LASIK治疗小儿屈光参差性弱视初步报告

目的探讨用LASIK治疗小儿屈光参差性弱视的可能性.方法对1 7例4～1 2岁的屈光参差患儿进行LASIK手术治疗,术前屈光度从+5.50～-11.00D不等,且两眼屈光参差超过5D.对屈光度较大的患眼施行手术.手术在表面麻醉或基础麻醉下施行,术后再进行弱视治疗.结果经术后6～13个月随访,17眼裸眼视力均较术前提高,6眼裸眼视力超过术前矫正视力,7眼达术前矫正视力;12眼屈光度在±1.00D之间.结论对屈光参差性弱视小儿施行LASIK,可矫正屈光不正,提高视力,为弱视治疗提供保障.     

早期老年性白内障患者视力和屈光变化观察

目的 探讨早期老年性白内障患者的视力和屈光状态。方法 47例确诊为早期老年性白内障视力下降患者，作仔细眼部和屈光状态检查，并矫正其视力。结果 裸眼视力随年龄的增长下降愈明显，通过扩瞳验光，矫正视力≥0.6者77只眼(81．9％)与裸眼视力≥0．6者27只眼(28．7％)相比，本组病例的矫正视力有显著提高。结论 早期老年性白内障患者，可通过矫正屈光不正提高视力。     

虹膜夹持型前房人工晶状体植入矫正超高度近视

目的 探讨虹膜灾持犁前房人工晶状体植入矫正超高度近视的临床效果.方法 对10例(19眼)超高度近视(-15.50D～-30.00D)进行虹膜央持犁前房人工晶状体(AMO)植入术,观察手术前后屈光状态、裸眼视力、眼压、瞳孔形态、角膜内皮细胞计数及人工晶状体位置.结果 19眼超高度近视通过植入虹膜夹持型前房品状体,全部达到术前最佳矫正视力,其中18眼超过术前最佳矫正视力1～3行.术前裸眼视力0.02～0.1,术后裸眼视力0.3～1.0.1眼因虹膜弹性差,术后发生瞳孔轻度变形人工晶状体前倾,手术后复位,其余患者均无特殊.结论 作为屈光性手术的虹膜夹持型前房人工晶状体植入术,用于矫正超高度近视,可获得满意的临床效果.由于其具有术后视力恢复迅速、屈光度稳定、并发症较少并且具有良好的可预测性的特点,所以是目前不宜行准分子角膜屈光手术的超高度近视的一种有效的手术矫正方法.     

超高度近视LASIK后视力及屈光变化

为观察超高度近视准分子激光原位角膜磨镶术 ( L ASIK)后 ,裸眼视力、矫正视力及屈光状态的变化规律 ,对治疗的 5 8例10 9只超高度近视眼 ( - 12 .0 0 DS以上 )定期观察裸眼视力、矫正视力及屈光状态。结果 :L ASIK手术后在六个月内平均裸眼视力逐渐下降 ,平均最佳矫正视力略呈上升趋势 ,屈光回退加重 ,屈光回退与术前屈光状态无直线相关。结论 :L ASIK手术治疗超高度近视安全有效 ,但预测性及稳定性略差。手术方法、术前拟矫正量的调整及计算机切削程序有待进一步改进。     

老年性白内障的屈光状态及矫正视力

本文对130例(251)眼老年性白内障患者作了屈光与视力矫正。发现93%的受检眼矫正后视力提高,提高0.3以上者占70.12%,提高0.5以上者占36.25%;裸眼视力≤0.3的107眼中,82眼(76%)矫正后视力≥0.4,皮质型白内障者远视较多,核型白内障者近视较多。混合型白内障者散光较多,白内障越重。屈光不正度数越高。     

LASIK矫正成人近视性屈光参差疗效分析

目的:探讨成人近视性屈光参差的病因,观察准分子激光原位角膜磨镶术(laser in situkeratomileusis,LASIK)矫正近视性屈光参差的临床疗效。方法:根据屈光度将104例208眼成人近视性屈光参差患者的双眼分为高度数组和低度数组,对186眼施行LASIK手术,采用术后6mo随访信息,对其手术前后的平均屈光度、屈光参差的程度、裸眼视力、最佳矫正视力和眼轴等进行比较分析。结果:LASIK术后6mo,所有术眼的裸眼视力均明显提高,屈光参差的程度明显减小;最佳矫正视力保持不变,或较术前有不同程度的提高。术前两组间比较角膜曲率无明显差异,而眼轴有明显差异。同一眼术前、后角膜曲率变化明显,眼轴无明显变化。结论:成人近视性屈光参差(>2.50D)主要是由于双眼轴发育不均衡造成的眼轴的参差。LASIK矫治成人近视性屈光参差安全、有效、预测性好,是此类患者提高裸眼视力及矫正视力,改善屈光参差的首选方法。     

