近距隐斜视与屈光不正的关系研究  

Studies on the relationship of near heterophoria and refractive error

作　　者：邓大明[1] 陈静嫦[1] 麦光焕[1] 

机构地区：[1]中山大学中山眼科中心眼科学国家重点实验室,广州510060

出　　处：《中国实用眼科杂志》2009年第10期1086-1088,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的 探讨近距隐斜视的发生、类型与屈光不正的关系.方法 连续收集近距隐斜视患者267例,男145例,女122例,年龄（8.05＋5.0）岁（3～44岁）,分别进行近距隐斜视检测,静态检影.结果 正视者63例,其中发生近距外隐斜60例,近距内隐斜3例,近距外隐斜所占比重明显高于内隐斜（P=0.000）.近距内隐斜47例,其屈光状态构成分别为正视和近视各3例,远视41例;近距外隐斜220例,其屈光状态构成分别为正视60例,近视64例,远视96例,经卡方检验,近距隐斜视类型与屈光状态有关（X2=29.47,P=0.000）.就137例远视患者而言,发牛近距内隐斜41例,其不同程度屈光构成分别为轻度远视12例,中度远视18例,重度远视11例;发生近距外隐斜96例,其不同程度屈光构成分别为轻度远视56例,中度远视27例,重度远视13例,经卡方检验,对远视患者而言,近距隐斜视类型与远视的程度有关（X2=16.61,P=0.000）,近距内隐斜多发生于中度远视,而近距外隐斜多发生于轻度远视.结论 近距隐斜视类型与屈光状态相关,其中近距内隐斜主要为远视眼未经屈光矫正引致;一定范嗣内的近距外隐斜可能是一种,圭理性眼位,而近距内隐斜则可能是一种病理性眼位,并与近视的发生发展相关.Objective To investigate the relationship of refractive error to the underlying mechanism and the direction of deviation of near heterophoria.Methods A total of 267 consecutive heterophoric patients （ 145 males and 122 females） were reviewed, with an age range of 3 to 44 years （mean 8.0±0.5 years ）.Near heterophoria and cycloplegic refraction were measured respectively.Results Of 63 cases of emmetropia, 60 cases showed near exophoria and 3 cases showed near esophoria, and the difference was statistically significant （P=0.000.Of47 cases of near esophoria, 3 cases of emmetropia, 3 cases of myopia and 41 cases hyperopia were showed respectively.Of 220 cases of hyperopia,60 cases showed emmetropia,64 cases myopia and 96 cases hyperopia.A significant correlation between the direction of deviation of near heterophoria and refractive error was demonstrated （x^2 =29.47,P=0.000）.As for all cases of hyperopia,41 cases showed near esophoria in which 12 cases of mild hyperopia, 18 cases of moderate hyperopia and 11 cases of severe hyperopia were in- cluded, and, 96 cases showed near exophoria in which 56 cases of mild hyperopia, 27 cases of moderate hyperopia and 13 cases of severe hyperopia were included.There was a significant relationship between the direction of deviation of near heterophoria and the degree ofhyperopic error （x^2= 16.611 ,P=-0.000）,more cases of near esophoria were found in moderate hyperopic errors and more cases of near exophoria were found in mild hyper- opic errors.Conclusions The direction of deviation of heterophoria was correlated to refractive error, and uncorrected hyperopia maybe a major factor in the etiology of near esophoria.A small degree of near exophoria may be a physiological condition, and near esophoria should be a anomalous condition which may be associated with the onset and the progression of myopia.

关 键 词：隐斜视 近距隐斜视 屈光不正 远视 近视 

分 类 号：R778.1[医药卫生—眼科] R777.43[医药卫生—临床医学]