3～6岁儿童视力动态观察

视力测定对研究小儿视觉发育、弱视、斜视和屈光不正有重要意义,2003年9月至2006年9月我们跟踪观察了学龄前儿童在幼儿园3年间的视力变化,以期待对同一样本的儿童视力有个动态了解。     

3～6岁视力低下儿童眼球生物学参数研究

目的 探讨3～6岁视力低下儿童眼球生物学参数特征。方法 回顾性研究。纳入2016年6月至2021年9月于西北妇女儿童医院眼科门诊首次就诊的3～6岁轻度远视性屈光不正儿童197人(197眼),排除眼部器质性病变,按有无视力低下分两组：视力低下组与视力正常组。睫状肌麻痹后检影验光记录球镜屈光度、柱镜屈光度及轴向、等效球镜度(SE)和最佳矫正远视力(BCDVA)。A型超声生物测量仪测量前房深度(ACD)、晶状体厚度(LT)、玻璃体腔深度(VCD)及眼轴长度(AL)。角膜地形图测量角膜平均屈光力(Km),计算角膜曲率半径(CR)及轴率比(AL/CR)。采用SPSS 23.0对数据进行统计学分析。结果 两组儿童年龄、等效球镜度及柱镜屈光度差异均无统计学意义(均为P>0.05)。与视力正常组相比较,视力低下组儿童LT、Km较高,VCD、AL较低,差异均有统计学意义(均为P<0.05),两组间ACD、AL/CR差异均无统计学意义(均为P>0.05)。视力低下组儿童SE与AL、VCD、AL/CR均呈负相关(r=-0.468、-0.448、-0.341,均为P<0.05),与Km...     

学龄前儿童视力普查

为了更好地开展屈光不正、弱视的防治工作 ,使其能够早期发现、早期治疗。笔者对广州 40所幼儿园 12 85 7名 4～6 a儿童进行视力普查 ,对 937例裸眼视力 <1.0者进行屈光检查 ,现将调查结果报告如下。1　资料和方法1.1　一般资料　本组为 1998～ 1999年 2 a间对广州市 40所幼儿园 4～ 6岁 12 85 7名儿童视力检查 ,男 6 6 5 1名 ,女6 2 0 6名。1.2　方法　使用国际标准视力表测视力 ,视力 <1.0者 ,用10 g· L- 1 阿托品点眼 ,每天 1次 ,连续 3d后行检影验光并检查眼前后段。屈光不正者酌情配戴眼镜 ,矫正视力 <0 .9者行弱视治疗。1.3　评价标…     

上海市学龄前儿童视力现况分析

目的了解学龄前儿童视力现况,为儿童眼保健计划提供依据。方法选择上海市具有代表性的三个区部分学龄前儿童（〉3～6岁）进行常规远视力检查,对视力结果按眼别、性别、年龄等进行统计与分析。结果〉3-4岁、-5岁、-6岁视力低常率分别为90．46％、66．99％和36．75％。女性高于男性。以人数计高于以眼数计。不同眼别结果差异无显著性。不同地区视力低常率有显著性差异。视力低常者中,轻度低常占95．57％。结论学龄前儿童远视力普查是儿童眼保健的重要指标,结果受多种因素影响,必须正确分析检查结果。     

广州地区3～6岁学龄前儿童视力发育及屈光状态流行病学调查

目的 了解广州地区3～6岁学龄前儿童的屈光状况及视力发育情况.方法 随机选取广州市不同行政区的10所幼儿园,对其中3～6岁学龄前儿童的屈光状态及视力进行检查.使用1%环戊酮麻痹睫状肌后,进行电脑验光检查,并用带状光检影复查;48 h后使用EDTRS视力表行主觉验光,记录最佳矫正视力.最后按年龄分组,对屈光及视力资料进行one-way ANOVA及Bonferroni统计学分析.结果 共2480名儿童完成检查,其中,3岁组男201例,女172例;4岁组男434例,女384例;5岁组男437例,女410例;6岁组男238例,女204例.各组的平均年龄分别为（43.3±2.8）个月、（53.8±3.3）个月、（65.5±3.4）个月及（75.1±2.6）个月.各年龄组的等效球镜度分别为（1.66±0.70）D、（1.67±0.80）D、（1.59±0.81）D及（1.48±0.72）D,4组之间等效球镜度的差异存在统计学意义（F=12.39.P=0.000）;以Bonferroni法进行两两比较发现,除3岁组与4岁组以及3岁组与5岁组之间差异无统计学意义（P〉0.008）外.其余各组间差异均有统计学意义（P〈0.008）.3岁组、4岁组、5岁组及6岁组的LogMAR视力分别为0.26±0.14、0.18±0.10、0.13±0.08及0.10±0.08,4组之间视力的差异存在统计学意义（F=406.2,P=0.000）;以Bonferroni法进行两两比较发现,任意两组间的差异均有统计学意义（P=0.000）.结论 对于3～6岁学龄前儿童,眼球屈光度向远视减小方向发展符合正视化过程的规律,他们的生理性远视的等效球镜度相差不大,都接近＋1.50 D;同时,视力随年龄增加而逐步提高,提示在弱视诊断时,应该将正常视力发育状况作为参考.     

