點用睫狀肌麻痺劑之國小近視學童其雙眼視覺功能與近距離閱讀表現之相關

中山醫學大學機構典藏 CSMUIR > 醫學科技學院 > 生物醫學科學學系暨碩士班 > 博碩士論文 > Item 310902500/12199

Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/12199

Title:	點用睫狀肌麻痺劑之國小近視學童其雙眼視覺功能與近距離閱讀表現之相關 The Correlation between Binocular Visual Functions and Near Task Reading Performance in Myopic Schoolchildren with Cycloplegia Treatment
Authors:	郭宜欣 I-Hsin, Kuo
Contributors:	中山醫學大學:生物醫學科學學系碩士班;郭蕙瑛
Keywords:	睫狀肌麻痺劑;雙眼視功能;閱讀表現;發展性眼動測試 cycloplegia;binocular visual function;reading performance;DEM test
Date:	2015
Issue Date:	2015-09-21T03:01:23Z (UTC)
Abstract:	現今臺灣國小學童其學習環境以近距離閱讀的視覺活動為主，長時間的近距離閱讀已證實與近視的發展高度相關，臺灣地區普遍使用睫狀肌麻痺劑作為控制近視的主要方法，然而點用睫狀肌麻痺劑會造成雙眼調節能力下降，進而影響雙眼視覺系統。故本研究之目的在於探討國小學童點用睫狀肌麻痺劑作為控制近視的效用下，對於其雙眼視功能與近距離閱讀表現之影響。本研究分為問卷調查、雙眼視覺功能檢查(瞳孔反應、眼壓、屈光度數測量等)及近距離閱讀測驗(發展性眼動測試，DEM Test)三大部分。受測對象分為兩階段，第一階段蒐集對象為正視眼學童及近視且點用睫狀肌麻痺劑學童共171人，第二階段對象為近視學童分為點用睫狀肌麻痺劑與未點用兩組，人數共90人。調查結果顯示近視且點用組其近距離閱讀之副作用發生頻率皆高於正視眼組，且經由遠方全矯正度數測量其近距離視力值、立體視、近點聚合能力、雙眼調節力與近方斜位量顯示，除了近方斜位量之外，其他雙眼視功能皆比正視眼學童來的差。然而經由近用度數加入後，點用睫狀肌麻痺劑學童其近距離視力值與立體視皆獲得改善。發展性眼動測試(DEM Test)結果顯示，正視眼組在垂直閱讀時間與水平閱讀時間顯著高於近視且點用組，而水平錯誤個數及比值(水平閱讀時間/垂直閱讀時間)在統計上無顯著差異。此外，近視族群比較其點用睫狀肌麻痺劑與否之每週寫學校作業，每週讀課外讀物，每週打電腦或打電動及每週玩手機在統計上並無顯著差異。而近視點用組其近距離視力與水平錯誤個數值顯著比為點用組差，垂直閱讀時間，水平閱讀時間及比值(水平閱讀時間/垂直閱讀時間)無顯著差異。根據本研究結果發現，近視程度會影響閱讀速度，近視程度較高的閱讀速度比近視程度較低的快，而近視程度又與每週玩手機的時數呈現正相關，代表近視程度高的玩手機時數比近視程度低時間來的長。因而可以解釋透過練習近視族群在近距離閱讀的能力上可能比正視眼組來的好，也解釋為何近視學童測得的閱讀速度較快的原因。但是比較同樣是近視族群比較點用與未點用睫狀肌麻痺劑的DEM Test結果，發現點用組測得的垂直及水平閱讀時間與未點用組比較無統計顯著差異，然而其水平的錯誤個數顯著高於未點用組，推測可能與臨床上點用睫狀肌麻痺劑學童閱讀時產生跳字漏行情形有關。由此證實，點用睫狀肌麻痺劑會造成雙眼視功能下降，進而影響閱讀表現，因此建議近視且點用睫狀肌麻痺劑學童需搭配漸近多焦點的眼鏡來改善其雙眼視功能與近距離閱讀表現。Nowadays, learning environment of Taiwanese schoolchildren is mainly related to near work activities, such as reading and writing. And the long duration of near work has been demonstrated to lead to myopia development. The major way widely used in Taiwan to control myopia progression in schoolchildren is cycloplegia medication (e.g. Atropine). The purpose of this study is to investigate the relationship between binocular visual function and near task reading performance in myopic schoolchildren with cycloplegia treatment. The methods of this study were divided into three parts, which includes questionnaire, binocular visual function test and reading task (development of eye movement test, the DEM Test). There were two stages of data collection. The first stage was done for the emmetropic children and the myopic children who were on Atropine treatment (N=171). The subjects of the second stage were all myopic children who were divided into with and without Atropine groups (N=90). The results showed that the frequency of side effects occurred while reading was significantly higher in the myopic children with Atropine than in the emmetropic group. With distant full corrections, the functions of near visual acuity, stereopsis, near point of convergence and amplitude of accommodation were significantly worse in the myopic children with Atropine compared to the emmetropic children. And after applying near additions, near visual acuity and stereopsis of the myopic children were improved. The results of the Developmental Eye Movement Test showed that the reading speed in vertical and horizontal section of the myopic children with Atropine was faster than the emmetropic group. But, there were no significant differences in horizontal errors and the ratio (horizontal time/vertical time) between these two groups. The further study the differences in visual function and reading performance between the myopic children with and without using Atropine, the second stage was done. The results showed that the visual activity hours per week (writing homework, reading for pleasure, playing computer or video games and using mobile phone) were similar between the with and without Atropine group. However, the with Atropine group had significantly poorer near visual acuity and more horizontal errors than the without Atropine group. There were no significant differences in the vertical time, the horizontal time and the ratio (horizontal time/vertical time) between these two groups. The results of the DEM test showed that reading speed in the myopic children was faster than the emmetropic children. The reason could be due to that myopes may spend more time on near work activities and thus their reading ability is well-trained and performed better in the DEM test. However, the myopic children with Atropine had a significantly worse performance than those without Atropine in the DEM test. Therefore, it is suggested that using Atropine on slowing down myopia progression would affect children’s near visual function and reading performance. For those myopic children who are on Atropine treatment, it is recommended that wearing the progressive addition lenses is required to improve their near visual function and reading performance.
URI:	https://ir.csmu.edu.tw:8080/ir/handle/310902500/12199
Appears in Collections:	[生物醫學科學學系暨碩士班] 博碩士論文

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