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AIM: To investigate the role of visual perception training on the recovery of visual function at all levels and the improvement of perceptual eye position in children with intermittent exotropia(IXT).METHODS: Prospective clinical study. A total of 74 patients with IXT who received corrective surgery for strabismus in the Ophthalmology Department of the First People's Hospital of Lanzhou City from January to June 2022 were collected and followed up for 3mo. The patients were randomly divided into 2 groups at 1d after surgery: 35 patients in the training group received binocular visual perception training, and 39 patients in the control group did not receive visual training. The changes of visual function and perceived eye position at all levels were observed at 1d and 3mo after operation.RESULTS: There were 24 patients(69%)with simultaneous perception in the training group at 1d after surgery and 34 patients(97%)with recovered visual function at 3mo after surgery, which was significantly higher than 1d after surgery(P=0.002). Furthermore, there were 22 cases(56%)of fusion function in the control group at 3mo after surgery, 13 cases(33%)of far stereopsis, 20 cases(51%)of dynamic stereopsis and 17 cases(44%)of static fine stereopsis. In the training group, there were 31 cases(89%)of fusion function, 25 cases(71%)of far stereopsis, 30 cases(86%)of dynamic stereopsis and 27 cases(77%)of static fine stereopsis, which were significantly higher than those in the control group(all P<0.05). The degree of perceived eye displacement in the training group decreased more significantly than that in the control group(all P<0.05).CONCLUSION: Postoperative visual perceptual training in children with IXT can promote recovery of visual function at all levels, improve perceptual eye position and enhance the control of eye position at the perceptual level of the brain.
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@#AIM: To investigate the effect of rigid contact lenses with multifocal design on binocular visual function in myopic patients. <p>METHODS: A self-control study before and after. Fifteen myopic students of North Sichuan Medical College were recruited as test persons between July and August 2020. The subjects first wore framed glasses for binocular visual function examination, then wore single vision and multifocal rigid contact lenses(1wk apart), and binocular visual function examination was performed after wearing each lens for 2wk. One-way analysis of variance was used to compare the binocular visual function of multifocal rigid contact lens, single vision rigid contact lens and frame glasses.<p>RESULTS: There were no significant differences among the three lenses in stereopsis, far horizontal phoria, far positive fusional vergence, far negative fusional vergence, near negative fusional vergence, convergence and dispersion flexibility, convergence near point, adjustment magnitude, adjustment flexibility and negative relative adjustment(<i>P</i>>0.05). Compared with frame glasses, multifocal rigid contact lenses had significant difference in near horizontal phoria, near positive fusional vergence, accommodation lag, positive relative accommodation increased and AC/A decreased(<i>P=</i>0.023,0.048,0.001,0.013,0.046); Compared with single vision rigid contact lenses, multifocal rigid contact lenses had significant difference in near horizontal phoria, accommodation lag, positive relative accommodation increased and AC/A decreased(<i>P</i>=0.014,<0.001,0.001,0.009).<p>CONCLUSION:Wearing multifocal rigid contact lenses can lead to near horizontal phoria, accommodation lag, positive relative accommodation increase and AC/A decrease, which may have some influence on proximal use of eyes. These expected changes should be considered in clinical application in order to evaluate and manage patients correctly.
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@#AIM:To observe curative effect and safety of slanted bilateral lateral rectus recession for convergence insufficiency-type intermittent exotropia.<p>METHODS:This study included 29 patients who underwent slanted bilateral lateral rectus recession for convergence insufficiency-type intermittent exotropia in our hospital between October 2017 and November 2019 with a follow-up of 6mo, the deviation, the surgical success rate, the binocular vision function and the complications were observed.<p>RESULTS:In our study, the mean near deviations, the mean distance deviations and the near-distance deviation differences reduced from -41.72±3.35PD, -23.28±9.75PD and 16.90±2.47PD before surgery to -5.97±4.85PD, -2.66±4.78PD, 3.28±1.10PD 6mo after surgery, the surgical success rate was 76%. The Grades I and Ⅱ binocular vision function improved 6mo after surgery(<i>P</i><0.05), the distance stereopsis and the near stereopsis were not statistically significant(<i>P</i>>0.05). None of the patients developed A-V pattern, limitation of eye movement, restrictive strabismus, vertical strabismus, and rotated diplopia, some patients had transient horizontal diplopia, which disappeared within 2-3wk after surgery.<p>CONCLUSION:Slanted bilateral lateral rectus recession may successfully reduce the near exodeviations, the distance exodeviations and the near-distance deviations difference without obvious complications, proved to be a safe and effective procedure for the treatment of convergence insufficiency-type intermittent exotropia.