福州市21952名学龄前儿童视力调查

目的探索学龄前儿童视力低常状况,及弱视患病率,为临床治疗提供依据.方法对福州市3～7岁21952名学龄前儿童进行视力普查,将单眼或双眼视力低于1.0者,通知到门诊复查,将矫正视力＜0.9,定为弱视.结果视力低常与年龄密切相关,患病率14.35%,其中男14.11%,女14.58%;弱视患病率3.38%,各年龄组弱视患病率差异无显著性(P＞0.05);视力低常者屈光不正分布远视81.96%,近视8.43%,混合散光9.61%,三者差异有显著性.结论学龄前儿童年龄越小,视力低常率越高;各年龄组弱视患病率无差异;对3～4岁儿童进行弱视诊断时应注意年龄因素.     

学龄前儿童的条栅视力观察

目的了解婴幼儿条栅视力的发育情况。方法采用电脑控制的闭路式强化优先注视（COPL）系统,以普查的形式进行条栅视力检查,分析本系统与方法的可靠性、成功率及599例2～72个月的正常婴幼儿及学龄前儿童的视力发育趋势。结果所有年龄组2次检测结果均表现出良好的可重复性;此检查方法成功率较高,可达90％以上,体现了COPL系统的强化优先注视的优势。检查中2～12个月和42～72个月的幼儿配合较好,12～42个月的幼儿处于好动状态,配合率略低,但也远高于以往文献报道;随幼儿年龄增加,其条栅视力亦逐渐增加。通过散点图估计发育趋势线图,可见出生后12个月的幼儿视力提高显著,之后条栅视力稳步上升,30～36个月视力变化相对趋于平缓,36个月之后的条栅视力发育进入平台期。结论应用电脑控制的COPL视力检测系统对学龄前幼儿条栅视力检查有较好的临床效果,可有效地应用于学龄前婴幼儿视力发育的研究,了解不同年龄段条栅视力发育的快慢及其发育成熟的年龄和可以发育的最高程度。     

邢台市1219名学龄前儿童视力及立体视调查

目的了解我市学龄前儿童视力、立体视发育情况,及时有效地防治儿童弱视。方法由专门眼科医师对我市1219名学龄前儿童进行视力、立体视锐度检测。结果我市学龄前儿童弱视患病率为8.86%,可疑弱视患病率为26.58%。学龄前儿童有中心凹立体视者占58.41%。结论学龄前儿童进行视力、立体视普查很有必要,对视力低下或立体视检查明显低于同龄人者需密切随访。     

A new specialized visual acuity chart for amblyopic children aged 3-5 years old:development and its clinical applications

AIM: To introduce a new specialized visual acuity chart for amblyopic children aged 3-5 years old and its clinical applications.METHODS:The new visual acuity chart and notations were designed based on Weber-Fechner law. The optotypes were red against a white background and were specially shaped four basic geometric symbols:circle, square, triangle,and cross. A regular geometric progression of the optotype sizes and distribution was employed to arrange in 14 lines. The progression rate of the optotype size between two lines was 1.2589 and the testing distance was 3m. Visual acuity score could be recorded as logMAR notation or decimal notation. Age-stratified diagnostic criteria for amblyopia established by consensus statement on diagnosis of amblyopia (2011) among members of the Strabismus and Pediatric Ophthalmology Group, Ophthalmology Society, Chinese Medical Association (SPOGOSCMA) were illustrated in the new visual acuity chart.RESULTS: When assessing visual acuity in children aged 3-5 years old, this new visual acuity chart that consists of four symmetrical shapes (triangle, square, cross, and circle) overcame an inability to recognize the letters of the alphabet and difficulties in designating the direction of black abstract symbols such as the tumbling ‘E’ or Landolt ‘C’, which the subjects were prone to lose interest in. The visual acuity score may be recorded in different notations:decimal acuity and logMAR. These two notations can be easily converted each other in the new eye chart. The measurements of this new chart not only showed a significant correlation and a good consistency with the international standard logarithmic visual acuity chart (r=0.932, P<0.01), but also indicated a high test-retest reliability (89% of retest scores were within 0.1logMAR units of the initial test score).CONCLUSION: The results of this study support the validity and reliability of distance visual acuity measurements using the new eye chart in children aged 3 to 5 years over a wide range of visual acuities, and the new eye chart is great for early detection of amblyopia. It can be applied in various clinical settings.     

