| Purpose: To study the ocular accommodation and convergence function in patients with intermittent exotropia and exophoria.To compare the differences between them and the normal population,and analysis the causes of the differences among them.To explore the relationship between the binocular visual function and the development of concomitant strabismus.Methods: It was a case-control study.From December 2016 to October 2017,32 patients aged from 5 to 25,with intermittent exotropia in ophthalmology department of the Affiliated Hospital of Qingdao University were selected.Among them,there were 14 males and 18 females,and the best corrected visual acuity of the monocular was greater than 1.0,and the anisometropia was less than 1.0D,and the vertical strabismus was less than 5.There were 32 patients in the same age group,and the best corrected visual acuity was greater than 1.0,the refractive index was less than or equal to 1.0D,and the vertical strabismus was < 5,and the height of myopia,hyperopia,astigmatism,and no A-V syndrom were excluded,and no other ocular and systemic diseases and eye surgery history were observed.In the same period,normal people of the same age group were selected for the control examination,and the best corrected visual acuity was greater than1.0,the refractive index was less than or equal to 1.0D,no strabismus,amblyopia,high myopia,hyperopia,astigmatism,amblyopia and other ocular physical lesions,and the distance of 40 cm was between-6 and +2,and the range of 5m was between-4 and +2,and the collection function was normal,and no abnormal movement of the eye was observed.To investigate and collect the relevant medical history data of the patients with intermittent exotropia and the patients with exophoria,all subjects were examined by eye refractive examination,Worth4 spot examination,stereoscopic vision,strabismus,AC/A,far and near positive and negative convergence,positive and negative fusion range,positive and negative relative regulation,regulation response,and other related binocular vision functions.Using the Revised Newcastle Control Score,the eye level control score was performed on patients with intermittent exotropia.It was studied that the characteristics of the function of the binocular accommodation and convergence in patients with intermittent exotropia and exophoria,and compared the differences of the two sets of binocular coordination parameters.To investigate that cause of differences.Results: 1.The mean exodeviations of the group of intermittent exotropia was(-53.59 ±24.27)prism diopter when fixating at near target of 33 cm,and the exophoria group was(-10.75 ± 1.85).The difference between the two groups was statistically significant,P <0.05.2.The AC/A of the intermittent exotropia group was(4.64 ± 1.79)?/D,the AC/A of the exophoria group was(3.62 ± 1.26)?/D,and the normal group was(3.61 ± 0.80)?/D,the difference among the intermittent exotropia group,the exophoria group and the normal group was statistically significant difference;3.The accommodation response of the intermittent exotropia was(0.35 ± 0.76)D,the exophoria group was(0.59 ± 0.41)D,the normal control group was(0.27 ± 0.65)D,the Kruskal-Wallis test,H=3.27,P>0.05,the regulation response difference between the three groups was not statistically significant.4.The NRA of the intermittent exotropia group was(1.52 ± 0.87)D,the NRA of the exophoria group was(1.94 ± 0.30)D,and the NRA of the normal group was(1.86 ± 0.40)D,and the difference was not statistically significant.The PRA of Intermittent exotropia group was(-1.05 ± 0.59)D,the exophoria group PRA was(-1.84± 0.24)D,the normal control group was(-1.90 ± 1.90)D,the difference among the intermittent exotropia group,the exophoria group and the normal group was statistically significant difference;5.The results of this study found that the divergence ability of the intermittent new strabismus was stronger than the normal group,and the aggregate capacity was weaker than the normal group.Conclusions: 1.There are differences in the ocular function of accommodation and convergence among patients with intermittent exotropia and the patients with exophoria and normal people,and the change of deviation angle may be the cause of the differences.The change is involved in the development of concomitant strabismus.Through the training of the relevant collection function,the prognosis of the external oblique is improved by early prevention and control of the disease.2.The RNCS score is closely related to strabismus,but it is not significantly related to accommodation and convergence function. |
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