in a large urban cohort in western India and identify factors associated with poor HVA.Methods:This was a prospective study conducted over 10 days in September 2018 to assess the HVA in individuals attending a 10-day festival in Western India. Participants who volunteered to undergo vision screening and also filled the questionnaire form pertaining to demographic information including their age, gender, address, income, and educational status were included in this study. HVA was recorded with the distance correction that the participants were wearing when they attended the screening. The study evaluated the prevalence of visual acuity 6/6 or <6/6, 6/12, and 6/18 and the factors associated with lower visual acuity.Results:Of the 6300 participants, 1660 (26.3%) were females. Majority of the participants were from urban background (6084, 96.6%) and were of younger age group (18–40 years––3786, 60.1%; 41–60 years––2187, 34.7%; >60 years––327, 5.2%). HVA was recorded as 6/6 both eyes in 4136 (65.6%), at least 6/12 both eyes in 5691 (90.3%), and at least 6/18 both eyes in 5974 (94.8%) individuals. Only 11 patients (0.17%) had VA worse than 6/60 with only 3 patients (0.003%) having bilateral VA <6/60. Older age, female sex, lower education status, and low annual income were significant risk factors for poor HVA.Conclusion:Poor education, lower income, female gender, and old age are significantly associated with poor HVA even in urban Western India despite relatively easy access to affordable eye care facilities.     

Changing from Snellen to LogMAR: debate or delay?

Visual acuity is the most commonly used test to assess visual function. The Snellen chart is the universally accepted tool for testing visual acuity despite its poor reliability and reproducibility. Newer logMAR charts are now available that have negated the disadvantages of the Snellen chart. However, these charts are not being used regularly in daily practice. This article discusses the reasons for the delayed acceptance of the logMAR chart.     

儿童图形视力表与Teller视敏锐度卡在婴幼儿视力检测中应用分析

目的 探讨儿童图形视力表、Teller视敏锐度卡在婴幼儿视力检测中的可行性和可靠性.方法 对2010年1～12月在北京同仁医院眼科斜弱视门诊就诊的185例患儿,分别使用儿童图形视力表检测2～3岁患儿59例118只眼,用Teller视敏锐度卡检测5个月至2岁患儿126例252只眼.每2个月龄为一组,共分为10组进行视力检测,并对其检测结果进行分析评估.结果 应用儿童图形视力表检测视力结果:0.1～0.2者为14.41％ (17/118),0.3～0.5者为64.41％ (76/118),0.6者为21.19％ (25/118);应用Teller视敏锐度卡检测视力结果:13 cy/cm为21.43％ (54/252),4.8～9.8 cy/cm为20.63％(52/252),1.3～3.2 cy/cm为42.86％ (108/252),0.86 cy/cm为10.71％ (27/252),0.43 cy/cm为4.37％(11/252).结论 儿童图形视力表、Teller视敏锐度卡是一种安全、快速、经济、有效地婴幼儿视力评估检测系统,较常规检查能更早地发现低于该年龄段视力发育水平的低常视力,同时可以对眼部先天性疾患的婴幼儿低视力进行早期干预并制定跟踪治疗方案.     

Construction and validation of a Tamil logMAR chart

Purpose:  To design, construct and validate a new Tamil logMAR visual acuity chart based on current recommendations.
Methods:  Ten Tamil letters of equal legibility were identified experimentally and were used in the chart. Two charts, one internally illuminated and one externally illuminated, were constructed for testing at 4 m distance. The repeatability of the two charts was tested. For validation, the two charts were compared with a standard English logMAR chart (ETDRS).
Results:  When compared to the ETDRS chart, a difference of 0.06 ± 0.07 and 0.07 ± 0.07 logMAR was found for the internally and externally illuminated charts respectively. Limits of agreement between the internally illuminated Tamil logMAR chart and ETDRS chart were found to be (−0.08, 0.19), and (−0.07, 0.20) for the externally illuminated chart. The test – retest results showed a difference of 0.02 ± 0.04 and 0.02 ± 0.06 logMAR for the internally and externally illuminated charts respectively. Limits of agreement for repeated measurements for the internally illuminated Tamil logMAR chart were found to be (−0.06, 0.10), and (−0.10, 0.14) for the externally illuminated chart.
Conclusions:  The newly constructed Tamil logMAR charts have good repeatability. The difference in visual acuity scores between the newly constructed Tamil logMAR chart and the standard English logMAR chart was within acceptable limits. This new chart can be used for measuring visual acuity in the literate Tamil population.     

视觉评估领域的SLCT和锥细胞对比敏感度测试的临床应用分析

目的：描述新的对比敏感度及色觉检查的原理及其临床应用。方法：对比敏感度用SLCR来评估。SLCT是由几行大小不变(20／25)，但对比度逐渐降低的字母组成的对比敏感度表。色觉以锥细胞的对比敏感度来评估，这是一种视屏测试方法，每一个字母都代表三种视锥细胞中的一种类型(红、绿或蓝)，对比度逐渐降低，分别确定分辨的阈值。测试对象分别为正常受试者以及有眼部疾病的患者。结果：SLCT在检查微小的离焦量以及早期眼部疾病方面比传统的检查具有更大的优势。锥细胞对比敏感度测试比传统的色觉检查敏感性高，不仅可以揭示遗传性色觉异常的类型及其严重程度，而且可以发现不同疾病造成的敏感度的下降。结论：这些新的方法拓展了视觉评估领域，揭示了人眼分辨力的微小变化，提示了遗传性、获得色觉异常眼病的类型和严重程度。     

The measurement of visual acuity in children: an evidence‐based update

Over the past decade, a number of large clinical trials have provided important information relating to the reliability and repeatability of commonly used paediatric tests of vision and their role in the diagnosis and management of paediatric ocular diseases. The aim of this review is to summarise recent findings on the use of paediatric visual acuity tests in clinical practice and to discuss the validity and accuracy of visual acuity measurements in infants and young children. We provide a broad overview of the benefits and challenges of measuring visual acuity in children and then discuss age‐appropriate tests for measuring visual acuity in infants through to school‐age children. We also discuss normative values for visual acuity in each age group and, where possible, provide comparisons of results between tests with a particular focus on the importance of optotype design.