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.

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.

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.

脑力劳动者视疲劳影响因素分析与预测模型构建

目的了解脑力劳动者视疲劳的影响因素并构建预测模型。方法采用横断面调查方法纳入脑力劳动者作为研究对象。通过问卷星平台收集参与者的基本信息、生活习惯和眼健康状况等资料。应用眼表疾病指数(OSDI)、过敏性结膜炎量表(AC-12)和视疲劳量表(ASQ-17)评估参与者的眼部健康状况。使用单因素和多因素Logistic回归分析确定视疲劳的影响因素并构建预测模型。通过受试者工作特征(ROC)曲线及其曲线下面积(AUC)、校准曲线、决策曲线以及Bootstrap自助抽样法评价模型性能。结果共纳入221名脑力劳动者,其中102名(46.15%)存在视疲劳。多因素Logistic回归分析显示干眼[OR=1.16,95%CI(1.10,1.21)]和过敏性结膜炎[OR=1.17,95%CI(1.06,1.28)]为视疲劳的危险因素,每晚8~<11 h的睡眠时间[OR=0.14,95%CI(0.02,0.98)]和每天饮茶的习惯[(OR=0.40,95%CI(0.16,0.99)]与视疲劳风险降低有关(P<0.05)。构建的视疲劳预测模型展现了较好的预测性能,AUC为0.913[95%CI(0.875,0.950)];模型的预测概率与实际观测结果高度一致,具有较好的校准度;内部验证结果显示准确率为80.6%,Kappa值为0.609;决策曲线表明模型的应用净效益显著优于“无干预”和“全面干预”策略。结论应采取措施改善干眼、过敏性结膜炎和屈光状态异常症状,推广良好的睡眠习惯和饮茶习惯,有助于缓解脑力劳动者的视疲劳问题,提高工作效率和生活质量。

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.

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。

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。

北京市海淀区高校学生视疲劳流行现况及其相关因素

目的:分析探讨当前北京市海淀区高校学生视疲劳流行现况及其相关因素。方法:采用多阶段分层整群抽样方法,对北京市海淀区4所高校2 246名在校学生视疲劳状况进行问卷调查,采用因子分析和多因素Logistic回归模型分析视疲劳发生的相关因素。结果:高校学生视疲劳的检出率为64.9%,其中男生为65.1%,女生为64.7%;本科生为58.9%,研究生为75.7%。居室环境条件差、使用电脑、个人体质不佳可增加视疲劳的发生危险,其比值比(95%可信区间)分别为1.185(1.078～1.302)、1.490(1.355～1.640)和1.323(1.182～1.481);良好的睡眠精神状态、社会心理状态、生活方式和膳食可降低视疲劳的发生危险,其比值比(95%CI)分别为0.691(0.628～0.760)、0.793(0.720～0.873)和0.649(0.587～0.717)。结论:高校学生视疲劳检出率较高,其发生与精神心理、环境、个人体质、膳食及生活方式等多方面因素相关,应加强对高校学生的健康教育。

教室荧光灯色温对学生学习效率和生理节律的影响

为了研究教室荧光灯色温对学生学习效率和生理节律的影响,通过实验对比了3种典型色温T5荧光灯在不同照度水平下对受试人学习效率、视疲劳、脑疲劳的影响。实验采用安菲莫夫字母表和近点测定法对学习效率和视疲劳进行测试,用学习效率变化率作为特定光环境下出现的脑疲劳指标。结果表明,由于Cirtopic效应作用,中间色温荧光灯在恰当的时间长度内可对学生产生适量的良性刺激,对大脑起到"唤醒"或"放松"的作用,达到提高学习效率、缓解视/脑疲劳的效果;而高、低色温荧光灯的作用则相反;不同色温的荧光灯光源,其最佳照度值并不相同;在实验研究的基础上,提出了教室照明中应避免的色温—照度组合。

高校学生配镜不适引起视疲劳的临床分析

目的:通过对配戴不合适眼镜所致大学生视疲劳的探讨,提出防治措施。方法:对124例大学生视疲劳患者进行验光试镜,核对原眼镜度数;用Topcon-CL100电脑焦度计核对原眼镜镜心距(眼镜光学中心间距离);用近视力表近用视标检查辐辏和调节近点,并检查视功能。结果:所有124例248眼均有屈光不正,77%球镜和69%的柱镜有误差(≥±0.50D),镜心距与瞳孔距离差异有统计学意义(U=5.27,P<0.01),87%的镜心距较瞳距大2mm以上,戴不合适眼镜为主因引起视疲劳占62%。结论:戴不合适眼镜是引起大学生视疲劳的主要原因之一,科学配戴眼镜可有效防治视疲劳。

三棱镜效应改善老视眼的肌性视疲劳

目的:应用改变近用老视镜的光学中心所产生的三棱镜效应,消除老视患者近距离阅读和工作的肌性视疲劳。方法:对戴用近用眼镜后仍有视疲劳症状的患者,进一步检查屈光情况、隐斜度、融合力,确定为肌性视疲劳。通过移动老视镜的光学中心的方法,产生三棱镜效应,按外隐斜度数的1/2～1/3给予三棱镜度,平均加在左右2眼。结果:本组病例在试戴相应的老视镜后,能持久近距离阅读,视疲劳症状消失。结论:对配验老视镜后仍有视力疲劳症状的患者,进一步检查屈光、隐斜、融合力,对有肌性视力疲劳的患者通过改变老视镜的光学中心,产生三棱镜效应,能有效地改善和消除肌性视疲劳。