高中毕业青年报考军校体检眼部情况分析

Eye examination results of high school graduates to be recruited by military academies during physical examination

背景眼科体检结果异常一直是征兵入伍或报考军校者被淘汰的主要原因。高中毕业青年作为军校招生的主要来源,眼科检查情况应受到重视。目的分析高中毕业青年报考军校眼科检查不合格的原因,为更好地开展军队院校招收学员工作提供支持。方法分析2020年7月我中心高中毕业青年报考军校眼部体检的情况,体检标准按照2017年颁布的《军队院校招收学员体格检查标准》执行。在亮度合适的空间及距离进行视力和色觉检查;使用裂隙灯对结膜、角膜、前房、晶状体等进行检查;暗室下使用直接检眼镜进行眼底检查;通过提供病例、诊断证明、询问病史等方式获得眼部疾病史及手术史。结果共进行眼科检查630人,合格558人,总合格率88.6%,其中男性420人,女性138人,男性合格率略低于女性,但差异无统计学意义(87.7%vs 91.4%,P=0.242)。合格者中有角膜屈光手术史34人,飞秒激光小切口角膜基质透镜取出术(small incision lenticule extraction,SMILE)是主要的手术方式。不合格72人,不合格率为11.4%,其中裸眼视力不足占65.3%,角膜屈光手术时间<6个月占23.6%,人工晶体(implantable collamer lens,ICL)植入手术占4.2%,屈光度大于6.0 D占2.8%,晶状体中央区混浊、角膜白斑、矫正视力不足各占1.4%。结论裸眼视力不足和角膜屈光手术时间不足是眼科检查不合格的主要原因,应提前进行宣传教育,引导有参军意向的青年提前做好准备。

Background Abnormal ophthalmic examination results have always been a main reason why young individuals are rejected during military recruitment.Since high school graduates are the main source of military academy recruitment,their ophthalmic examination results should be taken seriously.Objective To investigate the reasons for unqualified ophthalmic examination results in high school graduates planning to sign up for military academies,and provide better support for the recruitment of high-quality military trainees.Methods The ophthalmic examination results of the high school graduates who underwent physical examination in our hospital in July 2020 were analyzed according to The Physical Examination Standard for Military Academy Applicants issued in 2017.Visual acuity and color vision were examined at the space and distance with proper brightness;a slit lamp was used to examine the conjunctiva,cornea,anterior chamber,and lens;a direct ophthalmoscope was used to examine the fundus in a darkroom;histories of ophthalmic diseases and surgeries were obtained through surgical records,diagnosis certificates,and medical history inquiries.Results A total of 630 individuals underwent ophthalmic examination,among whom 558 were qualified,with an overall qualification rate of 88.6%;among these graduates,there were 420 males and 138 females,and the male individuals had a slightly lower qualification rate than the female individuals(87.7%vs 91.4%,P=0.242).Among the individuals with qualified results,34 cases had a history of corneal refractive surgery,with SMILE as the main surgical approach.There were 72 individuals with unqualified results,accounting for 11.4%,among whom the individuals with insufficient uncorrected visual acuity accounted for 65.3%,those with a time of<6 months after corneal refractive surgery accounted for 23.6%,those undergoing the implantation of implantable collamer lens accounted for 4.2%,those with spherical equivalent exceeding 6.0D accounted for 2.8%,and those with central lens opacity,leukoma,or insufficient corrected visual acuity accounted for 1.4%.Conclusion Insufficient uncorrected visual acuity and insufficient time after corneal refractive surgery are the main reasons for unqualified ophthalmic examination results,and proper education should be carried out in advance to guide young people to prepare for recruitment.