老年人白内障摘除人工晶体植入术后的立体视觉异常原因探讨

目的探讨老年人白内障摘除后人工晶体植入术后立体视觉异常的原因及发病机制。方法随机抽取老年性白内障人工晶体植入术后患者150例,常规眼部检查并矫正屈光不正和老视,采用同视机检查双眼同时视功能和融合功能,采用颜少明《立体视觉检查图》检查立体视功能。对其中立体视功能未恢复或异常的患者97例进行分析。结果97例中,53例（54．6％）术前已患有影响视力和双眼单视的眼病,其中以眼底黄斑病变最常见（13只眼）;27例（27．8％）手术合并角膜散光、后发白内障、眼肌麻痹性斜视、复视及黄斑水肿等;此外另一侧未手术眼的白内障17只眼（17．5％）和术后两眼屈光参差9例（9．3％）亦是影响立体视的常见原因;8例患者原因不明。结论老年白内障患者原有眼病、手术并发症、对侧未手术眼的白内障及两眼屈光参差均是影响视力康复和双眼立体视重建的主要因素。     

单纯配镜对学龄前儿童戴镜视力改善作用的临床研究

目的探讨屈光不正儿童在戴镜前后的视力变化,评估单纯屈光矫正在学龄前儿童视力改善中的临床作用。方法回顾性分析112例(224眼)2~7岁的屈光不正儿童,给予合理的屈光矫正后,随访3个月、6个月后戴镜视力的变化情况。结果按年龄分组:在戴镜3个月后,3个年龄组间戴镜视力提升有差异(χ~2=29.391,P=0.000),其中3~5岁提升最明显,5~7岁年龄组其次,3岁年龄组最差;戴镜半年后各年龄组间戴镜视力的提升差异无统计学意义(χ~2=8.210,P=0.084)。按屈光状态分组:在屈光矫正半年后,各组间的戴镜视力提升差异有统计学意义(χ~2=23.517,P=0.003),其中单纯远视或远视散光的儿童戴镜视力改善最好,其次分别为复性远视散光组、混合散光组、单纯近视或近视散光儿童,复性近视散光儿童效果最差。结论单纯屈光矫正可提升学龄前儿童的戴镜视力,其中屈光矫正在3~5岁年龄段效果最好,单纯远视或远视散光眼的戴镜视力改善最明显,并且部分儿童戴镜后视力可达同龄儿童的正常水平。     

90岁以上老年人眼部状况及疾病分析

目的　调查 90岁及以上长寿老年人的视力状况和眼部疾病情况。　方法　对 135例90岁以上老年人常规检测视力 ,外眼、眼前节、眼底及眼压。对合作者进行验光 ,矫正屈光不正。　结果　 135例老年人右眼视力平均 0 4 6± 0 5 0 ,左眼 0 4 9± 0 5 0。盲和低视力分别为 7(5 9% )例和14 (10 3% )例。 4 3例 (81 1% )老年人验光后视力提高 1～ 5行 (平均 3行 ) ,验光前、后视力改善差异有统计学意义 (P <0 0 1)。所有老年人均有眼睑下垂、角膜类脂环、眼底动脉硬化、老视等老年性眼部变化。平均每位老人患有 2 4 (2～ 7)种眼病和 7 6 (3～ 12 )种全身主要脏器病变。对视力产生普遍影响的因素是屈光不正 ,诸多眼病中白内障居首位 ,严重影响视力的眼病是黄斑病变和各种原因的视神经萎缩。　结论　 90岁以上老年人盲和低视力的发生率高 ,其原因既有衰老退化因素 ,又有老年人常见眼病和屈光不正的影响。     

