大学生双眼视和调节异常情况的研究
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摘要
目的：调查我国全日制大学生中非斜视性双眼视和调节功能异常的发病情况，为眼视光临床工作提供依据。
方法：随机选取100名大学生，在完成双眼视症状问卷调查后，进行眼屈光检查、远近水平隐斜、水平融像性集散运动、集散敏捷度、集合近点、正负相对调节、调节敏捷度、调节幅度和立体视锐度检查，对症状显著者根据其检查的异常结果予以相应诊断。
结果：100名受试者中，38例(38.0％)有某种类型的调节和／或双眼视功能异常，其问题不能依靠单纯的矫正屈光不正来解决，需要相应的视觉训练或其他治疗手段。其中双眼视异常的发生率为34.0％，调节异常为4.0％。双眼视异常中以集合不足(18.0％)最为常见，远远超过集合过度(7.0％)。13例(13％)有双眼视或调节异常的症状，但无典型的体征，为屈光不正未准确、完全的矫正所致。28例(28％)有异常的体征，但无相应的症状，为双眼视或调节异常的代偿状态，需密切的临床观察随访。21例受试者既无明显症状也未检出异常体征，为双眼视及调节功能正常者。
结论：非斜视性双眼视和调节功能异常是我国，尤其是大学生中普遍存在的异常，临床工作中对有相应主诉的个体应予以重视，进行相应的检查，作出准确的诊断，以便进行相应的视觉训练。
Purpose: To survey the prevalence of nonstrabismic accommodative and
binocular dysfunction in the population of university students.
Methods: One hundred students were chosen randomly. A
symptom-questionnaire was taken which was related to their vision and
several key tests were performed to diagnose any form of refractive,
accommodative or binocular dysfunction.
Results: Of the 100 subjects examined, 38 subjects (38%) had some form of
accommodative or binocular dysfunction and required not just the correction
of the refractive error but related orthoptic treatment or other management for
each of the problems diagnosed. The frequency of binocular dysfuction was
34.0%, and 4.0% for accommodative anomalies. Convergence insufficiency
(18.0%) was more prevalent than convergence excess (7.0%). 13
subjects(13%) were symptomatic without typical abnormal signs. Their
symptom were attributed to inappropriate-corrected refractive error. 28
asymptomatic subjects showed some abnormal signs. It meant that they could
still compensate for their accommodative or binocular anomalies but required
close follow-up at optometric clinics.
Conclusion: Non-strabismic binocular vision and accommodative disorders
are prevalent conditions. Ophthalmologists and optometrists should keep
their presence in mind and avoid the non-detection of these anomalies in
daily optometric practice. Visual therapy and orthoptic treatment chose lie on
exact diagnosis.
方法：随机选取100名大学生，在完成双眼视症状问卷调查后，进行眼屈光检查、远近水平隐斜、水平融像性集散运动、集散敏捷度、集合近点、正负相对调节、调节敏捷度、调节幅度和立体视锐度检查，对症状显著者根据其检查的异常结果予以相应诊断。
结果：100名受试者中，38例(38.0％)有某种类型的调节和／或双眼视功能异常，其问题不能依靠单纯的矫正屈光不正来解决，需要相应的视觉训练或其他治疗手段。其中双眼视异常的发生率为34.0％，调节异常为4.0％。双眼视异常中以集合不足(18.0％)最为常见，远远超过集合过度(7.0％)。13例(13％)有双眼视或调节异常的症状，但无典型的体征，为屈光不正未准确、完全的矫正所致。28例(28％)有异常的体征，但无相应的症状，为双眼视或调节异常的代偿状态，需密切的临床观察随访。21例受试者既无明显症状也未检出异常体征，为双眼视及调节功能正常者。
结论：非斜视性双眼视和调节功能异常是我国，尤其是大学生中普遍存在的异常，临床工作中对有相应主诉的个体应予以重视，进行相应的检查，作出准确的诊断，以便进行相应的视觉训练。
Purpose: To survey the prevalence of nonstrabismic accommodative and
binocular dysfunction in the population of university students.
Methods: One hundred students were chosen randomly. A
symptom-questionnaire was taken which was related to their vision and
several key tests were performed to diagnose any form of refractive,
accommodative or binocular dysfunction.
Results: Of the 100 subjects examined, 38 subjects (38%) had some form of
accommodative or binocular dysfunction and required not just the correction
of the refractive error but related orthoptic treatment or other management for
each of the problems diagnosed. The frequency of binocular dysfuction was
34.0%, and 4.0% for accommodative anomalies. Convergence insufficiency
(18.0%) was more prevalent than convergence excess (7.0%). 13
subjects(13%) were symptomatic without typical abnormal signs. Their
symptom were attributed to inappropriate-corrected refractive error. 28
asymptomatic subjects showed some abnormal signs. It meant that they could
still compensate for their accommodative or binocular anomalies but required
close follow-up at optometric clinics.
Conclusion: Non-strabismic binocular vision and accommodative disorders
are prevalent conditions. Ophthalmologists and optometrists should keep
their presence in mind and avoid the non-detection of these anomalies in
daily optometric practice. Visual therapy and orthoptic treatment chose lie on
exact diagnosis.
