暗适应对主觉验光中双眼平衡的影响

The Effect of the Dark Adaptation to the Result of Binocular Balance in Subjective Refraction

目的探讨在常规主觉验光环境下,暗适应造成的双眼前视标背景亮度差异的持续时间。方法选择吉林大学第二医院眼科硕士研究生及进修医生40名(男11名,女29名,年龄在24-29岁之间),在常规单眼主觉验光完成后,双眼前加+0.75 DS球镜再次雾视,右眼前加3ΔBD棱镜,左眼前加3ΔBU棱镜。打开右眼前遮盖,同时开始计时,让被检者观察上下两行视标背景亮度,当亮度相等时报告,计时停止。结果40名学生的报告时间呈正态分布,反应时间最快的为25.16 s,最慢的为61.19 s,平均为42.71±9.71 s,单侧95%参考值上限为58.64 s。结论在双眼去遮盖1 min时间内,基本可以消除背景亮度差异对平衡结果的影响,建议在去雾视达到双眼球镜终点时,再进行一次双眼棱镜分离平衡。一方面可以消除暗适应的影响,验证雾视状态下的结果是否正确;另一方面可以避免一些特殊患者在雾视与去雾视状态下,双眼视力差距不同的影响。

Objective To evaluate the lasting time of background luminance diffemace of the fixation target between two eyes because of dark adaptation under routine subjective refraction.Methods 40 Students were chosen （11 males,29 females,hetween 24 to 29 years old）.After the routine examination of single eye,two ＋ 0.75 DS lens were placed in front of two eyes to fog again.3^△BD prism and 3^△BU prism were placed in front of right eye and left eye respectively. Counting was begun just after removal of the occlusion of the right eye. The Student was asked to observe the difference in the brightness perceived by the two eyes. Counting was finished when the brightness were the same. Results The data which students reporting were normal distribution. The shortest and longest time of reaction was 25.16 s and 61.19 s respectively.The average time was 42.71 ＋ 9.71 s.The upper 95% limit of reference value was 58.64 s. Conclusion The difference between the background brightness of the symbol would he eliminated within 1 rain after binocular occluded. When arriving at the unfog end point of binocular, we recommend to do equalization again.It could eliminate the effect of dark adaptation,and also could avoid the conditions that the difference of visual acuity varied between fog and unfog situation in some patients.