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@#AIM: To observe the curative effect of vision therapy on children with functional visual loss.<p>METHODS: Totally 22 children with functional vision loss were enrolled in our department between January 2018 and June 2018, including 12 males and 10 females, the mean age 7.5±0.8 years old. All patients had routine eye examinations, refraction and binocular visual function examinations. Children with or without astigmatism whose diopter spherical mirror was between±1.00D and were accompanied by astigmatism less than ±1.00D participated in personalized vision therapy. Paired <i>t</i> test was used to analyze the binocular visual function before and after vision therapy.<p>RESULTS: The average visual acuity of the 22 children were improved, but the diopters before and after vision therapy were -0.011±0.573D and -0.057 ±0.338D drespectively, without statistical significance(<i>P</i>=0.633). The average of the distant level phoria(DLP)before and after vision therapy were -3△ ±2.97△ and -1.18△ ±1.6△, which was not statistically significant(<i>P</i>=0.089). The near level phoria(NLP)were -6.27△ ±4.56△ and -2.82△ ±2.56△; the near point of convergene(NPC)were 7.73±2.15 and 3.05±0.69cm; the accommodation convergence/accommodation(AC/A)were 2.00±1.55, 3.64±0.5 before and after the training respectively(<i>P</i><0.05); The negative relative accommodation(NRA)and positive relative accommodation(PRA)before vision therapy were 1.61±0.41 and -1.98±0.71D; after training they were 2.09±0.23 and -3.89±0.71D respectively; binocular crossed-cylinder(BCC)was 0.09±0.38D, which improved to 0.39±0.13D after therapy; the average of amplitude of accommodation(AMP)were 9.55±2.54 and 11.55±1.13D; binocular accommodation facility(BAF)were 3.36±2.73 and 9.64±1.5cpm respectively before and after therapy.<p>CONCLUSION:It is necessary to perform binocular visual function examination base on the refractive examination for children with functional vision loss. Visual therapy can improve visual acuity and binocular vision function.
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· AIM:To discuss the effect of mental image network training on binocular visual function recovery in children with concomitant strabismus.· METHODS:Totally 100 children with concomitant strabismus were selected from March 2013 to March 2017 in our Hospital.According to the random distribution,they were divided into mental group and control group,50 cases in each group.Mental group was given the mental image network training,control group was given no training.The visual function of the two groups of binocular vision,the near stereoscopic visual acuity and the eye position of the two groups were compared.· RESULTS:The proportion of patients with vision function by synoptophore at Ⅰ,Ⅱ,Ⅲ after treatment of mental group and control group were significantly higher than those before treatment,the after treatment of mental group was significantly higher than that of control group,the difference was statistically significant (P＜0.05).In the aspect of rate of ceses without stereovision by Titmus near stereoacuity,that after treatment of mental group and control group were significantly lower than those of the before treatment,that after treatment of mental group was significantly lower than control group;in the aspect of central fovea,macular hole,peripheral stereoscopic vision,those after treatment of mental group and control group were significantly higher than those of the before treatment,those after treatment of mental group was significantly higher than that of control group,the difference was statistically significant (P＜ 0.05).During the follow-up for 6mo,the ocular position maintenance rate of mental group was significantly higher than that of control group,the difference was statistically significant (P＜0.05).· CONCLUSION:Mental image network training can effectively promote the recovery of visual function in children after concomitant strabismus surgery.It is beneficial to maintain the position of the eye of children.