【摘要】 目的：门诊治疗儿童弱视疗效观察。方法：对87例122眼儿童弱视在门诊通过检影配镜，常规遮盖治疗，精细锻炼，弱视治疗仪治疗。随访1～8a弱视疗效观察。结果：弱视程度越轻疗效越好,屈光不正性弱视与斜视性弱视效果好于屈光参差性弱视。小年龄组明显比大年龄效果好。结论：儿童弱视治疗越早效果越好，对大龄儿童弱视也不能轻易放弃治疗。常规配镜遮盖治疗是治疗儿童弱视经典疗法，再配合精细锻炼，治疗仪治疗，弱视治愈率可达83%。
【关键词】 门诊治疗;儿童弱视;疗效观察
Efficacy of outpatient treatment of children with amblyopiaMeiYing Zou, YongXin Wang, Ying YinDepartment of Ophthalmology and Otorhinolaryngology, the Peoples Hospital of Shanggao County, Shanggao County 336400, Jiangxi Province, ChinaAbstractAIM: To observe efficacy of outpatient treatment of children with amblyopia.METHODS: One hundred and twentytwo eyes of 87 patients with amblyopia in children in outpatient were treated with retinoscopy glasses, routine cover treatment, fine exercise, amblyopia therapeutic apparatus. Efficacy of amblyopia was followed up for 18 years.RESULTS: The lighter the degree of amblyopia, the better the efficacy. Efficacy of ametropic amblyopia and strabismus amblyopia was better than that of anisometropic amblyopia, and the small age group was significantly better than the large age in efficacy.
CONCLUSION: The sooner the treatment of amblyopia in children, the better the efficacy For older children with low vision,we can not easily give up treatment. Conventional optical and cover treatment is classic treatment of children with amblyopia,when coupled with sophisticated exercise and therapeutic equipment, amblyopia cure rate could be up to 83%.
KEYWORDS: outpatient treatment; children with amblyopia; efficacy
0引言
弱视是眼部无器质性改变，且远视力矫正<0.8，如果早期发现,坚持矫正，80%～90%以上的儿童均能得到治愈。恢复正常视功能。如果延误治疗(如超过10～12岁以上)将终生低视力。而严重影响学习工作及生活。儿童弱视大部分为远视占95%以上,少量近视,其主要原因是由于眼球发育不良引起屈光异常。我科自1997年起实行门诊配镜,遮盖,家庭用弱视治疗仪,穿针,描图,画画等煅练，治疗儿童弱视取得一定效果现报告如下[1]。
1对象和方法
1.1对象
选择1999/2007年日常门诊就诊患儿经常规散瞳带状光检影验光矫正视力<0.8，排除器质性眼病确诊弱视儿童87例122眼，年龄3～16(平均7.23)岁。
1.2方法
治疗前准备,常规检查远近视力,视功能,眼位,屈光介质,眼底,注视性质等。用10g/L阿托品眼膏散瞳，每天涂2次连涂3d后进行带状光检影配镜。配镜原则:远视性弱视在大瞳孔下直接配戴减+1.00～+1.50D屈光度的矫正眼镜。有内斜远视者首先配镜给予充分矫正,最好的视力最高的度数。外斜远视者远视镜稍欠矫配镜,最好的视力最低的度数。有散光者散光度数全部配足，近视性弱视者等瞳孔恢复后再配镜,原则是最好的矫正视力最低的矫正度数。配镜后所有患儿给予常规的遮盖优势眼或健康眼,或两眼交替遮盖等。遮盖方法与时间,视弱视程度,类型,注视性质而定。另嘱其行穿针穿珠等精细锻炼。条件好者买弱视治疗仪行光刷红闪等治疗。每天坚持30min。斜视弱视儿童在弱视治疗0.5～1a后建议其尽早进行斜视矫正手术。近视性弱视者限制视近,鼓励其坚持体育锻炼。弱视儿童一般1mo为一疗程。每一疗程结束后复查视力,定期行散瞳检影验光更新眼镜,后期视力稳定后可以改为3～6mo复查1次[2]。疗效判定：基本治愈：视力提高到>0.9且视力保持不变2a;进步：视力≤0.8,但较原视力提高2～5行;无效：视力退步、不变或提高1行。
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