| Objective:To investigate and analyse binocular visual status and its influencing factors in myopia children and adolescent, and discusse various factors on the occurrence and development of myopia may effect.Method:216 cases were selected out in myopia children and adolescents from July 2014 to February 2016 in The First Affiliated Hospital of Kunming Medical University optometry clinic.Ocular motor parameters measurement includes near and distance horizontal vergence, near and distance horizontal phoria, gradient AC/A ratio,positive and negative relative accommodation(PRA/NRA),adn take the standard to judge the parameters of Morgan reference, at the same time to carry on the binocular Vision Quality questionnaire (Vision Quality Scale VQS) survey.The 216 cases is divided into 7～12 years old group and 13～18 years old group according to the age, divided into not wearing glasses group and wearing glasses group according to the before and after refractive correction, divided into low, moderate and high myopia group according to the degree of myopia, divided into abnormal and normal binocular vision with Morgan reference value as the judgment standard, and divided into asymptomatic groups, mild symptoms group, moderate symptoms, severe symptom group by questionnaire score results.By SPSS 17.0 statistical software to compare and analyze the differences between groups.Results:1. the age distribution of all test results in the objects of study:There was no statistical significant difference of gender ratios between the two different age paragraph (P> 0.05); In 7～12 years old group,the not wearing glasses ratios is higher than that in 13～18 years old group, the differences are obvious statistical significant difference (P< 0.001);On the whole is given priority to with low degree of myopia, accounted for 61.11%, the differences of two different age groups of the degree of myopia group are obvious statistical significant difference (P< 0.01), including 13-18 years old teenagers ratios in high myopia group is higher than the proportion of low degree of myopia group and moderate myopia group (P< 0.01);On the whole is given priority to with normal binocular vision, accounted for 66.20%, binocular vision in 13-18 years old group was abnormal ratio is relatively higher in 7～12 years old group, the difference was statistically significant (P< 0.05);the overall abnormal binocular vision the highest proportion of mild symptoms,59.26%.2,The influence of refractive correction of binocular vision state:Without lens group was abnormal obviously than is the proportion of high wear lens group, the differences are significant statistical significance (P< 0.001);In the range of near positive and negative fusional vergence in the objects of study before and after refractive correction, the break point and the recovery point of near divergence,the blurred, break and the recovery of near convergence in wearing glasses group is higher than these in not wearing glasses group, the difference was statistically significant (p<0.05);The degrees of distant and near phoria in the two groups have no obvious statistical significant difference (p<0.05);The gradient AC/A ratio in not wearing glasses group is higher than that in wearing glasses group,the difference was statistically significant (p< 0.05);The difference of NRA before and after refractive correction has no statistical significance (p> 0.05), just PRA is higher in wearing glasses group than that in not wearing glasses group, the difference was statistically significant (p< 0.05).3, the influence of the degree of myopia of binocular vision state:①In the range of fusional vergence, the break point of distant divergence,the recovery point of near divergence,the recovery point of distant convergence,the blurred and break point of near convergence decease with the increase of myopia degree(p<0.05),The difference between low myopia with high myopia group was statistically significant;Gradient AC/A ratio increases with the increase of the degree of myopia,in which high myopia group is significantly higher than low myopia group(p<0.05), The degrees of distant and near phoria in the three groups have no obvious statistical significant difference (p<0.05);The absolute value of positive and negative relative accommodation were reduced, the difference was statistically significant (P< 0.05), and high myopia than low myopia was more decreased.②The ratios of near and distant phoria and normotopia in the objects of study with different degree myopia have no statistical significance (p> 0.05).From the point of view of population distribution,the ratios of near and distance phoria and normotopia in the objects of study are not all the same,the difference was statistically significant (P<0.05);near esophoria ratio is significantly higher than distant esophoria(P<0.05),distant normotopia ratio is significantly higher than near normotopia(P<0.05).4,Dependent variable (Y) on the results of questionnaire scores, gender,age, Morgan reference value judgment of binocular vision, before and after refractive correction, degree of myopia and the near type of phoria as the independent variable (X).According to the size of the role of the independent variable on the dependent variable and significant degree, multi-factor stepwise regression analysis;The ages X1, before and after refractive correction X2, myopic degree X3 was elected to the model, to establish the regression equation is: Y=-3.549+3.490Xl+2.808X2+1.512X3 Binocular vision can be seen from the equation, questionnaire abnormal degree of grading size and age,before and after refractive correction, degree of myopia were positively correlated, the 13-18 years old above 7～12 years old, not wearing glasses above wearing glasses, with the degree of myopia deepens, score higher.Conclusion:1, From the age distribution, Myopia occurs in children aged 7 to 12, High myopia mainly concentrated in the 13-18 years old age stage. Increased with the increase of age, the incidence of abnormal binocular vision, but overall normal binocular vision than was abnormal, and abnormal binocular vision most mild symptoms.Increased with the increase of age, the incidence of abnormal binocular vision,But on the whole, more normal binocular vision than was abnormal, abnormal binocular vision mild symptoms are the most.2,Wear glasses correcting myopia can reduce the occurrence of abnormal binocular vision,the near divergence and convergence,positive relative accommodation of wearing glasses are higher than these of not wearing glasses,but the gradient AC/A of not wearing glasses are higher than these of wearing glasses.So the refractive correction of myopia children binocular visiual function have certain effect, especially the near.3,As the degree of myopia, regardless of distance or near,the range of positive and negative fusional vergence have a certain degree of reduction,and near range to reduce, among them the high myopia is the low myopia have more obvious decrease;the gradient AC/A rise,the absolute value of positive and negative relative accommodation decease,high myopia than low myopia increased obviously;Regardless of distance or near,the ratios of type of phoria have no obvious difference,give priority to the exophoria,and generally,near esophoria ratio is significantly higher than distant esophoria,and distant normotopia ratio is significantly higher than near normotopia.4,Comprehensive analysis shows that binocular vision abnormalities increases with age and degree of myopia deepen and aggravate, not wearing glasses is worse than wearing glasses. |
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