Acrysof ReSTOR多焦点人工晶状体植入眼 阅读视力的临床研究

目的 比较植入多焦点人工晶状体(MIOL)与单焦点人工状晶体(SIOL)患者术后视力和阅读视力的差异,评价多焦点人工晶状体植入的有效性及优越性.方法 将74例(120只眼)老年性白内障患者按自愿选择的原则分为两组,每组60眼,行超声乳化白内障吸出术,MIOL组植入Alcon Acrysof ReSTOR多焦点人工晶状体,SIOL组植入Alcon Acrysof Natural单焦点人工状晶体.术后3个月对裸眼远视力、最佳矫正远视力、裸眼近视力、最佳矫正近视力,最佳矫正远视力下的近视力、63 cm和100 cm中视力、裸眼阅读视力、矫正近视力下阅读视力和矫正远视力下阅读视力等视功能进行检查.结果 两组裸眼远视力、矫正远视力及矫正近视力无明显差异(P＞0.05);裸眼近视力、矫正远视力下近视力、63 cm和100 cm中视力,MIOL组明显优于SIOL组(P＜0.05);植入MIOL眼裸眼阅读视力和矫正远视力下阅读视力均优于植入SIOL眼,裸眼近视力与裸眼阅读视力,矫正远视力下近视力与矫正远视力下阅读视力间分别存在直线相关关系( r1=0.802,r2=0.816);直线回归方程为:Y1=3.995+13.522X1(P＜0.05),Y2=3.696+13.122 X2 (P＜0.05)(X1=裸眼近视力,Y1=裸眼阅读视力;X2=矫正远视力下近视力,Y2=矫正远视力下阅读视力).结论 MIOL植入有效而优越,可以提供与SIOL一样良好的远视力,但近视力、中距离视力及阅读视力更好.良好的近视力是阅读视力的基础.     

视网膜调制传递函数测量与屈光不正矫正的关系

目的探讨屈光不正矫正与视网膜调制传递函数测量结果的关系。设计前瞻性非随机自身对照研究。研究对象无其他眼病的单纯性屈光不正者25例50眼。方法受试者首先测量裸眼视力,再分别测量在屈光未矫正、用框架眼镜矫正和用隐形眼镜矫正三种状态下不同干涉条纹视力(0.06、0.1、0.2、0.4、0.6、0.8)的视网膜调制传递函数值(用RM-800视网膜调制传递函数仪)。主要指标视网膜调制传递函数值。结果对于未矫正的屈光不正患者,视力表视力与干涉条纹视力有显著性差异(Z=9.009,P=0.000);对于矫正后的单纯性屈光不正患者,视力表视力与干涉条纹视力无显著性差异(Z=1.009,P=0.317);在屈光未矫正、用框架眼镜矫正和用隐形眼镜矫正三种状态下测得的视网膜调制传递函数值的差异有统计学意义(P﹤0.05),且戴隐形眼镜矫正所测得值略高于戴框架眼镜所测得值。结论干涉条纹视力比视力表视力更能准确反映视网膜-大脑的视觉功能;屈光未矫正进行视网膜调制传递函数的测量将可能出现假阳性,建议测量视网膜调制传递函数时要矫正屈光不正。     

近视屈光度、眼轴、裸眼视力的检测分析

目的　探讨近视眼患者的屈光不正度数、眼轴与裸眼视力的相互关系。方法　按屈光不正度数共分 3组 , 组 71只眼 ,屈光度 - 1.0 0～ 3.0 0 D; 组 86只眼 ,屈光度 - 3.2 5～ 6 .0 0 D; 组 2 4只眼 ,屈光度 - 6 .2 5～ 8.5 0 D。检测近视屈光度、眼轴、裸眼视力。分组进行 t检验 ,总体进行相关分析。结果　中度近视与低度近视的裸眼视力差别有非常显著性 (P <0 .0 0 1) ;高度近视与中度近视的视力 ,差别无显著性 (P >0 .0 5 )。屈光度数与眼轴各组之间均有非常显著性差别 (P <0 .0 0 1)。总体相关分析屈光不正度数与眼轴、裸眼视力之间有非常显著差别 (P<0 .0 0 1)。结论　眼轴越长 ,屈光不正度数越大。裸眼视力与屈光度两者有相关性 ,但并非绝对并行     