引文
1．李宏：职业性视疲劳与屈光不正的关系．眼外伤职业眼病杂志．2002；24：621-622
2．高健铭，韩芷敏，薛雪：视疲劳的屈光状态分析．临床眼科杂志．2001：9：141-142
3．潘以方，周莹，柯黎等：眼肌性视疲劳．中国实用眼科杂志．1996；14：678-679
4．陈君平，熊端华，宋文熹：三棱镜治疗肌性视疲劳的临床观察与分析．眼科新进展．1993；13：42-44
5．杨景存，王国军：视疲劳．眼外伤职业眼病杂志．1992；14：253-256
6．陈国策，关征实：集合不全与视疲劳(附22例分析)．眼科学报．1992；8：73-75
7. Scheiman M, Gallaway M,,Ciner E,et al.: Prevalence of visual anomalies and ocular pathologies in a clinic pediatric population. J.Am.Optom.Assoc. 1996;67:193-201
8．王海英，高雅萍，吴柳庭：双眼视觉的分析．中国眼镜科技杂志．2002；4：56-59
9．张洪波，杨培华：浅谈异常双眼视功能的评估方法．中国眼镜科技杂志．2002：6：26-27
10. Scheiman M, Wick B.:Clinical management of binocular vision. In: Heterophoric, Accommodative and Eye Movement Disorders (1994a), Lippincott, Philadephia, pp.3-31
11. Scheiman M, Wick B.:Clinical management of binocular vision. In: Heterophoric, Accommodative and Eye Movement Disorders (1994b), Lippincott, Philadephia, pp.41-81
12. Dwyer P, Wick B: The influence of refractive correction upon disorder of vergence and accommodation. Optom. Vis. Sci. 1995;72:224-232
13. Daum KM: Accommodative dysfuction. Documenta Ophthalmologica. 1983; 55:177-198
14. Hokoda SC: General binocular dysfunction in an urban optometry clinic. J.Am.Optom.Assoc. 1985;56(7):560-562
15. Lara F, Cacho P, Garcia A,et al.: General binocular disorders:prevalence in a clinic population. Ophthal. Physiol. Opt.2001 ;21(1):70-74
16. Rouse MW, Hyman L, Hussein M, et al.: Frequency of convergence insufficiency in optometry clinic settings. Optom. Vis. Sci. 1998;75(2):88-96
17. Porcar E, Martinez-Palomera A: Prevalence of general binocular dysfunction in a population of university students. Optom. Vis. Sci. 1997;74(2):111-113
18. Mazow ML: The convergence insufficiency syndrome. J. Pediatr. Ophthalmol. 1971 ;8:243-244
2．高健铭，韩芷敏，薛雪：视疲劳的屈光状态分析．临床眼科杂志．2001：9：141-142
3．潘以方，周莹，柯黎等：眼肌性视疲劳．中国实用眼科杂志．1996；14：678-679
4．陈君平，熊端华，宋文熹：三棱镜治疗肌性视疲劳的临床观察与分析．眼科新进展．1993；13：42-44
5．杨景存，王国军：视疲劳．眼外伤职业眼病杂志．1992；14：253-256
6．陈国策，关征实：集合不全与视疲劳(附22例分析)．眼科学报．1992；8：73-75
7. Scheiman M, Gallaway M,,Ciner E,et al.: Prevalence of visual anomalies and ocular pathologies in a clinic pediatric population. J.Am.Optom.Assoc. 1996;67:193-201
8．王海英，高雅萍，吴柳庭：双眼视觉的分析．中国眼镜科技杂志．2002；4：56-59
9．张洪波，杨培华：浅谈异常双眼视功能的评估方法．中国眼镜科技杂志．2002：6：26-27
10. Scheiman M, Wick B.:Clinical management of binocular vision. In: Heterophoric, Accommodative and Eye Movement Disorders (1994a), Lippincott, Philadephia, pp.3-31
11. Scheiman M, Wick B.:Clinical management of binocular vision. In: Heterophoric, Accommodative and Eye Movement Disorders (1994b), Lippincott, Philadephia, pp.41-81
12. Dwyer P, Wick B: The influence of refractive correction upon disorder of vergence and accommodation. Optom. Vis. Sci. 1995;72:224-232
13. Daum KM: Accommodative dysfuction. Documenta Ophthalmologica. 1983; 55:177-198
14. Hokoda SC: General binocular dysfunction in an urban optometry clinic. J.Am.Optom.Assoc. 1985;56(7):560-562
15. Lara F, Cacho P, Garcia A,et al.: General binocular disorders:prevalence in a clinic population. Ophthal. Physiol. Opt.2001 ;21(1):70-74
16. Rouse MW, Hyman L, Hussein M, et al.: Frequency of convergence insufficiency in optometry clinic settings. Optom. Vis. Sci. 1998;75(2):88-96
17. Porcar E, Martinez-Palomera A: Prevalence of general binocular dysfunction in a population of university students. Optom. Vis. Sci. 1997;74(2):111-113
18. Mazow ML: The convergence insufficiency syndrome. J. Pediatr. Ophthalmol. 1971 ;8:243-244