摘要
Abstract
Objective To explore the causes and clinical characteristics of initial diagnosis in children with high hyperopia,providing guidance for their clinical correction and early prevention and treatment of refractive amblyopia.Methods Collect clinical data of children with highly hyperopic refractive errors from January 2016 to November 2023.The study subjects were children diagnosed with high hyperopia(SE≥+5.00D in any eye)through the first ciliary muscle paralysis examination.Analyze the reasons for the first diagnosis,the age of the first dilated pupil,refractive status,visual acuity,eye position,and ocular biometric measurements.Results A total of 35 cases of highly hyperopic children were collected,including 19 males and 16 females.Reason for initial diagnosis:15 cases(42.9％)of refractive abnormalities were found during routine medical examinations in medical institutions;4 cases(11.4％)of kindergarten physical examination showed low vision and came to the hospital for treatment;11 cases(31.4％)were diagnosed with abnormal symptoms such as eye deviation,eye alignment,and crooked head vision;Due to other eye diseases,5 cases(14.3％)had abnormal refractive tests.The first diagnosis of ciliary muscle paralysis was confirmed by retinoscopy and optometry at an age of 11～53 months(36.54±10.96).35 cases(70 eyes)of patients had hyperopia in both eyes,with 57 eyes showing high hyperopia(SE≥+5.00D);13 cases(13 eyes)had high hyperopia in one eye,and 22 cases(44 eyes)had high hyperopia in both eyes.21 cases(60％,21/35)of anisometropia were all compound hyperopia,including 12 cases of mild anisometropia and 9 cases of high anisometropia.23 cases(38 eyes with SE≥+5.00D)were able to cooperate with visual acuity examination during the first dilated pupil examination.Among them,34 eyes(89.5％,34/38)had low naked eye far vision,and only 4 eyes(10.5％,4/38)had good naked eye far vision;22 eyes(57.9％,22/38)achieved the best corrected visual acuity standard,while 16 eyes(42.1％,16/38)had the best corrected visual acuity in a low state.25 cases were able to cooperate with ocular biological measurements during the first dilated pupil examination,and 39 cases had SE≥+5.00D,most of which showed axial hyperopia,with an average AL of 20.42±0.69mm.Correlation analysis showed a significant negative correlation between SE and AL(r=-0.520,P＜0.001),while there was no significant correlation with mean corneal curvature(r=-0.179,P=0.275).Among 35 children with high hyperopia,12 had strabismus,including 9 cases of accommodative esotropia,1 case of congenital esotropia,and 2 cases of concomitant exotropia.Conclusions High hyperopia in young children has a significant impact on vision,mainly axial hyperopia,which can occur only in one or both eyes simultaneously;Children are prone to complicat-ed with compound hyperopia and anisometropia;Partially merged accommodative esotropia.Strengthening early refractive screening for infants and young children,identifying abnormal symptoms and seeking timely medical attention,is beneficial for the effective prevention and treatment of refractive amblyopia.关键词
高度远视/屈光不正/临床特点Key words
High hyperopia/Ametropia/Clinical characteristics