A new specialized visual acuity chart for amblyopic children aged 3-5 years old:development and its clinical applications

AIM: To introduce a new specialized visual acuity chart for amblyopic children aged 3-5 years old and its clinical applications.METHODS:The new visual acuity chart and notations were designed based on Weber-Fechner law. The optotypes were red against a white background and were specially shaped four basic geometric symbols:circle, square, triangle,and cross. A regular geometric progression of the optotype sizes and distribution was employed to arrange in 14 lines. The progression rate of the optotype size between two lines was 1.2589 and the testing distance was 3m. Visual acuity score could be recorded as logMAR notation or decimal notation. Age-stratified diagnostic criteria for amblyopia established by consensus statement on diagnosis of amblyopia (2011) among members of the Strabismus and Pediatric Ophthalmology Group, Ophthalmology Society, Chinese Medical Association (SPOGOSCMA) were illustrated in the new visual acuity chart.RESULTS: When assessing visual acuity in children aged 3-5 years old, this new visual acuity chart that consists of four symmetrical shapes (triangle, square, cross, and circle) overcame an inability to recognize the letters of the alphabet and difficulties in designating the direction of black abstract symbols such as the tumbling ‘E’ or Landolt ‘C’, which the subjects were prone to lose interest in. The visual acuity score may be recorded in different notations:decimal acuity and logMAR. These two notations can be easily converted each other in the new eye chart. The measurements of this new chart not only showed a significant correlation and a good consistency with the international standard logarithmic visual acuity chart (r=0.932, P<0.01), but also indicated a high test-retest reliability (89% of retest scores were within 0.1logMAR units of the initial test score).CONCLUSION: The results of this study support the validity and reliability of distance visual acuity measurements using the new eye chart in children aged 3 to 5 years over a wide range of visual acuities, and the new eye chart is great for early detection of amblyopia. It can be applied in various clinical settings.     

Discrimination of paediatric acuity test optotypes by 6-year-old children

Purpose

To compare the discrimination performance of 6-year-old children for optotypes from six paediatric visual acuity tests and to fit Luce's Biased Choice Model to the data to estimate the relative similarities and bias for each optotype.

Methods

Full data sets were collected from 20 typically developing 6-year-olds who had passed a vision screening. They were presented with single optotypes labelled 6/12 at a distance of 9 m and were asked to identify the optotype using a matching task containing all optotypes from the relevant test. The data were combined to form a confusion matrix for each test and a biased choice model was fitted to the data.

Results

Median correct performance varied from 40% to 100% across optotypes, with the HOTV test having the highest values. Estimates of the similarity of each pair of optotypes indicated equal values for all pairs in the Landolt C, HOTV, Lea numbers and Tumbling E tests. The values differed for the picture tests, that is Lea Symbols and Allen figures. The estimates of bias for each individual optotype also indicated different values with the picture tests.

Conclusions

Previous studies of the threshold acuity of young children and adults have indicated differences in acuity estimates across paediatric tests. A recognition acuity task typically requires resolving the difference information between optotypes. The performance of the 6-year-olds here reveals variance in similarity and bias values for picture tests, particularly for the Allen figures when compared with the Lea Symbols. Ideally, this analysis should be performed when designing new tests, and these results motivate progression from the use of current picture tests to well calibrated letter or number tests at the earliest possible age.     

