Observation and study on uncorrected distance visual acuity and ocular adjustment function before and after excimer laser photorefractive keratectomy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the changes of uncorrected distance visual acuity(UCDVA)and ocular accommodation before and after excimer laser photorefractive keratectomy(PRK).METHODS: A retrospective study. There were 120 patients(240 eyes)who underwent PRK surgery in our center from December 2017 to December 2019 divided into two groups according to the diopter of spherical equivalent(SE): 70 cases with SE≤-6.00D in the mild to moderate myopia group and 50 cases with -6.00D<SE≤-9.00D in the high myopia group which were observed and analyzed. The UCDVA(LogMAR), monocular accommodative amplitude(AMP), negative relative accommodation(NRA), positive relative accommodation(PRA)and monocular accommodative flipper(AF)were measured before and after operation at 1wk, 1 and 3mo. RESULTS: In the group of low-moderate myopia and high-myopia group, the UCDVA at 1wk, 1 and 3 mo after operation was significantly increased compared with those before operation(all P<0.01). The increase of UCDVA of low to moderate myopia group was better than that in the high myopia group at 3mo after operation(P<0.05). Monocular AMP in the both groups firstly decreased and increased afterwards, and there was a significant decrease than that before operation at 1wk and 1mo after operation(P<0.01). AMP reached and was better than that before operation at 3mo after operation(P<0.01). The increase of low to moderate myopia group was both higher and faster than that of high myopia group. Compared with PRA before operation, the patients of low to moderate myopia group decreased at 1wk after operation(P<0.01), postoperative levels at 1mo recovered to preoperative level(P>0.05)and postoperative at 3mo was superior to preoperative operation(P<0.05); High myopia group did not change significantly at 1wk and 1mo after operation compared with preoperative operation(P>0.05), and increased at 3mo after operation compared with preoperative level(P<0.01). For low to moderate myopia group, there was no significant difference in preoperative and postoperative NRA, and at 1wk after operation, NRA of high myopia group temporarily increased compared with preoperative operation(P<0.01). At 1mo after operation, it returned to the preoperative level(P>0.05), and significantly increased at 3mo after operation compared with preoperative operation(P<0.01). Monocular AF for both groups significantly decreased at 1wk after operation compared with preoperative operation, recovered at 1mo after operation and was significantly better at 3mo after operation(all P<0.01); The low-to-moderate group increased more than the high-myopia group.CONCLUSION: PRK has a good correction effect for myopia below -9.00D, and people in low to moderate myopia have a better postoperative UCDVA correction effect than those in high myopia. The eye accommodation will be abnormal in a short period after operation. The recovery and improvement time of accommodative function in low-moderate myopia group are shorter than that in high myopia group, but both groups can recover and improve at 3mo after operation compared with the preoperative levels.

Effect of Wei's triple nine needling on eye regulation in patients with presbyopia complicated with visual fatigue of liver depression and spleen deficiency / 中国针灸

OBJECTIVE@#To compare the clinical efficacy between Wei's triple nine needling combined with esculin and digitalis glycosides eye drops and esculin and digitalis glycosides eye drops alone for presbyopia complicated with visual fatigue of liver depression and spleen deficiency.@*METHODS@#Forty-six cases (92 eyes) with presbyopia complicated with visual fatigue of liver depression and spleen deficiency were randomly divided into an observation group (23 cases) and a control group (23 cases, 2 cases dropped off). The cases in the observation group were treated with Wei's triple nine needling and esculin and digitalis glycosides eye drops. The acupoints included Shangming (Extra), Chengqi (ST 1), Cuanzhu (BL 2) to Jingming (BL 1), Sizhukong (TE 23) to Taiyang (EX-HN 5), etc; the needling was given once every other day, three times a week, and the eye drops were given one drop each time, three times a day. The cases in the control group were only treated with the eye drops. Both groups were treated for 7 days as one course of treatment, and 2 courses of treatment were given. The visual fatigue core symptoms score, adjustment amplitude, adjustment lag and best average corrected visual acuity were observed in the two groups before treatment, 1 week and 2 weeks into treatment, respectively.@*RESULTS@#Compared before treatment, the visual fatigue core symptoms scores in the two groups were decreased after 1-week and 2-week treatment (P<0.05); in the observation group, the adjustment amplitude was increased after 2-week treatment (P<0.05), while in the control group, the adjustment amplitude was increased after 1-week and 2-week treatment (P<0.05); in the observation group, the adjustment lag was decreased after 1-week and 2-week treatment (P<0.05). After 2-week treatment, the visual fatigue core symptoms score in the observation group was lower than that in the control group, and the adjustment amplitude was higher than that in the control group (P<0.05). There were no significant differences in adjustment lag and best average corrected visual acuity between the two groups after 1-week and 2-week treatment (P>0.05).@*CONCLUSION@#Wei's triple nine needling combined with esculin and digitalis glycosides eye drops could improve the visual fatigue and eye regulation ability in patients with presbyopia complicated with visual fatigue of liver depression and spleen deficiency, and the effect is better than esculin and digitalis glycosides eye drops alone.

