103例视疲劳患者的病因及治疗

目的 调查视疲劳的病因,探讨其治疗方法.方法 前瞻性系列病例研究.103例视疲劳患者,检查其眼前后节、远近隐斜、水平聚散力、集合近点、调节性辐辏/调节值、调节幅度、调节灵敏度、相对调节、调节反应,对视疲劳症状进行评分,分析视疲劳的原因.针对病因给予矫正屈光不正、调节辐辏训练、配戴三棱镜、药物治疗.评价这些治疗对视疲劳的治疗效果.采用独立样本t检验.结果 103例视疲劳患者性别比为男∶女=1∶1.5.其病因分别是:屈光不正38例(36.9％),干眼症26例(25.2％),肌性视疲劳29例(28.2％),调节性视疲劳10例(9.7％).治疗前视疲劳评分为(4.8±0.7)分,治疗后症状缓解,评分为(2.0±0.6)分,差异有统计学意义(t=16.0.P＜0.01).结论 视疲劳常见病因是屈光不正、辐辏异常、干眼症、调节异常,治疗方法主要有矫正屈光不正、视觉训练、配戴三棱镜、药物对症治疗等.

Pathogenesis and therapy in 103 cases of asthenopia

Objective To observe the pathogenesis and therapy of asthenopia. Methods It was a prospective case series study. One hundred and three patients with asthenopia were included. The function of accommodation and fusion test including distance and near phoria, horizontal convergence and divergence, near point, accommodative convergence/accommodation ratio, amplitude of accommodation, accommodative facility, relative accommodation, accommodative response was examed, and the pathogenesis was analyzed. Therapies include correct ametropia, vision training, prism correction, pharmacologic treatment. The symptom of asthenopia before and after treatment was evaluated with a questionnaire, and compared with a paired t test. Results The sex ratio of the 103 patients with asthenopia was 1：1.5 （male：female）. There were 38 cases of ametropia （36.9%）, 26 cases of dry eye （25.2%）, 29 cases with convergence or divergence problems （28.2%）, and 10 cases with accommodation problems （9.7%）. The symptom of asthenopia score was 4.8_＋0.7 before treatment,after treatment, all cases showed improvement in asthenopic symptoms,and the symptom of asthenopia score was 2.0＋0.6, compare with before treatment, the difference was significant （t=16.0, P〈0.01）. Conclusion Most of the patients with asthenopia had identifiable pathologies or deficits. The pathogenic causes of asthenopia are ametropia, dry eye, accommodation abnormalities, and convergence or divergence abnormalities. The therapy for correction of ametropia is training, prism, medication, etc.