老年人复视的临床观察

Clinical Analysis of Diplopia in Aged People

目的对老年人的复视症状进行分析,并对其病因进行筛查及诊治。方法研究对象分为2部分:第一部分为近3年部分省直单位健康查体人群中60岁及以上者,共351例,第二部分为笔者近4年经治的主诉复视或重影的60岁以上者共165例。所有患者在半暗室行9个方位红玻璃试验,判断复视的性质并给予治疗。结果351例健康查体者中3例红玻璃试验阳性(0.85%),为眼外肌不全麻痹。165例临床患者中双眼复视者114例(69.09%),主要原因为眼外肌麻痹或不全麻痹(105例),其它原因有:陈旧性眶壁骨折2例,重症肌无力3例,甲状腺相关性眼病3例,痛性眼肌麻痹1例。单眼复视者53例(32.12%),主要原因为屈光不正、早期白内障。治疗结果:眼外肌麻痹患者中89例(84.76%)经非手术治疗后复视消除,治疗时间20d～6个月,平均(97.2±29.8)d。单眼复视者分别给予病因治疗或解释病情。结论老年人双眼复视最常见的原因是眼外肌麻痹,非手术治疗有效;单眼复视的原因主要为屈光不正、早期白内障等。红玻璃试验简单易行,对此有快速鉴别意义。

Objective To investigate the reason of the diplopia in aged people. Methods 351 routine health check subjects and 165 clinic patients were examined with red-glass test,all the subjects were over 60 years old. Results 3 of 351 heahh check cases and 114 of 165 patients were found have binocular diplopia ,The main causes of binocular diplopia were palsies of the oculomotor nerves. 53 of 165 patients were found have monocular diplopia,the main causes of monocular diplopia were refractive error and early stage of cataract. Conclusions Red-glass test is a simple method which provides valuable information on the diagnosis and differential diagnosis of binocular diplopia and monocular diplopia.