功能性视力下降的病因和诊疗的研究进展

Research progress on etiology,diagnosis and treatment of functional vision loss

功能性视力下降是一种不归因于病理及结构异常的非器质性的视力下降,常见于儿童及青少年,多伴有不同程度的视力下降及双眼视功能异常,同时可伴随情绪及心理障碍、癔症及伪盲等情况。功能性视力下降的临床诊治较为复杂,常因为反复客观检查无异常、治疗效果欠佳等情况而降低患者满意度。目前关于功能性视力下降的临床诊治并无统一标准,本文从功能性视力下降的病因、影响及治疗3个方面进行综述,发现双眼视功能、情绪与认知以及干眼等因素可导致功能性视力下降,视觉训练及中药汤剂均能发挥良好的治疗效果。但目前仍然存在许多尚不明确的病因,同时尚无统一的诊疗标准,未来可随着眼科学、神经内科、心身医学科等学科的结合进一步研究。

Functional vision loss is a kind of non-organic vision loss which is not attributed to pathological and structural abnormalities.It is common in children and adolescents,and often accompanied by different degrees of vision loss and binocular visual dysfunction,as well as emotional and psychological disorders,hysteria and pseudo-blindness.The clinical diagnosis and treatment of functional vision loss is complicated,and patients are often unsatisfied because no abnormality shows in repeated objective examination and poor treatment effect.At present,there is no unified standard for clinical diagnosis and treatment of functional vision loss.This paper reviews the etiology,influence and treatment of functional vision loss.It is found that diseases and factors such as binocular vision function,emotion and cognition,dry eye and so on may lead to functional vision loss.Visual training and Chinese medicine decoction can yield a good therapeutic effect,but there are still many unclear causes,and there is no unified diagnosis and treatment standards.It can be further studied with the combination of ophthalmology,neurology,psychosomatic medicine and other disciplines.