Abstract: Objective To investigate the distribution of refractive state in 3- to 6-year-old children with subnormal vision,and to analyze the relationship between different refractive types and amblyopia. Methods A descriptive study method was adopted to select 1 644 3- to 6-year-old children (3 288 eyes) with subnormal vision. Refraction and corrected visual acuity were detected after cycloplegia using 1% atropine ointment. The distribution of refractive state,the incidence rate of anisometropia,astigmatism and amblyopia at different age stages were studied. Results The majority of the children were hyperopia. The first refractive causes of amblyopia were compound hyperopic astigmatism (60. 04%). With the increase of age,the proportion of children with hyperopia decreased gradually while myopia increased. The rate of anisometropia was 14. 05%,significantly decreased with increased age (χ²=37. 31,P＜0. 01). There was a significant decrease in anisometropia with increased anisometropia (χ²=79. 181,P＜0. 01). Difference was statistically significant on astigmatism diopter and astigmatism axis in different age groups (χ²=95. 919,150. 79, P＜0. 01). The rate of amblyopia was 12. 77%. The incidence of amblyopia was higher when the spherical equivalent difference between the two eyes was not less than 1 diopter. There was a significant increase in the occurrence of amblyopia with increased anisometropia (χ²=379. 15,P＜0. 01). Conclusions The majority of 3- to 6-year-old children with subnormal vision have hyperopia. Hyperopia,astigmatism,and anisometropia are prone to cause amblyopia.

Key words: preschool children, refractive, subnormal vision, anisometropia, amblyopia

摘要： 目的 分析3～6岁视力低常儿童的屈光状态分布,探讨不同屈光类型与弱视发生的关系。方法 本文采用描述性研究,收集2014-2018年1 644名(3 288眼)3～6岁视力低常儿童,并进行视力检查和阿托品散瞳后验光检查。分析不同年龄段屈光状态、屈光参差分布、散光分布及弱视发生状况。结果 各年龄组视力低常儿童屈光类型均以远视为主,在远视类型中又以复性远视散光比例最高,为60.04%。随年龄增长远视比例降低,近视比例明显上升。屈光参差发生率为14.05%,其发生率随年龄增加逐渐降低(χ²=37.31,P＜0.01)。屈光参差程度越高,高屈光参差患者发生率相对越低(χ²=79.181,P＜0.01)。各年龄组散光程度及散光轴向分布之间的差异有统计学意义(χ²=95.919、150.79,P＜0.01)。弱视的发生率为12.77%,双眼等效球镜度差值≥1D时容易引起屈光参差性弱视,并且弱视发生率随屈光参差程度增加而升高(χ²=379.15,P＜0.01)。结论 学龄前视力低常儿童的屈光状态分布以远视为主,远视性屈光不正、散光、屈光参差等屈光异常更容易引起弱视的发生。

关键词: 学龄前儿童, 屈光, 视力低常, 屈光参差, 弱视