Early onset and high incidence of myopia has caused great concern of the Party and the Government. On August 30th 2018, eight ministries and commissions, such as the Ministry of Education, jointly issued the Comprehensive Prevention and Control Implementation Scheme of Child and Adolescent Myopia, which put forward the actions and specific measures to various aspects, and particularly mentioned that the medical and health institutions should work together with families, schools, etc, to reduce the incidence of myopia. Medical institutions should do a good job in the following items: setting up visual archives for adolescents, so as to prevent and control myopia with pertinence and individualization; standardizing the process of diagnosis and treatment, doing a good job in refractive examination and correction of adolescents, and resolutely combating the commercial "treatment and correction" of myopia; strengthening myopia-related health education, and eliminating erroneous understanding to myopia prevention and control. Optometrists should play an important role in the prevention and control of myopia, speed up the cultivation of optometry talents, and call on the state to establish a professional title system and professional access standards for optometry talents as soon as possible.
Objective To investigate the influence of undercorrected orthokeratology on myopia control, and the correlation between target and central corneal epithelial damage. Methods A retrospective study was conducted on 22 undercorrected orthokeratology lens wearers (37 eyes) from January 2016 to February 2017, and 25 full corrected wearers (47 eyes) during the concurrent period were randomly selected as the control group. The changes of axial length before and after orthokeratology lens wearing and the within-6-month central corneal epithelial damage after orthokeratology lens wearing were analyzed. Results The average annual increase of axial length was (0.13±0.15) mm in the undercorrected group, and (0.14±0.16) mm in the full corrected group, the difference was not statistically significant (P>0.05). Multiple linear regression analysis showed that there was no correlation between the axial growth and the undercorrection of the target (P>0.05), but a negative correlation between the axial growth and the age (P<0.01). After using orthokeratology, the average annual growth of the axial length in children aged 7-10 years was (0.25±0.16) mm, and (0.10±0.14) mm in children aged 11-15 years, the difference was statistically significant (P<0.01). The incidence of central corneal epithelial punctate staining in the (–4.25)-(–5.00) D target group was 27.08%, and that in the (–3.00)-(–4.00) D target group was 16.67%, the difference was not statistically significant (P>0.05). Conclusions The effect of orthokeratology on myopia growth is not affected by the undercorrected target, not related to the undercorrection of target, but negatively correlated with the age. Undercorrected orthokeratology can still be used for myopia control in high myopia patients. No correlation is found between the target and central corneal staining.
ObjectiveTo investigate whether the corneal shape recovered after discontinuation of long-term orthokeratology and whether orthokeratology increased the corneal astigmatism and ocular astigmatism.MethodsFrom December 2016 to April 2018, a retrospective study was conducted on 33 myopic patients who had undergone two times standard orthokeratology in the outpatient department of West China Hospital of Sichuan University, and had stopped wearing the first orthokeratology lens for one month before fitting the second orthokeratology lens. A total of 32 myopia frame glasses wearers were selected by simple random sampling as control. The changes of corneal flat meridian curvature (flat K), corneal steep meridian curvature (steep K), corneal astigmatism and ocular astigmatism before and after discontinuation of orthokeratology were analyzed.ResultsAmong the patients with baseline myopia diopter of −0.25～−2.75 D, the average annual change of corneal flat K was (−0.03±0.21) D in the frame glasses group and (−0.24±0.14) D in the orthokeratology group, the difference was statistically significant (t=5.555, P<0.001). Among the patients with baseline myopia diopter of −0.25～−2.75 D, the average annual change of corneal steep K was (0.20±0.42) D in the frame glasses group and (0.15±0.20) D in the orthokeratology group, the difference was not statistically significant (t=0.785, P=0.435). Among the patients with baseline myopia diopter of −3.00～−5.75 D, the average annual change of corneal steep K was (0.29±0.39) D in the frame glasses group and (−0.01±0.20) D in the orthokeratology group, the difference was statistically significant (t=2.758, P=0.014). The average changes of corneal astigmatism were analyzed according to the difference of eyes, gender, age and baseline corneal astigmatism, the difference was not statistically significant (P>0.05), respectively. For patients with baseline astigmatism absolute value less than or equal to 0.50 D, the astigmatism annual change of the frame glasses group was 0.00 (0.50) D, and that of orthokeratology group was −0.33 (0.48) D, the difference was statistically significant (Z=−2.301, P=0.021).ConclusionsThe flat K of the cornea becomes flatter and the steep K does not change after one month’s discontinuation of long-term orthokeratology. There was no difference in the increase of corneal astigmatism compared with those wearing frame glasses. When the baseline ocular astigmatism is less than or equal to 0.50 D, the increase of astigmatism may occur after discontinuation of orthokeratology.
