| Objective: Comparative analysis of the effects of refractive properties,degree of anisometropia and refractive correction on binocular visual function in patients with anisometropia.Methods: Patients with anisometropia who were treated in our hospital from April2022 to December 2022 were selected.After excluding dominant strabismus(except accommodative esotropia),nystagmus,corneal disease,glaucoma,cataract,fundus disease and other conditions that affect vision,intellectual and neurodevelopmental disorders,patients with simple anisometropia were tested for visual acuity,computer optometry,corneal refraction,worth4 lighting,diopter and synopsis before and after 3months of refraction correction,and three-level visual function inspection of the machine.The anisometropia of both eyes is the difference between the equivalent spherical diopters(spherical diopter + 1/2 cylindrical diopter),and patients are divided into hyperopia group and myopia group according to the nature of diopter.According to the anisometropia 3.0D as the standard,they were divided into two groups,A and B.Group A(0D<ΔSE<3D)is mild to moderate anisometropia,and group B(3D≤ΔSE<6D)is severe anisometropia.The binocular vision function test uses a synoptic machine(TSJ-IV type of Changchun Photoelectric Instrument Co.,Ltd.)to check the subject’s far-distance strabismus angle and far-distance conscious squint angle(using a first-level picture);On the basis of the inspection,the patient’s distance fusion range(including the distance convergence range and the distance dispersion range)is checked by using the second-level pictures;the patient’s distance stereo vision is qualitatively and quantitatively checked by using the general stereo vision picture and the random point stereo vision picture.Refractive correction adopts the method of wearing frame glasses.All patients with myopic anisometropia were treated with compound tropicamide mydriasis optometry after the initial examination,eye drops once every 10 minutes,a total of 3 times,and computer optometry was performed after 20 minutes.All patients with hyperopic anisometropia were treated with 1% atropine sulfate for mydriatic optometry,with eye drops once every night before going to bed for 7 consecutive days.Patients with accommodative esotropia should receive corrective glasses after mydriasis and optometry.For the remaining patients,the diopter determined after subjective refraction based on the "MPMVA principle" after the compound pupil was the degree of the patient’s frame lens,which advises all children to wear glasses all day except sleeping.Results:1.The average age of myopic anisometropia group A was(11.19±0.233)years old,and the average age of group B was(12.05±0.445)years old,mean difference(0.86±0.212)years old;the average age of hyperopic anisometropia group A was(6.76±0.566)years old,and the average age of group B was(6.93±0.533)years old,mean difference(0.17±0.033)years old.2.Before wearing glasses for correction,exophoria accounted for 97.30% of the myopia group and 33.33% of the hypermetropic group among non-orthotropic patients;The proportion of extraphoria in the group was 96.77%,and the proportion of extraphoria in the hyperopic group was 37.5%.3.The monocular inhibition rate of myopic anisometropia patients was 0% before and after wearing glasses,and the degree of anisometropia was not correlated with the monocular inhibition rate(r=0,P=1).Before wearing glasses for correction,the monocular inhibition rate of patients with hyperopic anisometropia was55.41%,and the degree of anisometropia was significantly correlated with the monocular inhibition rate(r=0.508,P<0.05);after wearing glasses for correction for 3 months,the hyperopic anisometropia The monocular suppression rate was40.5%,and the degree of anisometropia was significantly correlated with the monocular suppression rate(r=0.353,P=0.002).4.Simultaneous visual function of patients with anisometropia after 3 months of refractive correction with frame lenses: the normal rate of simultaneous visual function in myopic group A after correction was 78.1%,which was statistically significant compared with that before correction(P<0.05).The normal rate of simultaneous visual function after correction was 71.1%,which was not statistically significant compared with that before correction(P=0.083);the normal rate of simultaneous visual function in hyperopic A group was 45.5%,which was not statistically significant compared with that before correction(P=0.317)The rate of normal visual function in group B after correction was31.7%,which was statistically significant compared with that before correction(P<0.05).5.Fusion function of patients with anisometropia after 3 months of refraction correction with frame lenses: the normal rate of fusion function in myopia group A after correction was 37.7%,and the rate of normal visual function in group B after correction was 39.5%,and there was no statistics compared with before correction The normal rate of fusion function in group A after correction was18.2%,and the normal rate of fusion function in group B after correction was17.1%,which were not statistically significant compared with those before correction(P=1,0.102).6.Stereoscopic function of patients with anisometropia after 3 months of refractive correction with frame lenses: the normal rate of stereopsis function after correction in myopia group A was 98.2%,and the normal rate of stereopsis function after correction in group B was 78.9%.There was statistical significance(P<0.05);the normal rate of stereopsis function in group A after correction was24.2%,which was statistically significant compared with that before correction(P<0.05),and the normal rate of stereopsis function in group B after correction was 4.9%.Compared with before correction,there was no statistical significance(P=0.157).Conclusion:1.Age comparison indicates that hyperopic anisometropia occurs at a younger age than myopic anisometropia.2.For myopic anisometropia patients with phoria,the type of strabismus is basically exophoria,and occasionally esophoria.For hyperopic anisometropia patients with phoria,the incidence of esophoria is higher than that of myopic anisometropia patients.3.The binocular single vision function of patients with myopic anisometropia is basically normal,and patients with hyperopic anisometropia are prone to monocular depression,and the rate of monocular depression is positively correlated with the degree of anisometropia.4.The stereopsis function of patients with myopic anisometropia is better than that of hyperopic anisometropia patients.5.The binocular vision function of patients with anisometropia improved after refractive correction with frame lenses,but in general,the degree of damage to binocular vision function of hyperopic anisometropia was more severe than that of myopic anisometropia.6.For children with myopic anisometropia,when the anisometropia is less than 3.0D,it has little effect on the binocular vision function,and when the anisometropia is≥3.0D,it has a significant impact on the binocular vision function;A deviation <3.0D will also significantly affect binocular vision. |
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