Development of a new 17-item Asthenopia Survey Questionnaire using Rasch analysis

AIM:To develop the 17-item Asthenopia Survey Questionnaire(ASQ)-17 by Rasch analysis,and to generate a predictiveness score.METHODS:Totally 739 participants were recruited and 680 were involved in the result analysis in this prospective,cross-sectional study.Three rounds of Rasch analysis were used to analyze the psychometric characteristics of items and options.RESULTS:Phase 1 assessed the original ASQ-19,adjusted the item scoring mode to a four-point Likert response rating scale and combined the 18th and 19th items into a new item.Phase 2 deleted the 11th item.Phases 3 and 4 assessed the new ASQ-17.All the evaluation indexes of ASQ-17 were acceptable.The Infit and Outfit MnSq values of items were 0.67-1.48,the variance explained by the principal component and the unexplained variance explained by the first contrast were 53.90%-59.40%and 1.50-1.80 in three dimensions.The curve peaks of scores in each dimension were separated and in the same order.The PSR and PSI values were 2.80 and 0.89,respectively.The mean scores of dimensions A(9.5±4.1 vs 3.5±3.2),B(7.3±3.3 vs 2.5±2.7),C(4.3±2.2 vs 1.4±2.0)and total(21.1±8.1 vs 7.4±7.0)in asthenopia participants were significantly higher than those without asthenopia(all P<0.001).The area under the curve in two groups was 0.899(P<0.001).Youden’s index was up to the maximum value of 0.784 when the cut-off value was 12.5.CONCLUSION:ASQ-17 has stronger option sorting and suitability than ASQ-19.It is an effective assessment tool for asthenopia with an optimal cut-off threshold value of 12.5,which is suitable for diagnosis and curative effect evaluation.

Prevalence of asthenopia and its risk factors in Chinese college students

·AIM: To determine the prevalence of asthenopia and identify any associated risk factors in the college students in Xi’an, China. · METHODS: From April to September 2012, 1 500 students from five universities in Xi’an were selected according to a multi -stage stratified cluster sampling method. Data on demographic features, lifestyle or dietary habits, health status, living environment conditions, sleep and mental status, and asthenopia symptoms were collected through a self -administered validated questionnaire. Univariate logistic regression and multivariate logistic regression analysis modified by the factor analysis were performed to evaluate risk factors for asthenopia. ·RESULTS: Fifty-seven percent of the college students complained of asthenopia. Statistically significant risk factors for asthenopia in the univariate analysis included 13 variables. Multivariate analysis revealed a significant relationship between the use of computer and asthenopia (OR 1.21, 95% CI: 1.09 to 1.35). Good sleep and mental status (OR 0.86, 95% CI: 0.76 to 0.97), good living environment conditions (OR 0.67, 95% CI: 0.60 to 0.76), and high intake of green leafy vegetables (OR 0.89, 95% CI: 0.80 to 0.98) were found to be strong predictors of decreasing the occurrence of asthenopia complaints. ·CONCLUSION: Asthenopia symptom appeares to be common among college students; and it is strongly associated with computer use, psychosocial state, environment conditions and dietary habits, suggesting that additional studies are warranted to verify these risk factors and establish prevention guidelines, especially for college students. ·

Fruit and vegetable consumption and its relation to risk of asthenopia among Chinese college students

AIM： To investigate the associations between fruit and vegetable consumption and risk of asthenopia among Chinese college students. METHODS： A total of 1022 students were selected from five universities by a multi-stage stratified cluster sampling method. They were surveyed via a self-administered questionnaire including socio-demographic features, dietary and lifestyle habits, eye-related symptoms, eye care habits and history of diseases. Ascertainment of asthenopia was based on participants＇ subjectively reported symptoms. The associations between fruit and vegetable intake with asthenopia risk were assessed using multivariate logistic regression analysis. RESULTS： There were no significant associations between total fruit and vegetable, total vegetable, or fruit and the risk of asthenopia. Higher intake of dark-green leafy vegetable was likely to be inversely associated with asthenopia risk [odd ratio （OR）： 0.60; 95%CI： 0.37-0.97; Ptrend=0.21] after controlling for nondietary and dietary risk factors. Stratified analysis showed that the inverse association between dark-green leafy vegetable intake and asthenopia risk was limited to participants with suboptimal eyesight （OR： 0.45; 95%CI： 0.25-0.82; Ptrend=0.05）, wearing glasses （OR： 0.35; 95%CI： 0.17-0.72; Ptrend=0.03） or using computer ≥3h/d （OR： 0.48; 95%CI： 0.25-0.93; Ptrend=0.08）. CONCLUSION： A higher consumption of dark-green leafy vegetable is associated with a lower asthenopia risk among college students with suboptimal eyesight and poor eye care habits.

