日常生活视力在儿童近视防治实践中的应用

Application of presenting visual acuity in the prevention and control of myopia in children

目的探讨日常生活视力指标在儿童近视防治实践中的应用,为在学校卫生领域正确评价儿童视力状况提供依据。方法整群抽取上海市8个区55所中小学校一～九年级41 243名学生,行裸眼远视力检查,戴镜者同时检查戴镜视力,分别以较好眼和较差眼分析日常生活视力实践应用情况。结果受检人群较好眼日常生活视力良好有24 461名(59.3%),视力轻度受损4 779名(11.6%),视力中度损害934名(2.3%);视力受损率(≤4.7)随年级增长而上升,上升趋势至四年级以上趋于平缓,保持在17%左右。较差眼裸眼视力<4.9者21 595名(52.4%),日常生活视力<4.9者15 717名(38.1%),以日常生活视力进行筛查可避免5 878名(27.2%)过度转诊。结论日常生活视力对提高近视筛查效率、反映儿童日常实际视觉质量有一定作用,建议将其作为评价补充指标纳入学生近视防控指标体系。

Objective To evaluate the role of presenting visual acuity in the prevention and control of childhood myopia. Methods With stratified random cluster sampling, 41 243 children of grade 1 to 9 from 55 schools situated in 8 districts in Shanghai were selected to conduct the uncorrected visual acuity. In children who were wearing glasses, visual acuity was measured both with and without spectacles. The analyses of presenting visual acuity were based on worse and better eye vision, respectively. Resuits Of the 41 243 children, the moderately visually impaired and the mildly impaired of presenting were 11.6% and 2.3 %, respectively. As the grades increased, the rate of visually impaired in children increased,to grade 4 it maintained at about 17%. Uncorrected visual acuity and presenting visual acuity worse than 4.9 were 21 595 （52.4%） and 15 717（38.1% ） children, respectively. In comparison with the uncorrected visual acuity, presenting visual acuity as an indicator for screening could help 5 878 （27.2%） children avoid having received appropriate refraction correction and being referred to the clinic again. Conclusion The use of presenting visual acuity as an indicator could help us to know the daily visual quality among children, and improve the efficiency of myopia screening. It may be a valuable indicator for the prevention and control of myopia in children.