目的 研究学龄前儿童双眼散光的轴向对称模式.设计 横断面调查.研究对象 3～4岁学龄前儿童164例.方法 采用美国伟伦Suresight手持式自动验光仪收集2017年6-8月在幼儿园体检的学龄前儿童的屈光资料,选取两种散光对称模型(直接对称模型和镜像对称模型)对学龄前儿童的不同散光对称模式进行统计分析,并研究性别、球镜值、散光值、散光类型和双眼散光差异等与散光轴向对称模型的关系.主要指标散光轴向差异.结果 直接对称模型的散光轴向差异中位数是8°,大于镜像对称模型的4°(P＜0.01).完全直接对称模式和完全镜像对称模式的比例分别为0％和6％.直接对称模型和镜像对称模型的散光轴向差异在15°以内的比例分别是77％和87％.直接对称模型和镜像对称模型中,顺规散光的轴向差异值均最小,中位数分别为8°和3°.对于直接对称模型,散光类型和双眼散光差异与双眼散光轴向差异呈正相关(R=0.42,P＜0.01;R=0.22,P=0.01);对于镜像对称模型,散光类型和双眼散光差异与双眼散光轴向差异呈正相关(R=0.44,P＜0.01;R=0.14,P=0.04),散光值与双眼散光轴向差异呈负相关(R=-0.20,P=0.01).结论 学龄前儿童双眼散光的轴向对称模式更倾向于镜像对称;双眼散光差异最小的和顺规性散光儿童的双眼轴向差异最小.

Objective:To evaluate the efficacy of the multimedia visual perceptual learning system for improving visual acuity in pediatric patients with amblyopia and to discuss factors influencing the therapeutic effects of perceptual learning.Methods:This was a prospective randomized controlled study Amblyopic children aged from 3 to 11 years (n=112) were recruited from the ophthalmology clinic.Participants were randomly assigned to the experimental group that utilized the multimedia visual perceptual learning system or a control group utilizing the synoptophore.All subjects underwent perceptual learning and patching or refractive correction,depending upon the individual situation.After the baseline visit,follow-up visits were held after 10,20,and 30 treatments.Finally,the clinical efficacy and improvement of visual acuity in the two groups were analyzed and compared,using chi-square test,independent-samples t test,Pearson correlation test.Results:The curative effect of the experimental group was better than the control group at different training periods (Z=-4.128,-4.806,-3.063,P＜0.O0 1).The change in visual acuity in the experimental group was significantly higher at the 10th and 20th training sessions (t=3.471,3.290,P＜0.05).In the moderate and severe amblyopia groups,the curative effect of the experimental group was better than the control group (Z=-3.050,P=0.021),and was the same as in the anisometropic amblyopia group (Z=-2.864,P=0.004) and 7-11 year-old group (Z=-2.631,P=0.009).There was a moderate correlation at baseline and an improvement in visual acuity in both groups (r=0.690,0.650,P＜0.05).Conclusions:The multimedia visual perceptual learning system can achieve an optimal effect in a short period of time.The improvement in vision relates to the sex of the patient,and the degree and type of amblyopia,which are clinically significant to amblyopia therapy.

The traditional treatment of amblyopia includes best optical correction,patching or atropine penalization of the fellow eye.Nevertheless,a deeper understanding of the pathogenesis of amblyopia has been obtained based on a much deeper understanding of experimental animal model of amblyopia,electrophysiology and neurobiochemistry.Activating the visual plasticity after the end of the sensitive or critical period of visual development has been proved to be feasible.Thus,a variety of new therapies,such as,perceptual learning,video gaming,dichoptic training,transcranial magnetic stimulation have been applied to treat amblyopia in children and adults.All these new therapies,collectively called behavioral treatment,serve restoring cortical plasticity and reducing interocular suppression as a strategy for the reinstatement of visual functions in amblyopic patients.

China is one of the countries with high incidence of myopia in the world, which has attracted the attention of the national health care department. However, at present, there are still no convenient and effective methods to prevent and treat myopia in modern medicine at home and abroad. In this paper, the author compared the similarities and differences between modern medicine and traditional Chinese medicine in the prevention and treatment of myopia by searching relevant literature. The modern medical study of pathogenesis of myopia and the traditional Chinese medical perception of holistic theory of myopia, the idea of prevention-oriented eye care in modern medicine and the theory of treating before disease attacking in traditional Chinese medicine, the modern medicine and traditional Chinese medicine therapy and other aspects were analyzed mainly. Finally, the application value and orientation of Chinese medicine in the prevention and control of juvenile myopia were explored to find a new developing way. Key words: Juvenile myopia; Traditional Chinese medicine; Modern medicine; Prevention and control; Orientation; Innovation-driven development

·Ocular refraction is mainly decided by the axial length, corneal power and lens power. Of these three refractive elements, only the change of cornea has aroused the most controversial discussion. Cornea has changed varying with refractive state and population characteristics. This paper is designed to review the information currently available concerning the change of the cornea in emmetropia and myopia.