Role of short-wavelength filtering lenses in delaying myopia progression and amelioration of asthenopia in juveniles

AIM： To evaluate the positive effects of blue-violet light filtering lenses in delaying myopia and relieving asthenopia in juveniles. METHODS： Sixty ametropia juveniles （aged range, 11-15y） were randomized into two groups： the test group （30 children, 60 eyes）, wearing blue-violet light filtering lenses; and the control group （30 children, 60 eyes）, wearing ordinary aspherical lenses. Baseline refractive power of the affected eyes and axial length of the two groups was recorded. After 1-year, the patients underwent contrast sensitivity （glare and non-glare under bright and dark conditions）, accommodation-related testing, asthenopia questionnaire assessment, and adverse reaction questionnaire assessment. RESULTS： After ly of wearing the filtering lenses, changes in refractive power and axial length were not significantly different between the two groups （P〉0.05）. Under bright conditions, the contrast sensitivities at low and medium- frequency grating （vision angles of 6.3, 4.0, and 2.5） with glare in the test group were significantly higher than in the control group （P〈0.05）, while the contrast sensitivity at low-frequency grating （vision angles of 6.3 and 4.0） in the absence of glare in the test group was higher than in the control group （P〈0.05）. Under glare and non-glare dark conditions, the contrast sensitivities of various frequencies in the test group did not show significant differences compared with those in the control group （P〉0.05）. In the test group, the amplitude of accommodation, accommodative lag, and accommodative sensitivity of patients wearing glasses for 6 and 12mo were significantly elevated （P〈0.05）, while the asthenopia gratings were significantly decreased （P〈0.05）. Nevertheless, in the control group,the amplitude of accommodation, accommodative lag, and accommodative sensitivity after 12mo were not significantly altered compared with baseline （P〉0.05）, and the asthenopia grating was not significantly decreased （P〉0.05）. In addition, after wearing glasses for 6 to 12mo, the asthenopia grating of patients in the test group decreased significantly compared with the control group （P〈0.05）. At 12mo, the constituent ratio of adverse reactions did not show significant difference between the two groups （P〉0.05）. CONCLUSION： A l-year follow-up reveal that compare with ordinary glasses, short-wavelength filtering lenses （blue/ violet-light filters） increase the low- and medium-frequency contrast sensitivity under bright conditions and improved accommodation. They effectively relieved asthenopia without severe adverse reactions, suggesting potential for clinical application. However, no significant advantages in terms of refractive power or axial length progression were found compared with ordinary aspheric lenses.

Electroencephalogram characters of parallax stereo watching asthenopia

The electroencephalogram（EEG）characters value of observers can be deduced by collecting brain electrical information when the observers are watching parallax stereo video.The characters value will change clearly when watching asthenopia appear.To investigate the characters of parallax stereo watching asthenopia,the EEG of observers were recorded through the whole watching process of parallax stereo films until watching asthenopia appeared.The recorded EEG data of observers belongs to time-domain information.Fourier transform can process these data to frequency spectrum information.Theαandβwaves average power can be got by Newton-Cotes equation from the information.The ratio ofβpower to the sum ofαandβpower,CV,can be defined as EEG characters value of parallax stereo watching asthenopia and used to estimate the asthenopia degree of observers.Our experiments show that the smaller the CVis,the more serious the asthenopia is.

