Pathogenic Factors Of Asthenopia Syndrome: Evidence-based Research

Asthenopia as eye fatigue , is consciously based on the eye symptoms, eyeor body and spirit differ factors (psychological) cross-cutting syndrome.Asthenopia is not an independent ophthalmic disease, and is often called asfatigue syndrome, psychosomatics category. Asthenopia pathogenic factors arecomplex. Including â‘ eye (refraction, accommodation and convergence);â‘¡theexternal environment factors (light, sound, chemical incentives);â‘¢ the inherentenvironmental factors (body diseases, living rhythm disorders);â‘£ mental(psychological) factors (stress, depression, personality, interpersonal).Therefore,every clear reasons and pathogenic factors of fatigue patients and further takesuitable for the illness or a combination therapy, is urgent to need to addressclinical issues. Evidence-based medicine is emerging in the past 10 years. TrishaGreenhalgh and Anna Donald gave the definition of " Evidence-based medicineis a method through listing systemically the relevant questions can be answered ,evaluating the probability of risk to apply mathematics methods, therebyimproving a traditional skill of clinicians in the diagnosis, treatment, preventionand related areas. Evidence-based medicine emphasizes clinical decision-making must be based on the macroeconomic evidence and classificate clinicalevidence. large-scale, multi-center, a forward-looking, double blind, random,even tens of thousands of patients lengthy clinical trials, is an effective manneraccess to quality clinical evidence. The other way is a secondary analysis ofclinical research data evaluation, such as systemic evaluation. before not toobtain test results in large-scale RCT, systemic evaluation is an effective way ofobtaining high-quality evidence.To get more effective evidence, we firstly search all have published about"the related pathogenic factors of asthenopia syndrome " in the randomizedcontrolled trial or semi-randomized controlled trial, and well-designed contentand case studies in the literature through electronic research According to theresults of electronic access, after reading the title and summary ,we go on withsearching full-text. According to Evidence-based medicine classificationstandards ,we evaluate these literature. Eventually getting four qualifiedliterature. Including one German test, one Chinese test, two Japanese test.From these feature literatures, we reach these conclusions : The use of VDThave clear correlation with asthenopia, and is one of pathogenic factors. Thecondition of asthenopia patients using VDT have connectation with the dailyworking hours in the video terminals. Working longer, the more obvioussymptoms. Asthenopia of VDT staff possibly have correlation with dry eyes,ametropia ,accommodation and convergence.Evidences we got can be directly applied to clinic. But there are someproblems have not been resolved : 1. whether there were correlation betweenage and asthenopia? 2. whether there were correlation between gender andasthenopia ? 3. What are the high incidence factors of asthenopia? Therefore, wedesigned a group of cases in the study, and hoped to get the answers through thisstudy.Continuously collecting asthenopia patients 83 cases (male 21 cases,female 62 cases ,aged 17~58 years) as a group of cases from February to Augustin 2005 in Jilin University first hospital ophthalmology clinic;According to thesame diagnostic criteria ,a unit workers had a routine medical examination andsome students volunteers not suffered from fatigue 65 cases (male 29 cases,female 36 cases, 21~53 years of age) as a comparison group. Collecting relevantinformation through research and ophthalmology examination. Investigationfactors are including gender, age, occupation, work environment, work pressureand job satisfaction;Eye examination are including near and far vision(correction and naked), slit-lamp microscopic examination ,fundus,examination,intra-ocular pressure,optometry, amplitude of accommodation, near point ofconvergence, heterophoria, stereopsis, tears dynamics. Through OR (odds ratio)and the Pearson coefficient of correlation â…¹2 test for statistical analysis ,eventually reached :gender, age, occupation have correlation with asthenopia.Asthenopia often were present in women of 30~50 engaged in fine work. someametropia types ,for example: particularly small degree of anisopia, smalldegree of hyperopia or myopia, and astigmatism against rule may havecorrelation with asthenopia. The decline of accommodation and convergence aredanger factors. Dry eyes has clear correlation with asthenopia.Through the evidence-based medicine study of asthenopia pathogenicfactors ,we received clinical evidences and provide basis for the clinicaltreatment of asthenopia. At the same time, we have mastered evidence-basedmedicine research methods. However, Asthenopia pathogenic factors are verycomplex, and there are certain defects of case control study . The questionnaireand checklist designed are relatively simple, and sample size is small. Therefore,in the future, we need require substantial, multi-center, forward-looking, doubleblind, random clinical trials to obtain high-quality clinical evidence.