Formulation rule and characteristic analysis of TCM compound health care products for relieving visual fatigue / 中草药

Objective: Through searching the information of health food with the function of alleviating visual fatigue published on the Special Food Information Query Platform, and the product information data of ophthalmic proprietary Chinese medicine with health care function in the prescription database of Chinese patent medicine based on Pharmaceutical Intelligence data network, so as to provide the basis and reference for the development of the health food formulations and products with the function of relieving visual fatigue. Methods: Microsoft Excel 2016 software and Traditional Chinese Medicine Inheritance System were used to make statistics on the detected product information and analyze its formula characteristics. Results: A total of 141 kinds of health food with visual fatigue relief function were collected, of which 64 kinds (45.4%) contained traditional Chinese medicine in the formula of health food. There were six herbs of Chinese materia medica raw materials with frequency ≥ 5, which were used 145 times (72%), from high to low, Chrysanthemum morifolium, Lycium barbarum, Cassiae Semen, Mori Fructus, Rehmannia glutinosa and Poria cocos were used respectively. Three new prescriptions were obtained by unsupported entropy clustering. Non-traditional Chinese medicine raw materials are widely used in health food to alleviate visual fatigue, there were 60 products containing foreign natural plant resources and 17 products containing xanthin and vitamins. According to statistics on the products with health function in ophthalmic Chinese patent medicine, there were seven kinds of traditional Chinese medicine materials with frequency ≥ 4, which were used 32 times (29%), from high to low, they were Lycium barbarum, Cassiae Semen, Cuscuta chinensis, Rehmannia glutinosa, Chrysanthemum morifolium, Schisandra chinensis, and Plantago asiatica. A new prescription was obtained by unsupervised entropy hierarchical clustering. Conclusion: The choice of raw materials of Chinese materia medica in health food is basically consistent with traditional Chinese medicine theory in the treatment of visual fatigue principle, that is, nourishing the liver and kidney, calming liver and improving eyesight. However, they are different in the selection range of traditional Chinese medicine raw materials, the compatibility of raw materials, the types of dosage forms and so on. In addition, under the guidance of syndrome differentiation and health care theory, this paper attempts to apply the statistical method of literature data processing to screen new formulas and develop new products, which opens up new ideas and methods for the research and development of health care products of traditional Chinese medicine compound.

Association of electronic devices usage and visual fatigue in Chinese college students / 眼科新进展

Objective To investigate the prevalence of visual fatigue among Chinese college students with the usage of electronic products.Methods A total of 6000 college students were recruited from 127 universities in 29 cities (except Taiwan,Qinghai,Tibet,Ningxia and Xinjiang).The questionnaire involved questions pertaining to the dependence of electronic products,use of electronic products in dormitory,home,vehicles,and prevalence of visual fatigue.Logistic regression was performed to analyze the potential risk factors for visual fatigue.Results A total of 4848 questionnaires were valid,involving 2259 male and 2589 female students.The results revealed that the incidence of visual fatigue in Chinese college students was 53.5％,a higher rate in females than in males.And 33.8％ of whole group admitted that they had become relied on electronic products.The proportion of electronic products used at the table,on the bed,transport equipment reached 91.3％,87.6％ and 74.8％,respectively.In terms of the usage duration,38.3％ of surveyed students use mobile phone,Tablet PC over 4 hours per day,with 29.7％ using electronic products over 1 hour on the bed and 49.1％ in vehicles over 0.5 hour.Univariate logistic regression analysis showed that the prevalence of visual fatigue were related to gender,dependence on electronic products,the use of electronic products in dormitory,home,vehicles.Conclusion The prevalence of visual fatigue is relatively high among Chinese college students,which may be associated with the following several factors,including gender,dependence on electronic products and the use of electronic products in dormitory,home and vehicles.

