婴幼儿视力检查2011视光班答题.ppt

What can children see ? 注视和追随的能力 Quality of fixation-Fix Follow 行为检查 Behavioral testing What can children see ? 注视偏好检查 Fixation preference 行为检查 Behavioral testing What can children see ? 视动性眼球震颤OKN 行为检查 Behavioral testing What can children see ? 强制性选择性观看 Forced preferential looking (Teller acuity) 行为检查 Behavioral testing What can children see ? 视力表 Optotypes 图案 字母 行为检查 Behavioral testing What can children see ? 视觉诱发电位 VEP acuity 快速记录多振幅线条轨迹 Rapid display of stripes of multiple widths ERG振幅波峰与条带宽度成比例 Amplitude of EEG “spike” is proportional to stripe width 电生理检查 Electrophysiologic testing 固视和追随 Quality of Fixation Fix follow (F F) 中心注视，稳定注视，维持注视 Central, steady, maintained (CSM) 斜视儿童注视偏好检查 Fixation Preference Test (FPT) in children with strabismus 注视偏好检查主要用于探查: 无法获得可信视锐度的儿童(除外患有微小斜视以及有显斜视的儿童)是否患有弱视. Fixation-preference testing has been useful in detecting amblyopia in children unable to give reliable visual acuities, except for children with small-angle tropias and those without manifest deviations. 斜视儿童注视偏好检查 SFPT 检查方法: 将14度垂直三棱镜置于一眼前,从而诱导出垂直斜视.当双眼被分离后, 可以检测出患儿的注视偏好,并用于推测弱视是否存在. By placing a 14-diopter vertical prism over one eye, we induce a vertical deviation. Once the eyes are dissociated, fixation preference is evaluated and used to predict the presence of amblyopia. 垂直棱镜诱导斜视试验 Vertical induced tropia test (VITT, 14Δ prism test) 正常反应: 注视眼应该是没带棱镜的眼 Fix pref should be eye without prism 垂直棱镜诱导斜视试验 Vertical induced tropia test (VITT, 14Δ prism test) 如一眼存在弱视，当另一眼前置棱镜时， 未戴棱镜的这一眼不能很好的注视目标。 斜视儿童注视偏好检查 FPT 结果 通过测试 两眼可以自然的交替注视 ( Alternates ) 能持续注视一段时间(5秒)直到眨眼 ( Holds well--5 sec pursuit or thru a blink) 未通过测试 坚持看很短的时间(3秒)即眨眼 (Holds briefly-up to a blink ~ 3 sec) 只能坚持看一瞬间(1~2秒) (Holds momentarily ~1-2 sec) 不能注视 (Will not hold) PFT检查是否好用? ? 敏感性1 Sensitivity 当弱视被定义为≥2 行 15% 当弱视被定义为≥3 行 25% 对年龄更小的婴幼儿敏感性更差 特异性1-2 Specificity 75-95%* (5-25% false +) 如果外斜或内斜 10Δ 40% 微小