22例学龄儿童调节痉挛临床诊治体会

目的观察儿童调节痉挛的临床表现，探讨诊疗特点。方法回顾性分析22名调节痉挛患者的临床资料，总结诊治经验。结果22名患儿44只眼初诊平均裸眼视力0．27±0．07，小瞳电脑验光结果均表现近视，等效球镜均值-2．75±0．35D；经0．5％托吡卡胺快速散瞳后检影验光等效球镜均值＋0．68±0．64D，平均矫正视力0．47±0．05；经1％硫酸阿托品凝胶点眼，2次／天，连续5天后检影验光，中度远视者23眼、低度远视者17眼，轻度近视者4眼，44眼散光值均不超过1．0D，等效球镜均值＋2．96±0．93D，矫正视力均可达到0．8以上。结论学龄儿童过强的调节力可导致部分远视患者表现为假性近视状态；对于远视导致调节痉挛的儿童宜使用阿托品散瞳验光。

A study of spasm of accommodation of 22 children.

Objective To observe the clinical feature on the diagnosis and treatment of accommodative spasm in children. Methods This is a retrospective study. 22 participants with spasm of accommodation were recruited and the data were analyzed. Results 22 children （44 eyes） with accommodative spasm showed myopia in small pupil optometry and their average diopter is -2.75± 0.35DS, average naked vision is 0.27 ± 0.07. After getting some com- pound tropicamide eye drop, their average diopters were ＋0.68 ± 0.64DS.But after using atropine eye ointment, there were 23 eyes with medium hypermetropia, 17 eyes with mild hypermetropia and 4 eyes with mild myopia. Their average diopter were ＋2.96±0.93DS. Conclusions School-age children with excessive adjustment can lead to the pseu- domyopia in partial hyperopia patients. Children with accommodative spasm must use atropine eye ointment in mydriat- ic optometry