Diagnostic values of questionnaires of Convergence Insufficiency Symptom Survey and College of Optometrists Vision Development Quality of Life in the screening of convergence insufficiency

AIM:To compare and analyse the diagnostic efficacy of the College of Optometrists Vision Development Quality of Life Questionnaire(COVD-QOL)and the Convergence Insufficiency Symptom Survey(CISS)in detecting convergence insufficiency and to compare their diagnostic value in clinical applications.METHODS:Using the diagnostic test method,62 adult patients with convergence insufficiency(age:24.74±3.75y)and 62 normal participants(age:23.61±3.13y)who visited the Optometry Clinic of West China Hospital of Sichuan University from April 2021 to January 2023 were included.All subjects completed the CISS and COVD-QOL.Statistical analysis of the sensitivity and specificity of the CISS and COVD-QOL and comparison and joint experimental analysis of their diagnostic efficacy were performed.RESULTS:The sensitivity of the CISS and COVD-QOL for convergence insufficiency was 64.5%and 71.0%,respectively,while the specificity was 96.8%and 67.7%,respectively.Compared to the CISS alone,the combination of the CISS and COVD-QOL demonstrated lower sensitivity and specificity.The areas under the receiver operating characteristic curve of CISS,COVD-QOL and CISS combined with COVD-QOL were 0.806,0.694 and 0.782,respectively.CONCLUSION:Considering the low sensitivity of the CISS and the low specificity of the COVD-QOL,it is recommended to supplement these questionnaires with other screening tests for the detection of convergence insufficiency.

Post-PRK muscular asthenopia and eccentric ablation

Objective To investigate the relationship between muscular asthenopia post photorefractive keratectomy (PRK) and eccentric ablation.Methods 16 eyes of 8 myopia cases whose muscular asthenopia was corrected by subjectively accepted triangular prism after PRK with vision more than 0.8 were followed up for 6-14 months. On the basis of data provided by the pre-PRK, post-PRK and their difference corneal topography, we calculated the real corrected corneal diopter (D) with the Holladay formula and measured the ablating eccentricity (h) and its direction. According to the formula δ≈Dh, the prism effective value (δ) caused by the eccentric ablation was computed and compared with objectively accepted triangular prism.Results The subjectively accepted prism was similar to values calculated from the formula. Their mean difference is 0.10±0.25. The direction of the subjectively accepted prism was in the direction of ablation deviation.Conclusions Eccentric ablation was the chief cause of post-PRK muscular visual asthenopia. The triangular prism effective value from eccentric ablation may be estimated by the formula δ≈Dh. We must pay attention to the diagnosis, treatment and prevention of post-PRK muscular asthenopia.

眼健康教育与用眼卫生对小学生视疲劳的影响

目的通过对小学生开展眼健康教育2年后视疲劳和用眼卫生状况的调查,评估眼健康教育与用眼卫生对小学生视疲劳发生率的影响。方法2018年在无锡市所有小学采取多种形式对小学生及其家长开展健康用眼宣传;2020年通过网上和现场填写问卷的方式随机对20所小学1~6年级小学生进行视疲劳和用眼习惯问卷调查。结果共收集2217份有效问卷,眼健康教育的知晓率为85.12%;有视疲劳症状者为35人,视疲劳症状的发生率为1.58%;每天电子产品使用时间、每天使用电子产品单次最长时间、每晚睡眠时间、每日户外活动时间、居家照明常识的了解情况、抗疲劳眼药水使用不同情况下小学生视疲劳发生率比较差异有统计学意义(P值均<0.05);每天运动、饮食、眼保健操措施不同情况下小学生视疲劳发生率比较差异无统计学意义(P值均>0.05)。结论眼健康教育知识的宣教、普及可有效地降低小学生视疲劳的发生。

医学生视频终端使用现状与眼部症状的相关分析

目的探讨医学生使用视频显示终端(visual display terminal,VDT)和眼部症状之间的关系。方法2022年1月采用随机整群抽样法,对同济大学医学院787名在校大学生进行VDT相关的眼部症状问卷调查,对数据采用χ^(2)检验及多因素logistic回归统计学分析。结果VDT相关的眼部症状中最常见的是干涩不适;平均每天使用VDT时间≥6 h会增加眼痛、视力下降或视物模糊的不适[OR=2.102,95%CI(1.560,2.831),P<0.05];相比本科生,研究生平均每天使用VDT时间≥6 h的情况增加,但其将手机作为最常用的VDT的比例及其出现眼痛的现象降低[OR=0.628,95%CI(0.455,0.866),P<0.05]。手机屏幕测评等级与眼部干涩症状相关[OR=1.256,95%CI(1.108,1.424),P<0.05]。结论医学生VDT相关最常见的眼部症状为干涩不适;调整使用距离、减少使用时间和改善屏幕等级可降低VDT综合征的发生。

