儿童盲和低视力的病因与屈光状态及远用助视器康复研究

A study of children with childhood blindness and low vision: pathogenesis,refraction states and distant vision rehabilitation

目的:分析儿童盲和低视力的病因、屈光状态、屈光矫正和配用光学远用助视器矫正后的视力情况。方法:选取2015-12/2018-04我科门诊接诊及盲校筛查的6～16岁低视力儿童和盲童212例422眼,通过相关检查明确病因和屈光状态,对部分患儿进行屈光矫正和光学远用助视器验配矫正,分析矫正后视力情况。结果:儿童盲和低视力病因以先天性和遗传性眼病为主,本组病例中先天性白内障是首位原因(19.3%),低视力屈光不正以轻中度远视和近视多见(65.3%),屈光矫正后脱盲率(26.4%)和脱残率(14.6%)均低于联合远用助视器验配矫正后的脱盲率(58.3%)和脱残率(91.1%),差异均有统计学意义(P<0.01)。结论:儿童盲和低视力病因复杂,应加强预防和筛查工作,低视力儿童应常规进行屈光矫正并配合使用远用助视器矫正,以利获得满意的康复效果。

·AIM:To analyze the pathogenesis,refraction states,refractive error correction with glasses and distant vision rehabilitation using optical far-range visual aids in children with childhood blindness and low vision.·METHODS:A selection of 212 blind and low vision children,422 eyes,aged 6-16,were examined by our team at the Kunming Children’s Hospital Opthalmology Clinic and Kunming School of the Blind during opthalmic screening from December 2015 to April 2018 for their pathogenesis and refraction states.A portion of those patients were able to receive refractive error correction and be fitted with optical far-range visual aids to have their rehabilitation condition analyzed afterwafrds.·RESULTS:The most common pathogenesis discovered in blind and low vision children was congenital genetic oculopathy with congenital cataracts reported as the leading disease in our group(19.3%).Mild,moderate myopia and hyperopia was the most common in subjects with low vision refractive error(65.3%).Children achieved blindness correction(26.4%)and disability correction(14.6%)with refractive error correction alone was much less than those achieved blindness correction(58.3%)and disability correction(91.1%)using refractive correction alongside fitted far-range visual aids;differences were statistically significant(P<0.01).·CONCLUSION:The pathogenesis of children with blindness and low vision is multi-faceted and complex;priority should be given to prevention by working to provide regular opthalmic screening.Children with low vision should receive routine refraction examinations and be prescribed glasses as well as fitted far-range visual aids for satisfactory rehabilitation results.