Suresight视力筛查仪检查柱镜呈±9.99D屈光意义的探讨

目的探讨学龄前儿童Suresight视力筛查仪检查柱镜呈&#177;9.99D的屈光意义。方法 Suresight视力筛查仪检查柱镜呈&#177;9.99D的学龄前儿童,采用1%阿托品散瞳后检影验光,分析检影验光结果。结果 Suresight视力筛查仪检查柱镜呈&#177;9.99D32例36眼,屈光状态分布以混合散光最多,27眼,占75.00%;远视性屈光9眼,占25.00%,近视性屈光0眼;散光绝对值分布,柱镜绝对值为3.50D-4.75D,平均为4.00D。结论学龄前儿童Sure-sight视力筛查仪检查柱镜呈&#177;9.99D都是大散光眼,绝对值为3.50D-4.75D,平均为4.00D,以混合散光为主。     

老年性屈光参差与视力功能分析

对本省正厅级老干部600例次进行检查，发现40例有不同程度的屈光参差，并且进行视力功能分析．近视性屈光参差占总数15％，远视性屈光参差占57.5％，混合性占32．5％．视力功能一级提高在0．4以上占矫正视力70％．目前来见有老年性屈光参全方面的报道．我们对于≥60老年人屈光参差进行初步分析．配带眼镜是矫正屈光参差最佳选择。     

准分子激光角膜原位磨镶术治疗散光疗效观察

采用准分子激光角膜原位磨镶术（ＬＡＳＩＫ）对７６例（１３５只眼）散光患者进行了治疗，并对其术前及术后６个月的散光度及视力进行了对比分析。结果显示，本组裸眼视力由０．０７±０．０４提高到０．９９±０．２１，验光散光度由－２．９１±１．３９Ｄ降至－０．５６±０．４４Ｄ，均无严重并发症发生。提示ＬＡＳＩＫ治疗散光疗效肯定，安全性高。     

168例中老年人屈光不正临床分析

１６８例中老年人屈光不正临床分析刘新亚朱玲江苏省省级机关医院（２１００２４）表１中老年远视、逆规则散光与发病年龄（只）年龄（岁）眼数远视远视散光Ａ×１８０°±１０°单纯散光复性散光近视散光Ａ×９０°±１０°４０～４９７８２４３１１６７５０～５９８７４...     

电脑验光与试镜验光151例结果对照

屈光不正者约占我国总人口的30％，配戴适宜的眼镜仍是矫正屈光不正，提高视力常用的方法之一。目前，临床对屈光不正者验光时多采用电脑与试镜验光相结合的方法。2002年7月～2003年3月，我院对151例(302眼)屈光不正的患者，采用上述两种方法验光；现对结果进行分析比较。     

老年人再生障碍性贫血68例临床分析

目的探讨老年人再生障碍性贫血（ＡＡ）的临床特点。方法分析同期收治的老年人及非老年人ＡＡ各６８例，对照比较其临床特点及疗效。结果老年患者发病前有致病因素接触史者占４４．１％，临床上贫血、感染及出血症状多见且严重，并存症多，骨髓增生程度低下更为显著，治疗效果差，随访１～９年，老年人慢性ＡＡ（ＣＡＡ）及严重型ＡＡ（ＳＡＡ）１年及５年生存率分别为７９．６％、５７．９％及２０．４％、５．３％，与非老年患者（分别为９４．０％、７２．２％及７６．０％、１６．７％）比较差异有显著性。结论老年人ＡＡ预后不佳，除加强支持治疗和并存症治疗外，对于其骨髓衰竭的治疗应采取更加积极的措施。     

老年玻璃体混浊100例临床分析

目的了解老年人玻璃体混浊的发病情况以便有针对性的进行防治,保持良好的视功能。方法对６９５例≥６０岁的老年人进行视力、裂隙灯和眼底检查。视力低于５０者电脑验光、试镜。结果６９５例老年人中有１００例玻璃体混浊（１４３８％）,其中屈光不正７８例,眼病８例。随年龄增长玻璃体混浊的发病率逐渐增加。结论轻度玻璃体混浊对视力无明显影响,无需治疗。眼病等引起的玻璃体混浊需采取相应治疗措施。     

