90岁以上老年人眼部状况及疾病分析

The investigation of the eye condition and analyses of the diseases in the longevous aged 90 years or over

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。

Objective To investigate the vision and the eye conditions of the longevous aged 90 years or over Methods The vision was examined by Snellen chart, and the outer eye, anterior segment, fundus and intraocular pressure were examined by slit lamp, funduscope and non contact tonometer in 135 longevous cases Some related examinations were adopted on suspective cases The refractive errors were corrected in 53 cases who were cooperative to examination Results The visions of right eyes were 0 01～1 0 with the average of 0 46±0 50, and the left eyes were 0 03～1 0, with the average of 0 49±0 50. The probabilities of blindness and low vision were 5 93% and 10 27% respectively. In 43 cases (81 13%)the vision increased by 1～5 lines (the average in 3 lines)after optometry compared with pre optometry ( P <0 01). All the elderly had senile eye changes, such as ptosis, corneal arena, fundus arterosclerosis, presbyopia etc. On an average, there were 2 4 kinds (2～7 kinds) eye diseases and 7 6 kinds (3～12 kinds) general chief organs diseases in every elderly. The general factor which influenced vision was refractive error. Prevalence of cataract was the highest among the eye diseases. The eye disease which influenced vision most severely was macular disease and optic nerve atrophy. Conclusions Blindness and low vision are relatively common in the longevous. The reasons for them include the ageing related degenaration and eye diseases, especially refractive error.