北京市密云县学龄前儿童视力状况分析

目的:了解密云县学龄前儿童视力状况,为学龄前儿童眼保健工作提供指导依据和可行性方法。方法:选择密云县具有代表性的三个区域部分学龄前儿童(4～6岁)进行常规远视力检查,对视力结果进行统计分析。结果:学龄前儿童4,5和6岁视力低常率分别为36.29%,24.43%和20.86%;城镇视力低常率为36.76%,城乡结合部为24.35%,农村为17.08%;视力低常者中,轻度84.38%,中度8.99%,重度6.63%。结论:学龄前儿童的视力低常率以4岁组最高,城镇视力低常率明显高于城乡结合部和农村,视力低常者中以轻度低常为主。学龄前儿童视力是儿童眼保健工作的重要内容,结果受多种因素影响,应正确分析对待。     

南京市雨花台区3岁在园儿童视力和屈光状态的调查分析

目的:了解南京市雨花台区3岁在园儿童的视觉状况,分别进行城区和郊区、性别、视觉检测方法比较。方法:统一筛查标准,对雨花台区22所幼儿园1519例3岁在园儿童进行裸眼远视力、SureSight屈光筛查仪检查,并进行比较。结果:儿童1406例接受远视力表检查视力,异常检出率为12.30%。其中男童视力低常检出率为6.97%,女童5.33%。1 501例儿童接受SureSight屈光筛查仪检查屈光状态,屈光异常检出率为12.92%。城区儿童屈光异常检出率6.86%,郊区6.06%。结论:屈光不正是造成3岁在园儿童视力异常最常见的眼病。早发现、早干预是我们进一步有待完善的工作。     

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。     

学龄前儿童视力和屈光状态分析

目的:了解北京市通州区学龄前儿童的视力现况,并对其屈光状态进行分析。方法:横断面调查研究。于2021-12/2022-01采用整群随机抽样法选取北京市通州区9所幼儿园3～6岁儿童1 513人3 026眼,均进行视力和屈光度检查,并分析不同年龄段儿童视力和屈光度分布情况。结果:纳入儿童视力低常率为15.47%,屈光异常率为14.24%,且随着年龄增长,屈光异常检出率减少,而屈光异常类型以单纯近视性散光为主(11.46%),随着年龄增加,单纯性远视率逐渐降低,单纯性近视率逐渐增加。屈光度检查结果显示,纳入儿童球镜度为0.50(0.25,1.00)D,柱镜度为-0.25(-0.50,-0.25)D,等效球镜度为0.375(0,0.625)D。不同年龄段儿童球镜度和等效球镜度均无差异(P>0.05),但柱镜度有差异(P<0.001)。结论:3～5岁儿童视力低常率随年龄增加逐渐降低,6岁后又呈增加趋势。3～6岁儿童屈光异常以单纯近视性散光为主。学龄前儿童视力发育情况应重点关注,应定期进行视力和屈光状态检查。     

武汉市新洲区学龄前儿童视力调查分析

目的:了解武汉市新洲区学龄前儿童视力发育状况及弱视患病率。方法:受检儿童3211例使用目前我国通用的国际标准视力表检查视力。3岁及以上视力低于0.5,4～5岁低于0.6,6～7岁低于0.7或双眼视力相差两行以上者,通知到医院门诊复诊。结果:受检儿童3211例视力异常检出率为7.51%。视力异常眼的屈光状态以远视为主;在屈光不正性弱视中,轻度弱视占比例最大,中度弱视次之,弱视患病率为6岁组3.68%,5岁组3.76%,4岁组7.93%,3岁组16.48%。各年龄组的视力随年龄增长而逐渐提高,各年龄组视力主要分布:3岁(0.5518±0.1910)、4岁(0.6444±0.1584)、5岁(0.6662±0.1544)、6岁(0.7601±0.1119)。视力异常率在3岁年龄组差异有统计学意义P<0.05,视力异常率在4～6岁年龄组差异无统计学意义,P>0.05。结论:儿童的视力呈动态发育过程,对弱视的诊断应考虑年龄因素。应加大弱视常识及危害性的宣传,提高家长、社会对弱视的认识和重视。     

学龄前儿童视力发育状况及影响因素分析

目的:探讨南京市部分幼儿园学龄前儿童不同年龄段视力发育标准及视力异常的影响因素。方法:选取2011年南京市部分4~6岁儿童进行视力检查,并填写影响因素调查问卷,进行统计分析。结果:选取4,5,6岁儿童视力水平P5分别为0.4,0.5,0.6,屈光、孕周、出生体质量、近距离用眼时间、每日看电视时间、每日户外活动时间、挑食情况、咀嚼情况、父母屈光度、家庭的采光状况等与视力异常有统计学关联,影响因素评分的P5为5。结论:将各年龄段视力小于P5定位视力异常,影响因素评分小于5的定位视力异常高危人群,需要密切关注视力情况。