屈光不正性弱视误诊分析

An analysis of misdiagnosis of ambyopia in outlying hospitals

目的 :了解基层医院对屈光不正性弱视诊断的正确性。方法 :①对 36例 45眼屈光不正性弱视重新散瞳检影验光 ,分别记录球镜度、柱镜度、轴向和矫正视力 ,并与原结果进行对比分析。②按屈光性质分远视性散光、近视性散光及混合性散光三组 ,分别对三组被误诊患者的年龄、误诊时间进行统计分析。结果 :柱镜度及轴向与原结果存在显著性差异 ,混合性散光占 41.6 6 % ,三组中误诊年龄、时间以近视性散光为最高。结论 :屈光不正性弱视误诊的方面主要是柱镜度及轴向 ,以混合性散光为多。误诊年龄、时间以近视性散光为高。对屈光不正性弱视进行正确诊断 ,过硬的检影技术是关键 。

Objective:To assess diagnostic accuracy in lower hospitals.Methods:①Cycloplegic refractions were repeated on 36 patients(45 eyes). Spherical and cylindrical diopters,the axis and corrected visual acuities were recorded and compared with previous measurements obtained in outlying hospitals.②Patients were divided into three groups based on type of astigmatism: hypermetropic,myopic or mixed astigmatism. The age of the patient and the frequency of misdiagnosis was statistically analyzed for the 3 groups. The frequency of misdiagnoses was compared between the county hospitals and suburban or city hospitals.Results:The measurements of the cylindrical diopter and the axis were significantly different from previous results,with mixed astigmatism accounting for up to 42.66% of the difference. Misdiagnosis was highest in the myopic astigmatism group,according to the age of the patient. The frequency of misdiagnosis was significantly different in the in country hospitals compared to those in the suburban or city hospitals.Conclusion:Cylindrical diopter and axis in ametropic amblyopia is commonly misdiagnosed,mainly when astigmatism is mixed. Age at the time of misdiagnosis and the frequency of misdiagnosis are highest in myopic astigmatism. These misdiagnoses are more common in country hospitals than in suburban or city hospitals. Specialized techniques are required for the proper diagnosis of ametropic amblyopia. The quality of optometrists working in the outlying hospitals should be improved. [FK(WB80011?6]