Clinical effects of Qingrun Yangmu Oral Liquid combined with artificial tears on dry eye visual fatigue patients due to Liver-Kidney Yin Deficiency Syndrome / 中成药

AIM To investigate the clinical effects of Qingrun Yangmu Oral Liquid combined with artificial tears on dry eye visual fatigue patients due to Liver-Kidney Yin Deficiency Syndrome.METHODS Ninety patients (180 eyes) randomly and equally were divided into artificial tears group (0.1％ Sodium Hyaluronate Eye Drops),oral liquid group (Qingrun Yangmu Oral Liquid) and combination group (0.1％ Sodium Hyaluronate Eye Drops and Qingrun Yangmu Oral Liquid) underwent a ten-day course of treatment,and they had their subjective symptom score,tear secretory volume (Schirmer Ⅰ test,SIT),tear film break-up time (BUT),corneal fluorescein staining (CFS) score and visuognosis persistence observed prior to the treatment,and on the 1 lth,21st,30th days after the treatment.RESULTS All the aforementioned indices in the three groups were improved after the treatment,especially of the 11th day (P ＜0.01).Obvious changes of BUT,CFS score and visuognosis persistence at different time points,in the three groups were found as compared with those data prior to the treatment (P ＜0.05),so were the subjective symptom score and SIT in the oral liquid group and combination group (P ＜ 0.05).The combination group displayed significantly better results than the other two groups (P ＜ 0.05),which exhibited no obvious differences between the interventions of artificial tears and oral liquid (P ＞ 0.05).A markedly higher total efficacy rate of combination group than the other two groups was achieved as well (P ＜ 0.05).CONCLUSION For patients of dry eye visual fatigue due to Liver-Kidney Yin Deficiency Syndrome,Qingrun Yangmu Oral Liquid combined with artificial tears can relieve their symptoms in terms of tear secretory promotion and prolonged BUT.

Exigências visuais e fadiga visual em médicos oftalmologistas / Visual demands and visual fatigue among ophthalmologists

Contexto: As exigências visuais, designadamente da visão ao perto, são cada vez mais frequentes no mundo do trabalho, podendo causar fadiga visual ou astenopia. Os médicos oftalmologistas exercem atividades que exigem esforço visual, o que determina o interesse no seu estudo pela saúde ocupacional. Objetivos: Identificar a prevalência das queixas visuais e a sua relação com as exigências do trabalho nos médicos oftalmologistas em um hospital universitário de Lisboa. Métodos: Avaliou-se a ocorrência de sintomas de fadiga visual por meio de um questionário de sintomas ­ Inventário de Eficiência Visual (IEV) ­ e pela determinação dos pontos próximos de acomodação e de convergência. Utilizou-se o teste de Schirmer para a avaliação da secreção lacrimal. Os resultados foram analisados com o auxílio da estatística descritiva, do coeficiente de Spearman e do teste de Wilcoxon para p<0,05. Resultados: Dos 27 médicos respondentes, a maioria refere fadiga visual (n=25), assim como a presença de olhos secos e o piscar frequentemente (n=27). Os resultados do teste de Shirmer evidenciam diferenças no final do dia de trabalho e os pontos próximos de acomodação e convergência evidenciam a presença de fadiga visual. Conclusões: Os resultados revelaram diferenças significativas entre o início e o final do dia de atividade profissional dos médicos oftalmologistas, indiciando a existência de fadiga visual ao final do dia de trabalho. Tal situação determina a necessidade de implementar um programa de vigilância da saúde para prevenir alterações visuais de natureza profissional.

Background: Visual demands, especially for near vision, are becoming increasingly more frequent at the workplace, and might cause visual fatigue or asthenopia. The tasks performed by ophthalmologists involve visual effort, raising interest in their study within the context of occupational health. Objectives: To estimate the prevalence of visual complaints and its relationship to work demands among ophthalmologists at a university hospital in Lisbon. Methods: Occurrence of visual fatigue symptoms was assessed by means of a symptom questionnaire ­ College of Optometrists in Vision Development Quality of Life (COVD-QoL) ­ and through the identification of near points of accommodation and convergence. Schirmer's test was used to assess tear production. The results were analyzed by means of descriptive statistics, Spearman's coefficient and the Wilcoxon test for p<0.05. Results: Most among the 27 analyzed physicians reported visual fatigue (n=25), dry eyes and frequent blinking (n=27). Schirmer's test evidenced differences at the end of the working day and the near points of accommodation and convergence indicated occurrence of visual fatigue. Conclusions: The results showed significant differences between the beginning and the end of the working day among ophthalmologists, with occurrence of visual fatigue at the end of the working day. These findings point to the need to implement a health surveillance program to prevent occupational visual disorders.

