视疲劳患者近视力受损的发生率及影响因素

目的：研究视疲劳患者中近视力受损的发生率及其影响因素。

方法：选取2017-05/2018-05在我院门诊就诊的视疲劳患者51例102眼,根据日常生活近视力是否受损分为日常近视力受损组(24例)和无近视力受损组(27例),收集两组患者的一般资料,并进行常规眼部检查、主觉验光和双眼眼动参数检测。

结果：本组患者中裸眼近视力受损者27例(53%),日常生活近视力受损者24例(47%),无最佳矫正近视力受损者。日常近视力受损组患者年龄显著高于无近视力受损组,其中≥45岁的患者比例显著高于无近视力受损组(P<0.01)。两组患者中≥45岁的患者NRA/PRA、水平聚散力\〖BO(40cm)\〗、水平聚散幅度(40cm)均有明显差异(P<0.05)。

结论：视疲劳患者多伴有近视力受损,年龄增大、正负相对调节不平衡是其发生的主要影响因素。     

Superior short-wavelength contrast sensitivity in asthenopics during reflexive readjustments of ocular accommodation

The purpose of this work was to characterize contrast sensitivity (CS) under short-wavelength illumination in 20 symptom-free subjects and eight asthenopics: all had normal unaided or corrected visual acuity and no sign of oculomotor disease. Threshold CS was assessed using the von Békésy tracking method from a viewing distance of 2.4 m (0.40 D). Three counterbalanced tasks required central fixation of black-and-white square-wave gratings (1, 5, 10, 14 and 17 c/deg) presented through a low-pass filter blue lens and (1) a +1.50 D lens; (2) a -1.50 D lens and (3) a 0 D lens, while attempting accommodation to minimize blur. Baseline increases in eye strain, which approached high levels at the end of the experiment, did not differentiate between the two groups of volunteers. All the subjects made evident appropriate accommodation during the low blur condition (0 D); the CS curve exhibited the expected characteristics. When the minus lens was placed before the eyes of the observers the distant square-wave gratings were still seen clearly, the eyes presumably had accommodated by an amount equal to the power of the negative lens. Compared with symptom-free subjects, asthenopics exhibited greater CS at the intermediate spatial frequencies both during the low blur and the minus blur conditions. Asthenopics may exhibit an individualized sensory tendency to react more strongly to shorter wavelengths of light and may therefore reflexively 'drive' their accommodative system harder than symptom-free subjects. This would explain the presence of their asthenopia in the first place. Blue light may, in addition, induce more arousal and higher alertness in this category of participants. This would boost the oculomotor aspects of their performance. These findings add to the current understanding of individual variability in the level of oculomotor loads following strenuous near work.     

The effect of coloured filters on the rate of reading in an adult student population

Meares-Irlen Syndrome is characterised by visual stress (visual discomfort) and visual perceptual distortions that can be alleviated by individually prescribed coloured filters. The benefit from coloured filters can be demonstrated with the Wilkins Rate of Reading Test (WRRT). Previous research using individually prescribed coloured overlays (sheets of plastic placed on a page) found that between one-fifth and one-third of unselected school-children show a significant (> 5%) improvement in their rate of reading with their chosen overlay. This 5% cut-off has good sensitivity and specificity for predicting those children who will continue to voluntarily use their overlay for a sustained period. Previous research has concentrated on children, and we sought to investigate the immediate effect of overlays on rate of reading in an adult population. Subjects were 113 unselected university students who answered a symptom questionnaire and were tested with the Wilkins Intuitive Overlays and WRRT. Some symptoms were common: 73% reported sore or tired eyes when reading and 40% reported four to 12 headaches a year. One hundred of the subjects chose an overlay as improving their immediate perception of text. These subjects were significantly more likely to report perceptual distortions and visual discomfort on viewing text than subjects who did not choose an overlay. The 100 subjects read 3.8% faster with the overlay than without any overlay (p < 0.00001), whereas the 13 subjects who did not choose an overlay read 1.7% slower with a placebo overlay than without (p = 0.37). Of the subjects who chose an overlay, 38% read more than 5% faster with the overlay and 2% read more than 25% faster. These results are comparable with those obtained for children. We conclude that Meares-Irlen Syndrome is likely to be as common in adults as it is in children.     

康视明合剂联合耳穴贴压治疗视疲劳临床研究

[目的]观察康视明合剂联合耳穴贴压治疗视疲劳临床疗效。[方法]将86例视疲劳患者随机分为治疗组43例用康视明合剂联合耳穴贴压治疗,对照组43例服用杞菊地黄丸。观察明视持久度测定和视疲劳症状积分变化情况,并评价临床疗效。[结果]治疗组的临床综合疗效、明视持久度及视疲劳症状积分改善均优于对照组,差异有统计学意义(P0.05)。[结论]应用康视明联合耳穴贴压可有效治疗视疲劳,可以显著改善明视持久度及视疲劳症状。     

原花青素在眼科应用的研究进展

原花青素是一种广泛存在于自然界植物中的多酚化合物。它具有极强的抗氧化活性和自由基清除能力,并且具有高效、低毒和高生物利用率等优点,可起到降血压、降血脂、抗炎、抗肿瘤、抗衰老、抗疲劳以及预防心脑血管疾病等功效。本文综述了原花青素的理化性质、药理作用、毒理作用及其在眼科应用的最新研究进展,主要是在角膜病、白内障、青光眼、葡萄膜炎、视网膜病变、视神经病变、眼外伤及视疲劳等方面进行概述。相信在不久的将来能对其药物作用机制进一步阐明,发挥其更大的医用价值,为眼科临床应用提供更多经济且有效的药物。     

Influence of stereopsis and abnormal binocular vision on ocular and systemic discomfort while watching 3D television

Purpose

To evaluate the degree of three-dimensional (3D) perception and ocular and systemic discomfort in patients with abnormal binocular vision (ABV), and their relationship to stereoacuity while watching a 3D television (TV).

