老年低视力和盲的病因及光学助视器在康复中的应用

Cause of low vision and blind in elderly and the application of optical aids in their rehabilitation

摘要:

目的：分析老年低视力和盲的病因及光学助视器在康复中的应用。

方法：收集我院老年视力残疾患者87例，其中低视力74例，盲13例。其中男53例，女34例。先进行常规内外眼检查，必要时采用特殊检查，再进行病因分析。均屈光矫正，然后试配远用和近用光学助视器，检查配戴助视器后远、近视力，远视力≥0.05为脱盲，远视力≥0.3为脱残，近视力≥0.5为有效，<0.5为无效。

结果：老年低视力患者致盲原因占首位的是高度近视，其次为黄斑变性、各类白内障、青光眼、糖尿病视网膜病变。经屈光矫正后视力提高≥2行者62例(71%)，视力不矫正或矫正≤1行者25例(29%)。联合远用助视器后视力≥0.3脱残者70例(80%)，远视力≥0.05脱盲者10例(11%)，<0.05者7例(8%)，脱残率92%。配阅读眼镜及近用助视器后近视力>0.5者 60例(69%)，<0.5者27例(31%)。助视器经常使用者58例，不经常使用18例，基本不用或放弃者11例。

结论：老年低视力及盲的病因占首位的是高度近视，其次是黄斑病变。光学助视器在其康复中的应用仍是目前可靠、经济、有效的矫治方法，应鼓励患者使用助视器，提高助视器的利用率，从而提高患者的生活质量。

Abstract:

AIM: To analyze the reasons of low vision and blindness in elderly patients and the application of optical aids in rehabilitation.

METHODS: Totally 87 elderly patients which had 74 cases of low vision, 13 cases of blind, including 53 males and 34 females. Routine internal and external eye examinations should be performed, and special removal examinations should be performed if necessary. Both refractive correction, and try with far and near optical aids, check after wearing a typoscope distant and near vision, distant vision ≥0.05 out the blindness, distant vision ≥0.3 out the disability. Near vision ≥ 0.5 was valid, <0.5 was invalid.

RESULTS: Among 87 elderly patients with low vision, high myopia was the leading cause of blindness, followed by macular degeneration, cataracts, glaucoma and diabetic retinopathy. The visual acuity after refractive correction increased ≥ 2 lines in 62 cases(71%), visual acuity was not correct or corrected for ≤ 1 of 25 cases(29%). With aids, far visual was ≥0.3 of the 70 cases(80%), ≥0.05 in 10 cases(11%), <0.05 in 7 cases(8%), residue removal rate of 92%. With reading glasses near and near visual acuity was >0.5 effective in 60 cases(69%), <0.5 ineffective in 27 cases(31%). Typoscope was often used in 58 cases, not often used 18 cases, 11 cases rarely used or give up.

CONCLUSION: High myopia is the leading cause of low vision and blindness in the elderly, followed by macular degeneration. The application of visual aids is still reliable and economical and effective treatment method, patients should be encouraged to use visual aids to improve the utilization rate of aids, so as to improve the quality of life of patients.