| Objective : Sreening asthenopia patient by VISUAL QUALITY SCALE , undertaking visual function examination and obtaining oculamotor parameter, then comparing it between asthenopia and non-asthenopia patients, search the feature of asthenopia patients oculamotor parameter, to investigate the relationship between asthenopia symptom and oculamotor parameter. Subjects and Method:The Subjects in asthenope group came from the out-patient who underwent complete examination becanse of the symptom (eyestrain etc.) from the November in 2005 to the march in 2006,each subject completed a 9-item quality of visual questionnaire to quantity the level of symptom, questionnaire were independently scored after completion of the examination .each question was scored on a scale of 0(symptomatic )to 100(asymptomatic)point using equivalent numericalinterval. Individual question results were summed and the result divided by 9 to calculate the symptom score, the symptom score less than 75point as inclusion criteria Exclusion criteria:1 ^ Habitual corrected visual acuity of less than 1.0 at distance or near in both eye by Snellen letter chart2> Have the organitic disease in visual organ examed by slit lamp and retinoscope3 > Have systematic disease or genetic myopia o 4> dry eye patient by examing the tear film quality 5 ^ More than 0.5D of unconnected astigmatism in the habitual state 6^ More than 1.00D anisometropia 7> presence of amblyopia 8 -. age more than 40 years9> The optic centure distance of Spectacle isn't equal to the pupil distanceThe Subjects in compared group came from the ophtholmologisters and the out-patient without asthenopia symptom <= exclusion criteria: 1 >intermittent strabismus 2n Have the surpression phenomena or unhealthy sensory fusion by Worth 4 doto In the binocular function abnormal patient, 1.3%-5.4% of them have no the binocular single vision so without asthenopia symptom. Considering the reason above ,we take on the exclusion criteria 0Based on all the exclusion criteria and in elusion criteria, we carry out the test as follow :1) subjective refraction;2) distance and near lateral phoria 3) distance and near vertical phoria 4) distance and near Positive relative convergence (PRC) and Negative relative convergence (NRC);5) distance and near vertical usional amplitude;6) positive relative accommodation and negative relativeaccommodation(PRA/NRA);7)Accommodative response by fused cross cylinder (FCC);8) Minus lens amplitude;9) AC/A ratios: calculated A C/A ratios and gradient AC/Aratios;10)near point convergence;11) accommodative facility by + 2.00D FlipperoAll data were dealt with statistic software SPSS 11.5 Results:1> The average age between the asthenopia group and the comparedgroup indicate no significant difference (t=5.009,p=0.000), thus ,there are comparability in the age between the groups. But there is significant difference in the sex component between the two groups ( *2=6.43l;p=0.0110.05), indicating females have higher asthenopia prevalence than males o2> Distribution of diopter of the asthenopia and the compared groupthe asthenopia group :the average equivalent diopter in right eye is -1.92DS + 2.72DS;the average equivalent diopter in left eye is -1.94 DS ±2.71 DS ,the average anisometropia between two eyes is -0.02 + 0.32 DS, there is no significant difference between right eye and left eye( t=0.405;p=0.687>0.05 ) so we can rule out the effect of anisometropia othe compared group: the equivalent diopter in right eye is -2.98 DS± 2.00 DS;the equivalent diopter in left eye is -2.90 DS+1.91 DS , average anisometropia between two eyes is -0.08 + 0.36 DS, there is no significant difference between right eye and left eye(t=-1.262;p=0.217X).05)o5there is no significant difference between the average equivalent diopter (t=1.915;p=0.059>0.05 ) and there is comparability in the refractive error between two groups, so we can remove the effect of emmetropiao3> phoria between two groups1) lateral phoria at distance :the average lateral phoria at distance in the asthenopia group is -1.16 A + 5.15;in the compared group is -0.06 A ±2.73;there is no significant difference between them (t=-1.107,p=0.271 >0.05 ) .the asthenopia group have more exophoria than the compared group 02) lateral phoria at nearthe average lateral phoria at near in the asthenopia group is -6.45 A + 6.8;in the compared group is -3.13A+4.18;there is significant difference between them(t=-2.840,p=0.006 (0.05), the asthenopia group have more exophoria than the compared group o4% caculative and gradient AC/A ratiothe compared group have higher AC/A ratio than the asthenopia, there is significant difference between them (t=-2.009,p=0.048<0.05)5-. Fusional function:1)> lateral fusional function at distance(D -. The power of BO blur\break \recovery point in the asthenopia group is less than the compared group, there is significant difference between them (t=-3.266,p=0.002<0.05;t=-3.58,pO.OOKO.O5;t=-2.375,p=0.02<0.05)(2), The power of BI blur\break \recovery point in the asthenopia group is less than the compared group, there is no significant difference between them (t=-1.027,p=0.307 >0.05;t=-0.283,p=0.778>0.05)2), lateral fusional function at near?> The power of BO blur\break \recovery point in the asthenopia group is less than the compared group, there is significant differencebetween them (t=-5A2l ,;?=0.000<0.05;/=-3.909,/?=0.000<0.05;f=-2.738,p=0.007<0.05)(D> The power of BI blur\break \recovery point in the asthenopiagroup is less than the compared group, there is significant difference between two groups in the power of BI blur(r=-2.091, p=0.039<0.05),but no significant difference between two groups in the power of BI break\recovery (t=-0.45,p=0.654groups of capitalt=-0.822,p=0.413> 0.05)6> Near Point Convergence(NPC):The average NPC is 7.98 + 5.25 in the asthenopia group;in the compared group is 5.02 + 2.45;.the NPC in the asthenopia group is more farther than the compared group,There is significant difference between two group (t=2.966,p=0.004<0.05)o7> Accommodtion Function :1)> The RAJVO\ LAMP > OUAMP in the compared group both are greater than the asthenopia group , There is no significant difference between two groups (t=-1.531,p=O.129X).O5;t=-1.683,p=0.096>0.05;t=-0.849,p=0.398>0.05)o2)> The PRA in the asthenopia group is smaller than thecompared group , There is no significant difference between two group (t=l .356, P=0.178>0.05)o no significant difference in the NRA (t=0.150, P=0.881>0.05)3)% The average accommodation response is -0.06DS + 0.59 in sathenopia group;the compared group is -0.13DS + 0.62;There is no significant difference between two group ( t=0.544,p=0.588>0.05);8> Accommodative Facility:The average accommodation Facility in asthenopia group (8.71cmp ±4.81 )is smaller than the compared group( 13.68 + 3.99), There is significant difference between two group ( t=-4.917,p=0.000 (0.05)1. Phoria at near in asthenopia group is larger than in compared group,greater exophoria is the main cause of binocular symptom: asthenopia for those people younger than 40 ageso2. Positive and Negative fusional amplitude at distance and near in asthenopia group both are smaller than in compared group, can't compensate the greater phoria, so become another reason of asthenopia3. The decreation of Accommodation Facility is anthor asthenopia agent4.the unbalance of accommodation and /or convergence is the fundamental cause of asthenopia5. Sheard" criteria is a effective method to evaluate the binocular function,but have no great significance 0... |
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