【摘要】 目的 观察综合疗法治疗大龄儿童弱视的疗效。 方法 回顾分析2008年1月-2010年10月在我院初诊并经综合治疗的8～13岁弱视儿童62例85只眼的临床资料。治疗前最佳矫正视力0.1~0.7，平均0.46±0.17。观察患者经弱视综合治疗后视力、空间对比敏感度及立体视提升效果。 结果 治疗后视力正常22例31只眼（36.5%），进步29例39只眼（45.9%），无效11例15只眼（17.6%）；总有效率82.4%，与治疗前相比，差异有统计学意义（Plt;0.001）。空间对比敏感度基本正常11例16只眼（18.8%），进步43例58只眼（68.2%），无效8例11只眼（12.9%）。弱视眼在1.5、3、6三个低空间频率的对比敏感度值与治疗前相比提升有统计学意义（Plt;0.001）；在12和18两个高空间频率，对比敏感度值与治疗前相比提升无统计学意义（Pgt;0.05）。立体视锐度正常12例（19.4%），进步26例（41.9%），无效24例（38.7%），立体视锐度与治疗前相比提升具有统计学意义（Plt;0.001）。 结论 综合疗法治疗大龄儿童弱视能取得令人较为满意的疗效，患儿视力显著提升，低到中等频率空间对比敏感度及立体视锐度也有较大提升。【Abstract】 Objective To explore the therapeutic effect of comprehensive therapy on elder children with amblyopia. Methods The clinical data of 62 patients (85 eyes) with amblyopia who underwent the comprehensive therapy between January 2008 and October 2010 were retrospectively analyzed. The best-corrected visual acuity was 0.1-0.7 (mean 0.46±0.17) before the treatment. The visual acuity, spatial contrast sensitivity and stereoacuity of the patients after the treatment were observed. Results After the comprehensive therapy, the visual acuity was normal in 22 patients (31 eyes, 36.5%), improved in 29 patients (39 eyes, 45.9%), invalid in 11 patients (15 eyes, 17.6%). The total effective rate was 82.4% which was differed significantly from that before the treatment (Plt;0.001). The spatial contrast sensitivity was almost normal in 11 patients (16 eyes, 18.8%), improved in 43 patients (58 eyes, 68.2%), and invalid in 8 patients (11 eyes, 12.9%). The examination of spatial contrast sensitivity showed that the improvement was only statistically significant when frequency equates 1.5, 3, or 6 (Plt;0.001) compared with those before the treatment; while no statistically significant improvement was observed in higher frequencies of 12, 18 (Pgt;0.05). The stereoacuity was normal in 12 patients (19.4%), improved in 26 (41.9%), and invalid in 24 (38.7%); the difference in stereoacuity before and after the treatment was significant (Plt;0.001). Conclusion The therapeutic effect of comprehensive therapy is good: the visual acuity of the patients improves obviously, and the low to middle spatial contrast sensitivity and stereoacuity improve apparently.
Optometry involves knowledge from multiple fields such as biology, physics, chemistry, psychophysics, and medicine. Traditional undergraduate education in optometry mainly focuses on knowledge transmission and lacks interaction, resulting in low student interest and unsatisfactory teaching outcomes. In order to improve this situation, the teaching team of Department of Optometry and Visual Science, West China School of Medicine, Sichuan University proposed a method of integrating real visual experiences into teaching. By combining multimedia tools and existing methods, real visual phenomena and personal visual experiences are integrated into the curriculum. This new teaching method stimulates students’ interest in learning, increases classroom interaction, promotes knowledge understanding and application through vivid visual phenomena and students’ own visual experiences. This article will introduce the above teaching method.
