儿童弱视愈后脱镜指标的探讨

目的:探讨儿童弱视治愈后脱镜指标。方法:儿童弱视治愈后必须符合4项指标才能脱镜,脱镜后要继续追踪观察3年。结果:368例678眼的弱视儿童治愈后,经3~7年的治疗,有205例364眼脱镜,占治愈眼数的53.69%。其中轻度弱视脱镜244眼,高于中度(114眼)和重度(6眼);屈光不正性弱视脱镜305眼,屈光参差性29眼,斜视性30眼;单纯远视性弱视脱镜316眼,高于单纯远散(11眼)和复性远散(37眼);而单纯近视性弱视和单纯近散、复性近散性弱视均没能脱镜。弱视儿童初戴眼镜属低屈光度脱镜289眼,中度58眼,高度17眼。从就诊时的年龄上看3~8周岁者脱镜率高。结论:儿童弱视治愈后按照4项脱镜指标摘掉眼镜是可行的。在脱镜前一定要坚持治疗复诊,即使脱镜后也要坚持追踪观察,最好观察超过视力发育敏感期12周岁之后。

Exploration on the indexes of taking off glasses after recovery in children with amblyopia

Objective:To explore the indexes of taking off glasses after recovery in children with amblyopia.Methods:The children with amblyopia could take off their glasses after recovery when they accorded with four indexes,and all the children were followed up for three years after taking off glasses.Results:368 children(678 eyes) with amblyopia were selected,after treatment for 3～7 years,205 children(364 eyes) took off glasses,accounting for 53.69%,including 244 eyes of mild amblyopia,the proportion was higher than those of middle amblyopia(114 eyes) and severe amblyopia(6 eyes);305 eyes had ametropic amblyopia,29 eyes had anisometropic amblyopia and 30 eyes had strabismic amblyopia;316 eyes had simple hypermetropic amblyopia,the proportion was higher than those of simple hypermetropic astigmatism(11 eyes) and complex astigmatism(37 eyes);the children with simple myopic amblyopia,simple myopic astigmatism and complex myopic astigmatism did not take off glasses;289 eyes were low diopter,58 eyes were middle diopter and 17 eyes were high diopter;the rate of taking off glasses in children aged 3～8 years old was high.Conclusion:It is feasible for children with amblyopia taking off glasses after recovery according to four indexes,treatment and follow-up before taking off glasses are necessary,even after taking off glasses,the time of follow-up more than 12 years(the sensitive period of visual development) is the best.