儿童弱视治疗中几个问题的讨论  

Several problems in treatment of amblyopia in children

作　　者：王洪峰[1] 王恩荣[1] 

机构地区：[1]吉林省松原市中心医院眼科,138000

出　　处：《眼科》2013年第5期295-298,共4页Ophthalmology in China

摘　　要：在儿童弱视治疗中，有许多标准及概念需要讨论：（1）脱镜指标。我们认为双眼裸眼远、近视力≥1．0半年以上者，眼位正常或斜视性弱视治愈后残余斜视度〈5°者，远视屈光度≤＋1．00DS者，远视散光度≤＋0．50DC者可以脱镜。（2）弱视复发的概念。我们认为弱视经过治疗后，矫正视力≥0．9或裸眼视力≥1．0后，视力又下降，散瞳验光后证明屈光度明显增加，即弱视复发。依此，按治疗儿童弱视不同阶段，弱视复发应分：基本治愈后弱视复发、痊愈后弱视复发和脱镜后弱视复发三类。（3）治疗年龄限制范围。我们认为应为2岁半即可验光配镜开始弱视治疗，2-6岁是治疗儿童弱视最佳时期，治愈率最高，7—12岁是治疗儿童弱视适宜年龄，对13-18岁的儿童弱视也不能轻易放弃治疗。（4）治疗期限。我们认为在弱视基本治愈后应随访观察3年，脱镜后结束治疗最安全，视力回退率最低。In the clinical treatment of amblyopia in children, many standards need to be defined. This article discussed the fol- lowing problems in children amblyopia treatment. （1） Indicators of taking off the glasses are thought to be as follow： （a） uncorrected visual acuity ≥1.0 remained more than half a year, （b） normal position of eyes or residual angle 〈5° for strabismic amblyopia, （c） the refraction ≤＋1.00 DS for hyperopia, （d） the refraction ≤＋0.50 DC for hyperopic astigmatism. （2）The recurrence standard of amblyopia is that visual acuity reduces and cycloplegic refractive error increases obviously after corrected visual acuity ≥.9 or uncorrected visual acuity ≥1.0 through treatment of amblyopia. According to different stages of the treatment, the recurrence of amblyopia should be divided into 3 types： recurrence after basically cured, recurrence after wholly cured and recurrence after taking off the glasses. （3） The age for treatment. Treatment of amblyopia can begin as early as two and a half years old. The best time for treatment is from 2 to 6 years old with the highest rate of recovery. The appropriate age for treatment of amblyopia is from 7 to 12 years old. The treatment for children aged 13-18 should not be given up easily. （4）Treatment period. Patients should be followed up for 3 years after amblyopia ba- sically cured. Finishing treatment after taking off the glasses would be the safest with the lowest rate of visual acuity reduction.

关 键 词：弱视 脫镜指标 弱视复发 

分 类 号：R777.44[医药卫生—眼科]