视觉训练改善儿童视功能异常伴视疲劳的疗效分析

目的:分析视觉训练对儿童视功能异常伴视疲劳的临床疗方效法。方法:回顾性病例研究。收集2022-01/2023-04在西安市儿童医院视光中心行视觉训练的视功能异常伴视疲劳患者57例114眼,年龄8.25±1.94岁。记录患者训练前后的屈光度、视疲劳量表问卷及视功能检查,视功能主要包括Worth 4点灯检查双眼视,Von-Graefe法测量远、近隐斜视,梯度法检查AC/A,移近法测量集合近点,负镜片法测量调节幅度,交叉柱镜测量调节反应,翻转拍测量调节灵活度。根据患者视功能及视疲劳情况制定训练方案。训练1 mo分别与训练前及训练3 mo比较。结果:训练前,训练1 mo时31例患者视疲劳量表得分分别为26.00±6.77、19.57±8.90分(P<0.05)。训练前与训练1 mo时比较,近距离隐斜度数,集合近点,左、右眼调节幅度,NRA及PRA,左、右眼及双眼调节灵活度均显著改善(均P<0.05),远距离隐斜度数及调节反应比较无差异(均P>0.05)。训练3 mo与训练1 mo左、右眼调节幅度,NRA、PRA及近隐斜视比较无差异(均P>0.05)。训练前及训练1 mo,低度近视患者30例(SE:-1.99±1.22 D),低度远视患者3例(SE:+1.01±0.13 D)及正视患者24例(SE:+0.25±0.11 D)的视功能参数无差异(均P>0.05)。训练1 mo后部分视功能大幅提高,训练3 mo时大部分视功能基本恢复正常。结论:视觉训练可有效提高视功能异常伴视疲劳儿童的双眼视功能,改善视疲劳症状,是一种简单易行且能有效缓解儿童视疲劳的方法。

An Experimental Study of the Protective Effects of Chinese Medicine Compound Eye-Patch on Asthenopia

Objective： To observe the therapeutic efficacy and the mechanism of Chinese medicine eye-patch with invigorating blood circulation and detoxification on asthenopia. Methods： A total of 180 rabbits were subjected to three tests, namely the skin microcircuiation, the microvascular regeneration in the skin and the skin temperature change, with 60 rabbits for each test. The rabbits in each test were randomly and equally divided into three groups： the normal control group was treated with physiological saline on naked back once per day, the low dose group was treated with the eye-patch on naked back for 15 min once per day, while the high dose group was treated for three times per day. Forty Hartley guinea pigs were randomly and equally divided into four groups for the muscle tone test： the normal control group was treated with physiological saline on naked back, the model group was treated without any medication, the low dose group was treated with the eye-patch on naked back for 10 min once per day, while the high dose group was treated for three times per day. All treatments were continued for 14 days until the termination of the test. The microcirculatory blood flow was observed by using a video-microscopy system. The histological sections were used to detect the microvascular regeneration by observing the expression of factor V$. The temperature changes on the skin surface were measured by using infrared thermometer, and the muscle tone was tested by the electromyography. Results： In compare with the normal or the model group, the improvement in the skin microcirculation and the blood vascular regeneration, and the decreasing in the muscle tone in low dose and high dose groups were statistically significant with confident level at P〈0.05. Conclusions： The eye-patch with invigorating blood circulation and detoxification has great enhancement in blood vascular regeneration and skin microcirculation, and great improvement in the indexes for muscle tone. The study explains certain therapeutic efficacy and mechanism of the eye-patch and shows that it could reduce the symptoms for patients with asthenopia.