目的 比较中高度散光患者配戴框架眼镜和透气性硬性接触镜（RGPCL）的主客观视觉质量。 方法 选取2008年6月－2011年5月中高度角膜散光20例共40只眼进行角膜地形图、综合验光仪验光等检查后，选择合适试戴片作配适评估并定制RGPCL。要求患者戴镜后1周、1个月、3个月和6个月复查，记录矫正视力、镜片配适、眼部情况，并在第4次复查时进行对比敏感度视力检查及主观问卷调查。 结果 RGPCL矫正视力优于框架眼镜，但两者对比敏感度视力在各空间频率均无明显差异。主观评分时，远视力两者无明显差别；中距离视力框架眼镜评分（3.825 ± 0.245）分，RGPCL评分（3.525 ± 0.302）分，差异有统计学意义（t=5.339，P=0.000）；近距离视力框架眼镜评分（3.795 ± 0.233）分，RGPCL评分（3.690 ± 0.194）分，差异有统计学意义（t=3.462，P=0.030）。有45%患者选择RGPCL为主要配戴方式；40%患者选择RGP CL和框架眼镜交替使用的方式；10%患者选择仅在有特殊社交需求时使用RGPCL；另5%患者放弃使用RGPCL。 结论 RGPCL和框架眼镜矫正中高度角膜散光均能取得较满意效果，在中近距离精细作业时框架眼镜矫正视力更为稳定清晰。但由于RGPCL在成像质量和外观上的优势，多数患者仍愿意坚持配戴RGPCL。
ObjectiveTo evaluate the differences of visual evoked potentials (amplitudes and latency) between cerebral palsy (CP) children and normal children. MethodsThis study involved fourteen children aged from 4 to 7 years with CP (monoplegia) between 2009 and 2013. Another 14 normal children aged from 5 to 9 years treated in the Department of Ophthalmology in West China Hospital during the same period were regarded as the control group. Both eyes of all the participants were examined by multifocal visual evoked potential (mfVEP). The mfVEP examination results were recorded, and amplitude and latency were analyzed. First, we analyzed the differences of amplitudes and latency time between monoplegia children and children in the control group. Second, gross motor function classification system (GMFCS) was used to classify the fourteen monoplegia children among whom there were five GMFCS Ⅰ patients and nine GMFCS Ⅱ patients. The differences of mfVEP were analyzed between the two GMFCS groups. ResultsThe amplitude and latency of mfVEP in children with CP showed gradual changes similar to those in the normal children. The amplitudes were decreasing and the latencies were delaying from the first eccentricity to the sixth eccentricity. The amplitudes in children with CP were lower than those in the control group in the first to the third eccentricities for both eyes (P＜0.05), and latency of left eye was delayed in the first eccentricity in children with CP (P=0.045). No difference was found between the two GMFCS groups (P>0.05) except the amplitude of the first eccentricity (P=0.043). ConclusionsThe results of mfVEP show significant differences of amplitude and latency between CP and normal children, suggesting the existence of visual pathway impairments in cerebral palsy children. The results of mfVEP can provide an objective basis of visual impairments for cerebral palsy children.
Objective To investigate the efficacy of individualized surgical treatment on congenital superior oblique paralysis. Methods A total of 131 patients (180 eyes) undergoing surgery for congenital superior oblique palsy between October 2015 and January 2018 in West China Hospital of Sichuan University were reviewed. The clinical features, surgical methods and efficacy were analyzed. Results Among the 131 cases, 49 cases were bilateral congenital superior oblique palsy, and 82 cases were unilateral congenital superior oblique palsy; 94 cases were combined with horizontal strabismus; 17 cases (26 eyes) underwent inferior oblique recession, 53 cases (93 eyes) underwent superior oblique tuck, 4 cases underwent superior oblique tuck combined with contralateral superior rectus resection, 37 cases underwent superior oblique tuck combined with contralateral inferior rectus recession, 6 cases underwent inferior oblique recession combined with contralateral superior rectus resection, and 14 cases underwent inferior oblique transposition combined with contralateral superior rectus resection; 18 cases underwent horizontal strabismus correction at one stage, and 76 cases underwent horizontal strabismus correction at the second stage. After Surgery, there were 116 cases cured (88.55%), 15 cases improved (11.45%), and 0 case invalid. Conclusions The diagnosis of congenital superior oblique paralysis should be accurate. Individualized surgery should be designed according to the size and maximum orientation of the squint and the limitation or hyperactivity of the muscles in each diagnostic eye position.
目的:分析探讨单眼散光弱视患儿对比敏感度(CS)视功能的受损特点。方法:对正常儿童组36例、单眼散光弱视组34例、单眼非散光弱视组33例,共103例,用静态F.A.C.T图表和计算机Gabor斑CS检查程序分别检查患儿对侧眼、弱视眼及90°和180°两主子午线方向上的对比敏感度。结果:①单眼散光弱视组和单眼非散光弱视组的对侧眼、弱视眼的CS值在所有空间频率均较正常组的CS降低(Plt;0.05),表现为中、高空间频率区CS的明显受损(Plt;0.01)。②单眼散光弱视组的弱视眼在90°和180°两主子午线方向上的对比敏感度有显著差异(Plt;0.01)。结论:弱视儿童的对侧眼不正常。用计算机Gabor斑检查可以了解弱视散光儿童不同子午线上的CS存在的差异,明确定位弱子午线,并可以针对子午线性弱视,进一步开展知觉学习的治疗。