准分子激光原位角膜磨镶术治疗近视疗效的相关因素分析

目的:探讨术前角膜厚度、眼压和屈光度等因素对近视准分子激光原位角膜磨镶术疗效的影响。方法:采用LASIK对379例746眼进行治疗。根据术前屈光度进行分组,观察术后裸眼视力与术前角膜厚度、眼压、角膜厚度(CT)/眼压(IOP)比值及屈光度之间关系。结果:术后裸眼视力4.5～5.2,平均4.99±0.11,三组间有显著性差异(P=0.000)。二乘回归和相关分析显示,角膜较厚、眼压较低,即CT/IOP值大,术后裸眼视力较好,二者之间存在正相关;术前眼压与术后裸眼视力之间存在负相关,而术前角膜厚度与术后裸眼视力之间无相关性存在。结论:LASIK治疗近视是一种安全、有效的方法,但欲取得较好疗效,应考虑不同因素如术前角膜厚度、眼压等因素可能造成的影响,尤其是对高度或超高度近视,必要时采取部分矫正屈光力,剩余屈光度日后配戴低度眼镜方法,避免出现术后并发症及屈光回退。     

The Developmental History and an Evaluation of the Queensland Low Vision Care Centre

ABSTRACT: The decisive shift in attitute from partial blindness and conservation of residual vision towards partial sightedness and maximal use of residual vision in the last fifteen years has resulted in low vision care being a relatively new field of particular concern to health care professionals. In Australia, the first multi-disciplinary clinic providing a comprehensive low vision service was established at the Association for the Blind, Kooyong, Victoria in 1972. Since then, a number of low vision clinics in a variety of locations have developed throughout Australia, with the establishment of the Low Vision Care Centre in Brisbane, Queensland occurring in 1979. This paper describes the developmental history of this service and evaluates the comprehensive low vision care which this clinic provides to the Queensland population. The effectiveness and future considerations of this service are also discussed.     

Temporal properties of the visual responses to luminance and contrast modulated noise

Vision is sensitive to first-order luminance modulations and second-order modulations of carrier contrast. Our knowledge of the temporal properties of second-order vision is insufficient and contradictory. Using temporal summation and reaction time paradigms, we found that the type of visual noise (static or dynamic) determines the temporal properties of the responses to luminance and contrast modulations. In the presence of static noise, the temporal responses to both types of modulation of low and higher spatial frequencies were transient. When dynamic noise was used, the temporal responses to luminance and contrast modulations of higher spatial frequencies were sustained. At low spatial frequency, however, luminance modulations elicited transient responses, while contrast modulated dynamic noise produced sustained responses. The reaction times to near-threshold contrast modulations of low spatial frequency were slower than those to first-order patterns and they did not significantly differ at modulations of higher spatial frequency. The results suggest that the temporal characteristics of first-stage linear filters which feed the second-order pathway may determine the temporal responses to contrast modulated noise.     

江苏海门地区重度视力残疾状况调查

目的:调查江苏海门地区重度视力残疾(白内障除外)状况,并分析其中的原因.方法:2009-04/12对海门市视力残疾情况进行全面普查,由经过残疾评定培训的眼科副主任以上医师进行眼科检查,确定残疾等级及主要致盲原因.结果:共检出重度视力残疾3 266例,其中残疾一级2118例,二级1148例;男1308例,女1958例;前三位的致盲性眼病是视网膜色素膜疾病、先天性遗传性疾病、角膜病,分别占31.58%,23.47%,14.49%.结论:视网膜色素膜疾病、先天性遗传性疾病、角膜病是最重要的致盲原因,应该加强早期防治,降低残疾的发生率.     

Vision rehabilitation for Canadians with less than 20/40 acuity: the SmartSight model

Traditionally, vision rehabilitation was directed towards patients who were blind or had very low vision. There is increasing evidence that less severe vision loss is associated with increased risk of falls, hip fractures, medication errors, poor nutrition, reduced physical activity, social isolation, clinical depression, longer hospitalizations, and mortality. The American Academy of Ophthalmology (AAO) 2003 SmartSight initiative in low vision rehabilitation outlined a model of graduated low vision interventions. This paper is a review of the AAO SmartSight model and how it can apply in the Canadian setting. All patients with visual acuity less than 20/40, a scotoma, field loss, or loss of contrast sensitivity would be offered information about available low vision rehabilitation. Eye physicians would be encouraged to communicate with other health care providers to coordinate existing services and integrate graduated services. Enhanced communication among caregivers about the consequences of vision loss, such as depression, falls, and visual hallucinations, could help ensure that all patients who would benefit receive appropriate vision rehabilitation.     

Clinical examination of the chromatic saturation

The attribute of color vision known as ‘saturation’ was studied in the diagnosis of congenital and acquired dyschomatopsias, by means of tests elaborated from the Munsell Book of Color. The results were as follows

1. The desaturated Panel D-15 evidenced the color confusions occurring during dyschromatopsias, at a low level of saturation (Munsell chroma 2), thus allowing early diagnosis of neural and retinal diseases; on account of the test's great sensitivity, it is obligatory that the norms be assessed in relation to the subject's age.