Clinical Study on Point-toward-Point Needling for Asthenopia

Objective:To observe the effect of point-toward-point needling on asthenopia.Methods:A total of 60 asthenopia cases were randomized into an observation group and a control group,30 cases in each group.Pointtoward-point needling was used in the observation group;whereas point injection was used in the control group.The signs and symptoms including visual tasks and eye fatigue were observed before and after treatments.This was followed by an inter-group comparison of eye discomfort symptom score and therapeutic effects.Results:After treatment,the symptoms and signs in both groups were significantly improved,showing a statistical significance(P<0.01)and inter-group difference(P<0.01).The total effective rate of the observation group was 96.7%,versus 69.0%in the control group,showing a statistical difference(P<0.01).Conclusion:Both treatment protocols can help alleviate the clinical symptoms of asthenopia;point-toward-point needling can obtain better effect than point injection.

413例视疲劳患者中医证候学研究

目的 观察视疲劳患者的中医证候学特征。方法 对413例视疲劳患者进行视疲劳的中医证候学问卷调查,并分析视疲劳患者的中医证候分布特征和分型。结果 413例视疲劳患者中,肝火炽盛证198例(47.94%)、肝阳上亢证215例(52.06%)。结论 视疲劳证候分型以肝阳上亢证为主,以肝火炽盛证为辅。

中医药治疗视频终端综合征的有效性的meta分析

目的:系统评价中医药治疗视频终端综合征的有效性。方法:检索知网、万方、维普、WebofScience、Embase、Pubmed、the Cochrane Library数据库从建库至2023年6月期间发表的有关文献,运用Review Manager 5.4软件进行分析。结果:共有12篇文献被纳入分析,包括受试者1047名,meta分析结果显示:经中医药治疗后,与单独西药对比,有效性更为显著[OR=6.08,95%CI=(4.12,8.99),P<0.00001],差异具有统计学意义。结论:中医药治疗视频终端综合征能有效控制临床症状,疗效显著。

耳穴压丸联合七叶洋地黄滴眼液对视疲劳(肝肾不足证)的临床疗效观察

目的观察耳穴压丸联合七叶洋地黄滴眼液对肝肾不足视疲劳的治疗作用。方法收集贵州中医药大学附属医院眼科门诊共56例,按就诊顺序分为试验组及两组对照组,分别予耳穴贴压联合七叶洋地黄双苷眼液、耳穴贴压、七叶洋地黄双苷眼液治疗,疗程共10天,观察症状积分、明视持久度百分比、总有效率。结果①试验组积分降低最为显著,有统计学差异(P=0.004)。②明视持久度:试验组最优差异有统计学意义(P=0.011)。③临床疗效:总有效率为94.11%、77.78%、76.47%,试验组最优,有统计学意义(P=0.009)。结论两种方法对视疲劳均有效,但联合效果优于单一作用。

浅析近视合并调节及双眼视功能异常致视疲劳的诊治

近视合并调节及双眼视功能异常所致视疲劳,属复合因素致病。临床症状复杂多变,不典型者较多,不易明确诊断,继而不能给予有效的对因治疗,临床疗效往往欠佳。本文详细阐述了调节灵敏度不足、调节痉挛和调节不足继发集合不足所致视疲劳的临床诊断及鉴别,总结了相应的视觉训练方法,并简要介绍训练步骤。基于此类患者多具有眼、全身因素与精神、心理因素相互交织的特点,为了发挥中医药整体辨证的优势,在西医对因治疗的同时进行中医药辨证论治,予以口服中药汤剂或配合中医非药物疗法治疗,临床疗效可观。