Visual impairment in an aged care ward

Introduction: Visual impairment is common in older people, and is a risk factor for falls and hip fractures, reduced independence and quality of life. Objectives: To assess the prevalence and causes of visual impairment in an aged care ward, and to evaluate whether routine eye assessment, and referral to an eye specialist was worthwhile to detect patients with low vision that could be correctable. Method: Clinical eye examination of 100 consecutive inpatients and review of medical records. Patients with a new diagnosis of visual impairment were referred for ophthalmology or optometry assessment. Results: The prevalence of low vision was 36% and the prevalence of blindness was 9%. There were 18 patients referred for specialist review, three patients were recommended a new treatment but only two received treatment. Conclusion: Visual impairment was prevalent. Although refractive error and cataracts were common, in only a few cases did detection and specialist referral lead to improved visual outcomes.     

超高龄白内障患者人工晶状体植入术疗效观察

目的：探讨基层医院对90岁以上超高龄白内障患者进行小切口白内障囊外摘除术联合人工晶状体植入术的可行性、安全性、疗效和体会。方法回顾性分析2007-10～2012-10该院对90岁以上超高龄白内障患者43例（52眼）进行小切口白内障囊外摘除＋人工晶状体植入术的麻醉效果、手术安全性和临床效果进行分析。结果43例（52眼）白内障患者均顺利完成手术,术后视力恢复良好,术后1周矫正视力≥0.5者37眼（71.2％）,矫正视力在0.1～0.3者10眼（19.2％）,0.05～0.08者5眼（9.6％）,术后随访均无视网膜脱离、眼内炎、继发青光眼、角膜内皮失代偿和人工晶状体脱位等严重并发症发生。结论在基层医院对超高龄白内障患者实施小切口白内障囊外摘除术联合人工晶状体植入术,切口愈合快,术后反应小,术后散光小,易于操作,费用低,只要把握好适应证,同样可取得良好的效果。     

老年人视力残障及相关眼病

目的调查分析老年人的视力残障状况和致病原因。方法对年度体检中≥60岁的老年人常规检查视力、眼前节、眼底及眼压。对视力低于正常者予以验光矫正和相关眼病检查。筛选出双眼或单眼矫正视力<0.3者进行眼病统计分析。结果893例中单眼或双眼视力<0.3者121例(13.55%)。其中双眼盲和低视力患者43例(4.82%);单眼盲和单眼低视力78例(8.73%)。随年龄增长视力残障的发生率显著增加,各年龄组间差异有极显著性(P<0.001)。121例患者的164只患眼中,125(76.22%)只眼患有2种或2种以上的致盲性眼病,其中白内障居首位。采用Logistic逐步回归和相关分析显示,影响视力最主要的眼病是年龄相关性黄斑变性和高度近视眼底黄斑萎缩,其次是青光眼和白内障。结论老年人随增龄致盲性眼病的患病率显著增加。随着医疗技术的进步和普及,老年人视力残障的发生率可望减少,然而致盲眼病谱可能发生改变,难治性眼病增多。对视力残障老年患者除积极治疗原发眼病,还应重视康复治疗。     

Prevalence of eye disorders among the elderly in Los Angeles

A series of 431 vision screening records of seniors 55 years of age and older were analysed. Patients were examined by the UCLA Mobile Eye Clinic at two senior centers in the Los Angeles area, between the years 1982 and 1990. Sixty-eight percent of patients were females and 32% were males. The mean (+/-S.D.) age was 69 (+/-7.5) years. Common diagnoses were refractive errors (65.2%) and impaired visual acuity (37.0%). The prevalences of refractive errors were: hyperopia, 24.8%; myopia, 10.4%; presbyopia, 54.1%; and astigmatism, 31.8%. In most patients (94.0%), impaired visual acuity was corrected by spectacles. The prevalence of cataract was 29.5% and age-specific prevalences of cataract increased with age. The prevalences of other eye disorders were as follows: glaucoma, 6.3%; diabetic retinopathy, 1.2%; and macular degeneration, 5.1%. This study highlights the degree of ophthalmic disorders identified by vision screenings in the elderly population in senior centers; our results are consistent with previously reported studies of eye diseases in the elderly.     

