近距不同隐斜条件下视疲劳与无症状人群单双眼调节反应的差异  

Differences in accommodative response under monocular and binocular conditions in young asthenopes and asymptomatic individuals with heterophoria

作　　者：邹炳亮 马敏旺 张志鑫 ZOU Bingliang;MA Minwang;ZHANG Zhixin(Department of Ophthalmology,Characteristics Medical Center of Chinese People’s Armed Police Force,Tianjin 301600,China)

机构地区：[1]武警特色医学中心眼科,天津300162

出　　处：《武警医学》2024年第11期976-980,共5页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的 探讨近距离不同隐斜状态下,视疲劳患者与无症状人群单眼和双眼调节反应的差异。方法 选择2024-03至2024-05在武警特色医学中心眼科就诊的99名青年受试者,根据集合不足症状调查评分问卷(CISS)分为有症状组(33例)和无症状组(66例)。使用Van-Greafe法测量近距离水平分离性隐斜,并在40 cm的测试距离下,利用开放式电脑验光仪分别测量单眼和双眼状态下的调节反应。比较近距离不同隐斜状态以及有症状组和无症状组单眼和双眼状态下调节反应的差异,并进行统计学分析。结果 在双眼状态下,调节滞后量在内隐斜组最高,其次是正常组,在外隐斜组最低;不同隐斜组别间的单双眼调节滞后量差值有统计学差异(P<0.05)。此外,内隐斜组中,有症状组比无症状组单双眼调节滞后量差异更大(P<0.05),而这种差异在外隐斜组未表现出显著性(P>0.05)。结论 近距离隐斜的类型会影响双眼状态下的调节反应,其中外隐斜患者其双眼状态下的调节滞后量最小,内隐斜患者最大;且无论在内隐斜还是外隐斜状态下,有视疲劳症状的患者,其调节滞后量在单眼和双眼下的差异比无视疲劳症状者大,这可能是隐斜患者近距离出现视疲劳的原因之一。Objective To investigate the differences in monocular and binocular accommodation responses between asthenopes and asymptomatic individuals with different near heterophoria.Methods A total of 99 young subjects treated in the Ophthalmology Department of Characteristics Medical Center of Chinese People’s Armed Police Force from March 2024 to May 2024 were selected and divided into symptomatic group(33 cases)and asymptomatic group(66 cases)according to the Collection Deficiency Symptom Survey Score Questionnaire(CISS).The Van-Greafe method was used to measure the short-range horizontal dissociated heterophoria,and the open-field auto-refractometer was used to measure the accommodative responses under monocular and binocular vision at a test distance of 40cm.The differences of the accommodative responses in the monocular and binocular states between the two groups were compared and statistically analyzed.Results The accommodative lag was the highest in the esophoria group under binocular vision,followed by the normal group,and the lowest in the exophoria group.There was a significant difference in the difference of accommodative lag between monocular and binocular vision between different heterophoria groups(P<0.05).In addition,in the esophoria group,the difference in accommodative lag between monocular and binocular vision was greater in the symptomatic group than in the asymptomatic group(P<0.05),but this difference was not significant in the exophoria group(P>0.05).Conclusions The type of heterophoria in short distance can affect the accommodative responses under binocular vision,with the smallest amount of accommodative lag in exophoria patients and the largest in esophoria patients.Moreover,regardless of esophoria or exophoria,patients with asthenopia symptoms have a greater difference in accommodative lag between monocular and binocular vision than those without asthenopia symptoms,which may be one of the reasons for asthenopia in patients with heterophoria in short distance.

关 键 词：视疲劳 调节滞后量 隐斜 调节性集合 

分 类 号：R77[医药卫生—眼科]