【摘要】 目的：探讨学龄前儿童斜、弱视治疗的关键因素方法：对银川市新市区18所幼儿园中3～7岁儿童进行视力、眼位、屈光检查。结果：在1531例3062眼中，视力<0.9者，经散瞳验光不能矫正者52例78眼，诊断为弱视。弱视患病率为3.4%。男27例，女25例，弱视与性别无明显差异。按全国儿童弱视斜视防治组(198710)标准弱视分为五类，并按程度分为轻、中、重三度。结论：弱视是一种发育性紊乱，常伴有斜视、屈光参差或高度屈光不正。弱视和斜视使得患者不仅视力低下，还缺少完善的立体视，即缺少适应科技高速发展所必备的最高级视觉功能。弱视和斜视的疗效及立体视的建立与治疗年龄密切相关。年龄越小，治疗后效果越好，达成人后基本无望。
【关键词】 早期发现;早期治疗;视力检查;眼位检查;屈光检查;弱视
Screening and analysis of strabismus and amblyopic in preschool childrenLaiJun Xu, XueMei Xu, SiLe Peng1Department of Ophthalmology, Fengcheng Hospital, Yinchuan 750004, Ningxia Hui Autonomous Region, China;2Department of Ophthalmology, Peoples Hospital of Ningxia Hui Autonomous Region, Yinchuan 750021, Ningxia Hui Autonomous Region, ChinaAbstractAIM: To evaluated the key factors of the treatment for strabismus and amblyopic in preschool lhildred.METHODS: The children aged 37 of eighteen kindergartens in Yinchuan city were examined, including: sight inspection; ocular inspection; refractive inspection; diagnostic criteria. RESULTS: There were fiftytwo children 78 cases whose sights were less than 0.9 in 1531 children 3062 eyes. They were amblyopic. Amblyopic prevalence rate was 3.4%. There were 27 male and 25 female. Amblyopic had no significant difference between genders. According to the National Children's strabismus amblyopic treatment group standard, amblyopic was divided into five categories; according to the degree, it was divided into slight, normal and severe degree. CONCLUSION: Amblyopic is a developmental disorder, often accompanied by strabismus, anisometropia or high refractive errors. Amblyopic and strabismus are the dangers of not only poor eyesight, but also the lack of complete threedimensional vision, namely, the lack of the highest level necessary visual function. The efficacy of treatment of amblyopic and strabismus are closely related to the age. The younger, the better after the treatment; adults are hopeless.
KEYWORDS: early detection; early treatment; sight inspection; ocular inspection; refractive inspection; amblyopic0前言
弱视治疗的关键是早期发现，早期治疗[1,2]。为了更好地做好这项工作，我们对银川市1 531例学龄前儿童弱视、斜视的普查资料进行了整理，并结合立体视检查，现报告如下。
1对象和方法
1.1对象
对银川市新市区18所幼儿园中3～7岁儿童进行了检查。共1 531例，其中男782例，女749例。
1.2方法
视力检查：采用国际标准视力表，<4岁儿童使用儿童图形视力表(北京研究所编)，以40W日光灯光源，距离5m。检查前先由幼儿园老师讲练习，儿童学习1wk，然后正式检查。眼位检查：用角膜映光法及交替遮盖检查视近33cm和视远5m眼位，并用立体视觉检查图(颜少明著)和同视机(日本011型)检查立体视的辅助诊断。屈光检查：凡视力≤0.8者，均在医院对照复查，确定视力<0.9者，使用10g/L阿托品散瞳检影验光。诊断标准：排除其他器质性眼病，矫正视力<0.9者诊断为弱视，眼位>50为斜视。弱视性质分类：(1)斜视性弱视：患有斜视或曾有过斜视。(2)屈光参差性弱视：两眼屈光度差球镜≥1.50D，柱镜≥1.00D。(3)屈光不正性弱视：为双侧性，发生于没有戴过矫正眼镜的高度屈光不正患者，双侧视力相等或相似，远视力≥3.00D，近视≥6.00D，散光≥2.00D。 (4)形觉剥夺性弱视(在婴幼儿期由于屈光间质混浊，上睑下垂遮挡瞳孔，不适当的遮盖等引起的视功能障碍)。(5)其他。弱视程度分类：(1)轻度弱视：视力为0.6～0.8;(2)中度弱视：视力为0.2～0.5;(3)重度弱视：视力≤0.1。此分类为198710全国儿童弱视斜视防治组标准[3]。
统计学分析：本文数据结果均使用SPSS 14.0社会科学统计软件进行统计学处理，对计量数据进行了卡方检验，P<0.05为差异有统计学意义。
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