80岁以上白内障患者门诊手术安全性的评价

目的 探讨80岁以上老年人白内障门诊行超声乳化人工晶体植入术的安全性及临床效果。方法 对184例（226眼）80岁以上老年白内障门诊患者行超声乳化人工晶体植入术，观察其安全性、术中、术后并发症及视力恢复等。结果 226眼均安全地在门诊实行手术，术中无严重全身并发症发生。术后3个月198眼（87．6％）视力＞0．5，102眼（45．1％）＞1．0，主要并发症为角膜水肿58眼（26．2％），后囊破裂12眼（5．3％），后囊混浊16眼（7．1％）。结论 80岁以上老年白内障患者门诊行超声乳化人工晶体植入术是安全有效的，关键是术前认真进行眼部及全身状况检查，并作全身疾病的相应处理，手术中减少刺激并尽量减少术后并发症。     

Lowered vision as a risk factor for injurious accidents in older people

BACKGROUND AND AIMS: Poor vision in older people is often related to increased fall risk. However, the association of the severity between visual deficit and risk for all kind of injurious accidents has not been widely studied. The aim of this study was to examine whether visual loss is associated with higher incidence of injurious accidents and whether walking speed or physical activity play a mediating role in the association. METHODS: 416 persons aged 75 and 80 years at baseline underwent visual acuity measurements. Visual acuity (VA) <0.3 in the better eye, with spectacle correction when necessary, was defined as visual impairment, VA >or=0.3 but 0.5 as normal VA. Hospital records of accidents resulting in injury were monitored for 10 years after baseline. RESULTS: During the 10-year follow-up, 239 (58%) participants suffered at least one injurious accident. The risk for injurious accidents in a multivariate model adjusted for age, gender, eye-related diseases, diabetes and cardiovascular diseases among participants with lowered vision was 1.45 (95% CI 1.08- 1.94), compared with that for people with normal visual acuity. Participants with visual impairment did not have an increased risk for injurious accidents (HR 1.20, 95% CI 0.82-1.75). Furthermore, neither walking speed nor physical activity had a mediating effect on the relationship between visual loss and accidents. CONCLUSIONS: Lowered vision is a risk factor for injurious accidents in older people independent of mobility and physical activity. Interestingly, more severe visual impairment did not increase the risk. Early intervention strategies, for example, proper correction of refractive errors or cataract extraction, may potentially prevent injurious accidents in older people.     

The Prevalence and Causes of Visual Impairment and Blindness Among Older Adults in the City of Lodz,Poland

To investigate the prevalence and causes of visual impairment and blindness in a sample of Polish older adults.The study was designed in a cross-sectional and observational manner. Data concerning the vision status were assessed in 2214 eyes from 1107 subjects of European Caucasian origin; most of whom live in the city of Lodz, in central Poland. Visual impairment was defined as distance visual acuity <20/40 in the worse-seeing eye. Low vision was defined as best-corrected visual acuity (BCVA) <20/40 but >20/200 in better-seeing eye, and blindness was defined as BCVA ≤20/200 in both eyes (United States criteria).Visual impairment was found in 27.5% subjects in the worse-seeing eye. Multiple regression analysis showed that increasing age (OR 0.98, 95% CI 0.97–0.99) and female gender (OR 1.47, 95% CI 1.11–1.93) were independent risk factors. No association was found between visual impairment and socioeconomic status of subjects. Noncorrectable visual impairment was found in 7.0% of subjects, including 5.2% of subjects with unilateral and 1.8% of subjects with bilateral visual impairment. Low vision and blindness accounted for 1.3% and 0.5%, respectively, and were only associated with older age (OR 1.05, 95% CI 1.02–1.10). Retinal diseases represented the major cause of noncorrectable visual impairment and accounted for more than half of causes of blindness.Provision of appropriate refractive correction improves visual acuity in 75% subjects presenting with visual impairment. Retinal diseases are a major cause of noncorrectable visual impairment and blindness in this older population.     

