学龄前儿童视觉发育状况调查研究

A study on visual development among preschool children

目的了解学龄前儿童视觉发育状况及斜弱视患病率。方法对4610名城乡3～6岁学龄前儿童进行随机抽样调查，项目包括视力、屈光状态、眼位、斜视弱视等。用）（2检验城乡及不同年龄视力分布差异。结果3岁、4岁、5岁和6岁组儿童视力1．0以上检出率分别为28．4％、39．3％、46．2％、76．5％，各年龄组视力主要分布3岁（0．63±0．19）、4岁（0．69±0．16）、5岁（0．71±0．22）、6岁（0．79±0．29），乡镇较城市儿童视力好。屈光状态以远视为主；显性斜视检出率为2．21％，外斜视多见于内斜视；隐性斜视检出率为33．52％，主要是外隐斜；弱视患病率以现行诊断标准为6岁组2．93％，5岁组4．81％，4岁组16．21％，3岁组33．33％。结论学龄前儿童视力随年龄增长而上升；国内弱视诊断中视力标准偏高，应尽快制定各年龄组弱视诊断视力标准。屈光不正、斜视和弱视是影响学龄前儿童正常视功能的主要因素，依然是儿童时期防盲治盲的重点。

Objective To evaluate the visual development and prevalence of amblyopia, strabismus among preschool children. Methods A random sample survey was performed in 4 610 preschool children from both urban and rural, aged 3 to 6 years. Participants underwent eye examination including visual acuity, refractive status, eye position, strabismus and amblyopia. Results Percentage of visual acuity above 1.0 was 28.4% , 39. 3% , 46.2% and 76. 5% in children of 3, 4, 5 and 6-year-old group, respectively. The mean visual acuity of each group was 0. 63 ± 0. 19 in 3-years old, 0. 69 ± 0. 16 in 4-year- old, 0. 71 ± 0. 22 in 5-year-old, 0. 79 ± 0. 29 in 6-year-old. Rural children have better vision acuity compared with those from urban. Hypermetropic was frequent efractive errors. Manifeststrabismus was found in 2. 21%, with exotropia being more prevalence than esotropia; detection rate of recessive strabismus was 33.52%, mainly being exophoria; Based on current diagnostic criteria, the prevalence of amblyopia were 2.93% in 6 year-old group, 4. 81% in 5-year-old group, 16. 21% in 4-year-old group, 33.33% in 3-year- old group. Conclusion Vision aeutiy is increasing with age in preschool population. A diagnosis standard of amblyopia suitable for each age group should be established to substitute the current one which has a high visual standard for amblyopia. Refractive error, strabismus and amblyopia are the leading causes of visual impairment among preschool-aged children, which represent the focus of prevention of blindness in preschool children.