芍药甘草汤眼贴治疗视疲劳的即时疗效观察

目的观察芍药甘草汤眼贴治疗视疲劳的即时疗效。方法纳入2018年6月—2018年12月在浙江省舟山医院诊治的视疲劳患者90例(180只眼),随机分为中药眼贴组(A组)、纯净水眼贴组(B组)和休息组(C组)各30例(60只眼)。A组予中药眼贴贴敷治疗;B组予纯净水眼贴贴敷治疗;C组嘱患者闭目休息。3组均观察20 min。检测受试者治疗前后的症状积分,调节幅度,正、负相对调节、调节反应和集合近点,并做统计分析。结果3组治疗前的症状积分,调节幅度,正、负相对调节、调节反应和集合近点比较,差异均无统计学意义(P>0.05)。(1)症状积分:治疗前后比较,3组治疗后症状积分均较治疗前降低(tA组=14.198,tB组=12.515,tC组=7.131,均P=0.000),差异均有统计学意义。治疗后3组间症状积分比较差异有统计学意义(F=10.624,P=0.000)。两两比较,与A组比较,B组和C组症状积分均较A组升高(tB组=2.386,P=0.019;tC组=4.787,P=0.000);与B组比较,C组症状积分较B组升高(t=2.143,P=0.034),差异均有统计学意义。(2)调节幅度:治疗前后比较,3组治疗后调节幅度均较治疗前升高(tA组=4.168,P=0.000;tB组=4.557,P=0.000;tC组=2.538,P=0.012),差异均有统计学意义。而治疗后3组间调节幅度比较,差异无统计学意义(P>0.05)。(3)正相对调节:治疗前后比较,3组治疗后正相对调节均较治疗前降低(tA组=7.957,tB组=7.545,tC组=6.099,均P=0.000),差异均有统计学意义。而治疗后3组间正相对调节比较,差异无统计学意义(P>0.05)。(4)负相对调节:治疗前后及治疗后3组间负相对调节比较,差异均无统计学意义(P>0.05)。(5)调节反应:治疗前后比较,A组、B组治疗后调节反应均较治疗前降低(tA组=2.980,P=0.004;tB组=2.795,P=0.006),差异均有统计学意义,而C组治疗前后差异无统计学意义(P>0.05)。治疗后3组间调节反应比较,差异均无统计学意义(P>0.05)。(6)集合近点:治疗前后及治疗后3组间集合近点比较,差异均无统计学意义(P>0.05)。结论芍药甘草汤眼贴能较明显改善视疲劳即刻症状,而在提高视功能方面效果不明显,可能与治疗时长及次数有关。

视疲劳及其中医证候动物模型的构建策略

视疲劳已发展为全球性的健康问题,临床注重对其预防和保健,可通过调整用眼模式,使用适宜物质、物理干预、休息等方式缓解症状体征。目前视疲劳主要以主观症状进行诊断,尚无准确反映该状态的客观评价指标,导致实验和临床评价方法及机制研究匮乏。建立视疲劳动物模型,并结合中医对视疲劳的认识及诊疗特色建立视疲劳相关中医证候模型,有助于深入阐释视疲劳发生发展机制,全面挖掘中医对视疲劳的预防保健优势。现总结了视疲劳动物模型研究现状,提出了视疲劳模型的构建原则及策略;结合中医临床文献调研,分析出视疲劳人群中医证型主要为肝肾阴虚型、肝郁气滞型和肝血不足型,进一步提出了视疲劳相关中医证候模型的构建原则及策略,以期为缓解视疲劳中药产品的研发提供思路,并为其辨证保健及精准应用提供指导。

中医外治法治疗视疲劳的研究进展

视疲劳作为一种眼或全身器质性因素与情志因素相互交织的综合征,已经呈现出广泛化、低龄化的发病趋势。通过回顾近5年来中医外治法治疗视疲劳的研究发现,中医外治法种类丰富、历史悠久,如针刺、耳穴贴压、中药热敷熨帖、灸法、中药超声雾化、穴位按摩及刮痧等,具有操作简单、易于接受、副作用小等优势。国内外大量临床与基础研究证实了其有效性与安全性,但目前临床使用率还较低。因此,文章系统整理了视疲劳的流行病学调查、病因病机及各类中医外治法的操作特点、临床疗效等方面并进行综述说明,以期为临床诊疗提供新思路。

学龄期儿童青少年电子屏幕用眼健康管理专家指导意见

我国未成年人使用各类电子产品、数字化设备呈普遍化、低龄化发展趋势。长时间使用智能手机、笔记本电脑、平板电脑等进行在线学习、网络社交、网上娱乐,会显著增加学龄期儿童青少年近距离用眼负荷,挤占正常的社会交往、体育活动与户外自然光暴露时间。家长及监护人对儿童青少年使用电子屏幕的管理缺位,儿童青少年易养成不健康的屏幕用眼习惯与行为,对学龄期儿童青少年的生理、心理以及屈光发育可能带来不良影响。为促进学龄期儿童青少年养成屏幕用眼的良好习惯,使他们健康科学地使用各类电子显示屏幕,减缓儿童青少年近视的发病与进展,基于循证医学证据、行业标准规范及临床经验制订《学龄期儿童青少年电子屏幕用眼健康管理专家指导意见》至关重要。