Refractive outcome of premature infants with or without retinopathy of prematurity at 2 years of age: a prospective controlled cohort study

This study evaluated the extent to which refractive morbidity is correlated to preterm birth or retinopathy of prematurity (ROP) itself, or both, and examined the risk factors associated with refractive errors in a cohort of preterm infants with and without ROP compared with full-term infants. This longitudinal, prospective, controlled cohort study enrolled 109 infants, including 74 preterm and 35 full-term infants. Infants were divided into the following groups: no ROP, regressed ROP, laser-treated threshold ROP, and full-term. Cycloplegic refraction was determined at 6 and 24 months’ corrected age. Multiple regression models, analysis of variance (ANOVA) with post hoc comparisons, paired t test, and the χ² test were used for data analysis. ROP status was highly predictive of significant refractive errors in preterm infants. Eyes with laser-treated threshold ROP had significant myopia at both ages (mean spherical equivalent [MSE] in right eye at both refractions ?0.72, ?1.21 diopters [D]), astigmatism (MSE ?1.62, ?1.80 D), and anisometropia (MSE 0.82, 1.02 D; ANOVA p < 0.05), and increased refractive errors across ages (paired t test p < 0.05). Eyes with regressed ROP (MSE + 0.35 D) and eyes without ROP (MSE + 0.78 D) were less hyperopic than the controls (MSE + 1.60 D) before 1 year (post hoc comparisons p < 0.05). After 1 year, however, hyperopic status, astigmatism, and anisometropia were similar to eyes with regressed ROP (MSE + 0.38 D, astigmatism ?0.94 D, anisometropia 0.32 D), eyes without ROP (MSE + 0.35 D, astigmatism ?0.51 D, anisometropia 0.31 D) and the controls (MSE + 0.72 D, astigmatism ?0.59 D, anisometropia 0.50 D) by post hoc comparisons (p > 0.05). Thus, the persistent hyperopic status across ages in patients with regressed ROP and in patients without ROP differed significantly (paired t test p > 0.05) from that in the full-term infants, with a reduction in hypermetropia noted for the first 2 years of life (paired t test p < 0.05). The incidence and magnitude of significant refractive errors increased with severe ROP and with age. Although the emmetropization process of preterm birth, including regressed ROP and no ROP, differed from full-term birth in early infancy, we found no differences in the refractive status after 1 year in patients with regressed ROP and in patients without ROP, who were at risk of developing ametropia similar to that of full-term patients. Therefore, apart from laser-treated ROP, children with regressed ROP and without ROP can likely be observed with a verbal vision screening at 3–4 years of age.     

年龄相关性白内障患者术前的散光特征及相关因素分析

目的：了解术前老年性白内障患者的散光特征,并与年龄、眼轴、角膜中央厚度等相关因素进行分析。方法收集2013年10月至2014年10月期间被诊断为老年性白内障的患者498例（眼）,观察角膜散光情况,对年龄、眼轴、角膜中央厚度、角膜曲率等因素与角膜散光的关系进行分析。结果选取对象年龄为（72.19±9.98）岁,角膜散光值（1.13±0.84）D,顺规性散光152眼（30.52%）,逆规性散光249眼（50%）,斜轴散光97眼（19.48%）;年龄增长跟眼轴变化呈现正相关。结论在年龄相关性白内障患者中术前角膜散光患病率较高,主要是轻到中度散光;随着年龄增加,逆规性散光比例逐渐增大,眼轴变短,散光度数也有增大趋势,尤其是在＞80岁的患者。年龄较轻的白内障患者近视眼人群比例较高。