老年人466眼屈光状态临床分析

Clinical analysis on the refractive condition of the aged

目的:探讨老年人眼屈光变化的规律,做好老年人视力保健。方法:标准照明下查56岁以上的老年人466眼的远视力,扩瞳状况下应用Topcon-KR8100PA综合验光仪验光和检查角膜曲率,试镜矫正视力,查晶状体混浊形态和程度(LOCSII分类法)、玻璃体和视网膜。结果:全组屈光不正458眼(98.3%),56～75岁以远视居多,其中61～65岁比例最高,以后趋向减少,至75岁以后近视多于远视。散光258眼(55.4%),其中不合例散光占76.0%,散光的比例随年龄的增长而增长,而各散光轴向均与角膜曲率显示的散光轴向一致。各年龄组矫正视力都有明显的提高。结论:老年人眼不合例散光居多是角膜老年性变化对眼屈光的影响,不属于晶状体老化所出现的晶状体屈光性改变的范围。高龄老年人近视状态居多的原因可能是核型老年性白内障的演变病程较慢,所以,尚未行白内障摘除之高龄老年人,以核型白内障居多而出现核性近视。屈光不正是最早和最普遍影响老年人视力的主要原因,定期检查老年人眼屈光状态应作为眼科常规检查之一。

AIM： To explore comprehensively the basic pattern of the changes of refraction of old people,and to do a better job for the vision care for them. METHODS： An examination was done under standard lightng for the distance visual acuity of 466 eyes of the aged, using the KR-8100PA Auto Kerato-Refractometer for an examination diopter and corneal curvature. The turbid shape and turbidity of the crystalline lens （LOCS Ⅱ classifcation）, the vitreous and the retinas were examined. RESULTS： There were 466 ametropic eyes in the whole group （98.3%）. Host of the examinees aged from 58-75 were farsighted The proportion of farsightedness in the group of the age of 61-65 was the largest, and the proportion in the group aged over 65 tended to decline. Examinees that were over 75 years old were shortsighted more than farsighted. The rate of astigmatism was 55.4%, among which the astigmatism against rule accounted for 76.0%. The proportion tended to grow with the increase of age. The rectification of vision in various age groups had a satisfactory improvement. CONCLUSION： These findings suggest that astigmatism against the rule in most cases is the result of the refraddon of cornea of the senior changes but not the result of lenticular factor. The reason for the commonness of shortsighbedness among the aged is probably the relatively long pathological changing process of nuclear cataract, and the old aged who escape from removal of cataract suffer form nuclear cataract in most cases, thus shortsightedness nuclear begins to develop. Ametropia is the main cause that affects the vision of the old earliest and most commonly. Regular cheek on the condition of refraction the eyes of the aqed people should be onepart of the regular examination.