2. The 'New Color Test', in the separation phase, directly evidenced the neutral zone of the dyschromatopsias, thus indicating the axis of the color deficiencies.

3. The New Color Test, in the color classification phase, evaluated the severity of color deficiencies according to the level of saturation.

4. The New Color Test, in the grey classification phase, may give indications as to the luminous relative efficiency curve and lightness discrimination.

5. Some experiments (not yet commercially available) also gave promising results for the evaluation of saturation in daily clinical practice.     

Determinants of the spatial properties of cone-rod interaction

Photopic increment thresholds can be elevated by 0.2-1.9 log units, depending on the diameter of a concentric scotopic background. This cone-rod interaction displays spatial properties that resemble the spatial sensitization (Westheimer effect) observed in the isolated scotopic and photopic systems. This raises the possibility that the spatial properties of the interaction are determined by the same mechanisms or pathways that determine the spatial properties of either scotopic or photopic vision. When annulus backgrounds are used, the spatial properties of interaction match those of the scotopic system but not the photopic system. When disk backgrounds are used, the spatial properties of interaction match those of neither photopic nor scotopic systems. Thus, under some conditions, the scotopic visual system alone is sufficient to determine the spatial properties of cone-rod interaction. Under other conditions, additional complications arise. The results are discussed in terms of the center-surround model that has previously been applied to cone-rod interaction.     

太原市盲校学生视残病因及视力分析

目的:探讨太原市盲校学生视残原因并对其视力作出相应分析,为防治儿童盲提出依据,对该盲校盲童及低视力分班教学可行性进行评估。方法:应用眼科常规检查方法对太原市盲校学生进行全面的眼科检查,全部视力检查结果均为矫正视力,对调查结果进行分析评估。结果:视残主要致病因素为先天性/遗传因素,占总例数的69.9%。前3位病因分别为先天性小角膜小眼球、先天性白内障、先天性眼球震颤。盲校中有可利用残余视力者占总例数的50.4%。结论:先天性眼球异常和遗传性疾病是导致儿童视残的主要原因,考虑是由遗传、先天或围产期的原因所致。对目前尚无法治疗的先天性眼球异常应着重预防,对可治性先天性白内障及先天性青光眼,应不断提高两种常见儿童致盲眼病的手术成功率。盲校中可利用残余视力者超过总例数的1/2,说明盲校的低视力分班教学十分必要。     

An investigation of the optometric correlates of reading disability

The optometric correlates of dyslexia are reviewed. A small study is described that aimed to explore the ophthalmic correlates of reading disability and identify the most appropriate tests for further investigation. Full psychometric data were available for the subjects, most of whom had varying degrees of reading disability. A comprehensive optometric examination was carried out, including several tests of oculomotor performance, two versions of the Dunlop Test, and a test of pattern glare. Certain optometric variables were found to be significandy correlated with the degree of reading retardation, most notably the convergence and accommodative amplitudes. These results were still significant when the effects of intelligence and age were partialled out. Although the sample size limits the interpretation of these findings, several areas and optometric techniques for further investigation were identified.     

Detection of functional vision loss using the Ishihara plates

Many techniques have been described for the detection of functional visual loss. We report four cases in which Ishihara pseudo-isochromatic colour plates gave objective evidence of functional vision loss. In all cases the patients were able to read the first test pattern (No. 12), but could not distinguish any of the following pseudo-isochromatic numbers (plates 2–17). However, they experienced no difficulty in tracing the winding lines (plates 18–24), demonstrating that they in fact had normal colour vision.     

助视器提升低视力患者生活质量

目的：调查低视力助视器（LVAs）在提高低视力患者生活质量方面的有效性。方法：前瞻性临床研究。选取2017年1月至2018年2月在温州医科大学附属眼视光医院就诊的符合低视力诊断标准的患者55例，给患者验配远用、近用助视器。在低视力患者配戴LVAs前和配戴30 d后采用中文版低视力患者生活质量量表（CLVQOL）评估低视力患者的生活质量，问卷内容涉及远视力、移动和光感，心 理调节能力，阅读和精细工作能力及日常生活能力。对各组LVQOL评分结果进行配对t检验，对影 响因素进行回归分析。结果：55例低视力患者中，44例完成了基线和随访时的生活质量问卷调查。经过低视力助视器等辅助后，生活质量评分从77.8±19.0上升到82.3±22.5，差异具有统计学意义（t=4.56，P=0.001）。性别、识字率、学习状况和视力等因素不影响低视力患者生活质量。结论：低视力助视器可以提高不同年龄段、不同性别的低视力人群的生活质量。