Efficacy on visual display terminal syndrome treated withtherapy ofmedicine / 中国针灸

<p><b>OBJECTIVE</b>To observe the efficacy and explore the effect mechanism on visual display terminal syndrome treated withtherapy ofmedicine.</p><p><b>METHODS</b>Sixty-five patients of visual fatigue induced by the visual display terminal operation were treated withtrigeminy therapy ofmedicine, e.g. massage manipulation, acupuncture and cupping; acting on the specific stimulating areas inmedicine, relevant with orbit, temple, forehead, ear and Baihui (GV 20). Each treatment lasted 40 min, once every two or three days. Totally, 10 to 14 treatments were required. The scores of visual symptoms and the ocular hemodynamics before and after treatment were observed, and clinical effect were evaluated in the two groups.</p><p><b>RESULTS</b>After treatment, the scores of visual symptoms were reduced apparently as compared with those before treatment (all<0.05). The total effective rate was 84.6% (55/65). The peak systolic velocity (PSV), the end diastolic velocity (EDV) in anterior ciliary artery (ACA) and the central retinal artery (CRA) were improved obviously, indicating the significant differences before and after treatment (all<0.05).</p><p><b>CONCLUSIONS</b>Thetherapy ofmedicine alleviates the visual symptoms in patients of visual fatigue and improves visual quality. The effects are related to the improvement of ocular microcirculation.</p>

Prevalence of asthenopia in children: a systematic review with meta-analysis / Prevalência de astenopia em crianças: análise sistemática com metanálise

OBJECTIVE: To estimate the prevalence of asthenopia in 0-18 year-old children through a systematic review and meta-analysis of prevalence studies.SOURCES: Inclusion criteria were population-based studies from 1960 to May of 2014 reporting the prevalence of asthenopia in children. The search was performed independently by two reviewers in the PubMed, EMBASE, and LILACS databases, with no language restriction. This systematic review was performed in accordance with the Cochrane Collaboration guidelines and the PRISMA Statement. Downs and Black score was used for quality assessment.SUMMARY OF FINDINGS: Out of 1692 potentially relevant citations retrieved from electronic databases and searches of reference lists, 26 were identified as potentially eligible. Five of these studies met the inclusion criteria, comprising a total of 2465 subjects. Pooled prevalence of asthenopia was 19.7% (12.4-26.4%). The majority of children with asthenopia did not present visual acuity or refraction abnormalities. The largest study evaluated 1448 children aged 6 years and estimated a prevalence of 12.6%. Associated risk factors were not clearly established.CONCLUSION: Although asthenopia is a frequent and relevant clinical problem in childhood, with potential consequences for learning, the scarcity of studies about the prevalence and clinical impact of asthenopia hinders the effective planning of public health measures.

OBJETIVO: Estimar a prevalência de astenopia em crianças até 18 anos por meio de uma análise sistemática e uma metanálise dos estudos de prevalência.FONTES DOS DADOS: Os critérios de inclusão foram estudos de base populacional de 1960 a maio de 2014 que relataram prevalência de astenopia em crianças. A busca foi feita de maneira independente por dois analisadores nas bases de dados PubMed, Embase e Lilacs, sem restrição de idioma. Essa análise sistemática foi feita de acordo com as diretrizes da Colaboração Cochrane e com a Declaração dos Itens de Relatório Preferidos para Análises Sistemáticas e Metanálise (Prisma). A escala Downs & Black foi usada para avaliação da qualidade.SÍNTESE DOS DADOS: De 1.692 citações possivelmente relevantes recuperadas de bases de dados eletrônicas e buscas de listas de referência, 26 foram identificadas como possivelmente elegíveis. Cinco desses estudos atenderam aos critérios de inclusão e incluíram 2.465 indivíduos. A prevalência total de astenopia foi de 19,7% (12,4-26,4%). A maioria das crianças com astenopia não apresentava anomalias de acuidade visual ou refração. O maior estudo avaliou 1.448 crianças de seis anos, com prevalência estimada de 12,6%. Os fatores de risco associados não foram claramente estabelecidos.CONCLUSÃO: Embora a astenopia seja um problema clínico frequente e relevante na infância, com possíveis consequências para o aprendizado, a escassez de estudos sobre a prevalência e o impacto clínico da astenopia prejudica o planejamento efetivo das medidas de saúde pública.

Study on preventive treatment for prevention of juvenile myopia / 国际中医中药杂志

Juvenile myopia has become the most prominent issues to students' healthy growth in recent years,attracted widely concerns in the community.Evidence-based eye scientific research has shown that there is no method to cure myopia.Preventive treatment explores the unique effects of early interventions by providing patients with guidance on young people's daily life,diet and myopic prevention measures,which may effectively improve the incidence of juvenile myopia and has well social benefits.