【作者】 李娜；

【导师】 王剑锋； 姚淑玲；

【作者基本信息】 蚌埠医学院 ， 临床医学（眼科学）（专业学位）， 2016， 硕士

【摘要】 目的研究儿童近距离不同方式用眼前后各种屈光相关因素(视力、屈光度、角膜曲率、眼压、瞬目次数)的变化,探讨不同方式近距离用眼对儿童屈光状态的影响。方法20例(40眼)符合条件的受试儿童,其中男9例(18眼),女11例(22眼),年龄5~7岁(6.05±0.77)岁,裸眼视力≥0.8、屈光度在±0.75D范围。每位受试儿童试验前分别测量双眼视力、屈光度、角膜曲率、眼压及瞬目次数,让受试儿童连续使用电脑30分钟,立即测量以上指标。在之后不同的3天时间里,每天分别进行其他用眼方式(平板电脑、智能手机、图画书)的试验,测量记录观察指标,并将各项结果进行统计学分析。结果1.不同方式近距离用眼前后屈光各项指标的比较受试儿童连续使用电脑、平板电脑、智能手机、图画书30分钟后:平均视力及平均角膜曲率较试验前均无明显变化(P>0.05);平均屈光度均往近视方向改变,使用电脑前后及使用智能手机前后屈光度差异有统计学意义(P<0.01),使用平板电脑前后及使用图画书前后屈光度差异无统计学意义(P>0.05);平均眼压均有所升高,使用平板电脑前后眼压差异无统计学意义(P>0.05),其余用眼方式眼压均有显著升高(P<0.01);平均瞬目次数均明显减少,较试验前有显著差异(P<0.01)。2.不同方式近距离用眼之间对屈光各项因素的影响差异近距离不同用眼方式之间在屈光度及瞬目次数的影响上存在显著差异(P<0.05)。在眼压、角膜曲率的影响上均无显著差异(P>0.05)。3.不同方式用眼前后屈光度变化值与眼压变化值的关系Pearson相关性分析结果显示:不同方式近距离用眼前后屈光度变化值与眼压变化值之间均无明显相关关系。结论短时间(30分钟)连续使用电脑、平板电脑、智能手机、图画书对屈光各项指标可以产生下列影响:1.对儿童视力及角膜曲率均无明显影响。2.均可引起暂时的近视改变,其中使用电脑及智能手机对屈光度的影响有显著意义。不同用眼方式之间在对儿童屈光度的影响上存在显著差异。3.均可引起暂时的眼压升高,除平板电脑外,其他用眼方式前后对眼压的影响均有显著差异。不同用眼方式之间在对眼压的影响上无显著差异。4.不同用眼方式前后引起的屈光度变化与眼压升高之间无明显相关关系。更多还原

【Abstract】 Objective To study the changes in the refractive state(vision、refraction、corneal curvature 、 intraocular pressure and blink times) of the children after they used different ways of near work for a short time to explore the impact of different ways of near work on children’s eye refractive state.Methods Twenty children(40 eyes) aged 5to7 years,of whom the uncorrected visual acuity≧0.8、diopter range within ± 0.75 D,were enrolled in the study.The binocular vision、refractive、corneal curvature、IOP and blink times were Measured before the test, then repeat the above measurement indicators after continuous use of computer 30 min. immediately. The observation targets were Measured after using the other ways(Ipad 、 phone and picture book)during different times at 3 days intervals.And the results are analyzed statistically.Results1.The Comparison of the refractive indexes before and after different near work ways After using computer, ipad, phone, picture book for 30 minutes: The average visual and corneal curvature compared with the previous had no dominant variation(P>0.05).the average refraction compared with previous direction to myopia,after using computer and phone the change was statistically significant(P <0.01),after using ipad and picture books the change was not statistically significant(P> 0.05);the average IOP compared with previous increased,except for using ipad, the rest of the way IOP were significantly increased(P <0.01); the rage number of instantaneous directory were reduced significantly, there is a significant difference(P <0.01)compared with that before the test.The average number of eye blink rate,compared with the previous decreased significantly(P<0.01).2.The impact of the different ways of near wok on refractive factors. After using different near work ways:There are significant differences on the impact of refraction and blink times(P<0.05),on the impact of IOP and corneal curvature,there was no significant difference.(P>0.05).3.Pearson correlation analysis showed:No significant correlation between changes in IOP and refraction after different ways of near work.Conclusions After using computer、ipad、phone、picture book for 30 minutes can produce the following effects:1.there are no significant effect on visual and corneal curvature.2.All of them can cause temporary myopia changes, the affect after using computer and phone was significant. There were significant differences in the impact on Children’s refraction by different ways of near work.3. All of them can cause IOP increased, in addition to ipad, with the other way around eye on intraocular pressure were significantly different. Different ways of near work were no significant difference in the effect on IOP.4.No significant correlation between the changes in IOP and refraction after different ways of near work.更多还原