Methods

Patients with strabismus, amblyopia, or anisometropia older than 9 years were recruited for the ABV group (98 subjects). Normal volunteers were enrolled in the control group (32 subjects). Best-corrected visual acuity, refractive errors, angle of strabismus, and stereoacuity were measured. After watching 3D TV for 20 min, a survey was conducted to evaluate the degree of 3D perception, and ocular and systemic discomfort while watching 3D TV.

Results

One hundred and thirty subjects were enrolled in this study. The ABV group included 49 patients with strabismus, 22 with amblyopia, and 27 with anisometropia. The ABV group showed worse stereoacuity at near and distant fixation (P<0.001). Ocular and systemic discomfort was, however, not different between the two groups. Fifty-three subjects in the ABV group and all subjects in the control group showed good stereopsis (60 s of arc or better at near), and they reported more dizziness, headache, eye fatigue, and pain (P<0.05) than the other 45 subjects with decreased stereopsis. The subjects with good stereopsis in the ABV group felt more eye fatigue than those in the control group (P=0.031). The subjects with decreased stereopsis showed more difficulty with 3D perception (P<0.001).

Conclusions

The subjects with abnormal stereopsis showed decreased 3D perception while watching 3D TV. However, ocular and systemic discomfort was more closely related to better stereopsis.     

视频终端防护镜缓解视频终端操作者视疲劳的作用

目的：评估视频终端防护镜（蓝、紫光滤过镜）缓解长期操作视频终端引起的视疲劳的效果。方法：前瞻性临床研究。将在浙江省人民医院超声科工作的60 例（26~45 岁）符合视疲劳诊断的长期视频终端操作者随机分为2 组,实验组30 例和对照组30 例。实验开始时,2 组受试者常规医学验光后配戴普通非球面眼镜,在视频前工作1 h后开始测量双眼视功能和泪膜破裂时间（BUT）,最后进行视疲劳问卷评分。随即实验组配戴视频终端防护镜,对照组配戴普通非球面眼镜进行对比敏感度（CS）测量。2组配戴各自的眼镜3个月后,在视频前工作1 h后做双眼视功能和BUT检测,并再次进行视疲劳问卷评分。数据采用独立样本t 检验、配对t 检验、卡方检验进行比较。结果：实验开始时,实验组明环境带眩光中低频率光栅CS（1.0 cpd、1.7 cpd、2.6 cpd）显著高于对照组（t =2.181、2.012、2.088,P ＜0.05）,暗环境下低频率光栅CS（1.0 cpd、1.7 cpd）显著高于对照组（t =2.220、2.558,P ＜0.05）。无眩光时,实验组在明、暗环境下低频率光栅CS（1.0 cpd、1.7 cpd）高于对照组（明：t =2.123、2.530,P ＜0.05;暗：t =2.433、2.140,P ＜0.05）。实验组配戴视频终端防护镜3 个月后,调节幅度（AMP）、调节灵敏度和BUT值显著增高（t =-2.735、-3.281、-2.249,P ＜0.05）,集合破裂点（NPC）显著移近,近距外隐斜值减少,视疲劳评分显著降低（t =3.049、1.369、3.754,P ＜0.05）。对照组配戴普通非球面眼镜片3个月后,AMP、NPC、调节灵敏度、远/近距隐斜量和BUT值变化均不明显,视疲劳评分并 无显著降低。实验组和对照组实验前后调节性集合/调节值差异均无统计学意义。戴镜3 个月,2 组受试者不良反应构成比差异均无统计学意义。结论：通过3个月的观察,视频终端防护镜（蓝、紫光滤终端过镜）较普通框架眼镜能提高低、中频率CS,改善配戴者双眼视功能,提高BUT,缓解长期操作视频引起的视疲劳,配戴过程中未出现严重不良反应。     

重视电脑视觉综合征的防治

电脑已成为人们日常生活的一部分,越来越多的人由于持续使用电脑而出现眼部症状,即电脑视觉综合征。本文介绍电脑视觉综合征的症状、体征以及诊断标准,并着重介绍影响电脑视觉综合征的各种危险因素和防治措施,希望藉此唤起我国眼科医生对电脑视觉综合征更多的了解与关注。     

外直肌后徙术治疗外隐斜性视疲劳

目的观察外直肌后徙术治疗外隐斜性视疲劳的疗效。方法采用外直肌后徙术治疗引例外隐斜性视疲劳患者,术后随访1～2a。结果视疲劳治愈16例（76％）,来出现明显并发症。结论外隐斜性视疲劳可行外直肌后徙术治疗。