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屈光不正

屈光不正
眼镜为屈光不正常见的治疗方式。
症状视线模糊英语Blurry vision复视头痛眼睛疲劳[1]
类型近视远视散光老花[1]
诊断方法视力测试[1]
治疗眼镜隐形眼镜外科学[1]
患病率~15亿人[2]
分类和外部资源
医学专科眼科学
ICD-119D00
DiseasesDB29645
Orphanet98618
[编辑此条目的维基数据]

屈光不正(refractive error,refraction error),即眼睛的“折射误差”,是因球形状而让无法正确聚焦视网膜上的问题。常见的屈光不正有近视远视散光老花等。近视是看远方物体模糊不清,远视和老花是看近物模糊不清,散光是视物呈现不规则延伸或模糊。屈光不正可能并发症状有复视头痛眼睛疲劳[1]

近视是因为眼球长度过长,远视则是因为眼球长度过短,散光是因为眼角膜形状问题,老花眼则是因老化而无法有效控制眼睛的水晶体形状。部分眼屈光不正的患者父母也有类似问题。确诊方式是做视力测试[1]

屈光不正可经由佩戴眼镜隐形眼镜或接受手术来矫正。佩戴眼镜是最简单也最安全的治疗方式;隐形眼镜则可以提供较宽阔的视野,但也伴随着感染的风险。而接受屈光手术可以永久改变眼角膜的形状[1]

据估计,全球约有 10~20 亿人口患有屈光不正[2]。依地区不同,比例差距甚大;例如占欧洲 25% 人口,但在亚洲却高达 80% 人口[2]。其中最常见的就是近视[3],其比例约占成人的 15~49% ,孩童中则约占 1.2~42%[4]。远视则较常见于幼童及年长者[5][6]。患有老花眼者主要都在 35 岁以上[1]。据估计,2013年患有屈光不正者约有6.6亿(每100人中就有10人),其中的 9500 万人因此而失明[7]。眼屈光不正是视力丧失最常见的原因之一,其他原因包含白内障黄斑部退化,以及缺乏维生素A英语vitamin A deficiency[8]

屈光不正的分类

  1. 由于眼的屈光作用可使外面进入的平行光形成焦点,但这个焦点不像正视眼那样恰好落在视网膜上,根据焦点与视网膜的位置关系,焦点在视网膜之后者为远视;焦点在视网膜之前为近视
  2. 由于外面进入的平行光线通过眼屈光系统不能成焦点。散光即为这种情况。

引起屈光不正的原因分类

  1. 屈光系统中组成部分的位置关系:
  2. 屈光体表面不正常:
    • 角膜晶状体表面弯曲度过小或过大,成为曲率性远视或近视。
    • 屈光表面不规则,即在不同子午线上弯曲度有差别,成为散光
      • 弯曲度差别最大的两子午线互相成直角,称为规则散光。
      • 弯曲度差别最大的两子午线不成直角,称为双斜散光。
      • 各子午线的屈光不等,或同一子午线上各部分之间屈光不等,称为不规则散光。
  3. 屈光成分偏斜(引起散光):
    • 晶状体位置的偏斜,视网膜的偏斜
  4. 屈光成分的折射率不正常:
    • 主要因为房水、晶状体和玻璃体三者任意个折射率过高或过低,都会形成远视近视
    • 若在同一屈光介质中的不同部位发生不规则的折射率改变,会形成不规则散光
  5. 在屈光系统中缺少屈光成分:
    • 常见的是晶状体的缺失,即无晶状体,可形成高度远视

参考资料

  1. ^ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 Facts About Refractive Errors. NEI. October 2010 [29 July 2016]. (原始内容存档于28 July 2016). 
  2. ^ 2.0 2.1 2.2 Denniston, Alastair; Murray, Philip. Oxford Handbook of Ophthalmology 3. OUP Oxford. 2014: 826. ISBN 9780191057021. (原始内容存档于2016-08-15) (英语). 
  3. ^ Foster, PJ; Jiang, Y. Epidemiology of myopia.. Eye (London, England). February 2014, 28 (2): 202–8. PMC 3930282可免费查阅. PMID 24406412. doi:10.1038/eye.2013.280. 
  4. ^ Pan, CW; Ramamurthy, D; Saw, SM. Worldwide prevalence and risk factors for myopia.. Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists). January 2012, 32 (1): 3–16. PMID 22150586. doi:10.1111/j.1475-1313.2011.00884.x. 
  5. ^ Castagno, VD; Fassa, AG; Carret, ML; Vilela, MA; Meucci, RD. Hyperopia: a meta-analysis of prevalence and a review of associated factors among school-aged children.. BMC Ophthalmology. 23 December 2014, 14: 163. PMC 4391667可免费查阅. PMID 25539893. doi:10.1186/1471-2415-14-163. 
  6. ^ Grosvenor, Theodore. Primary care optometry 5. St. Louis (Miss.): Butterworth Heinemann, Elsevier. 2007: 70. ISBN 9780750675758. (原始内容存档于2016-08-15). 
  7. ^ Global Burden of Disease Study 2013, Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.. Lancet. 22 August 2015, 386 (9995): 743–800. PMC 4561509可免费查阅. PMID 26063472. doi:10.1016/s0140-6736(15)60692-4. 
  8. ^ Pan, CW; Dirani, M; Cheng, CY; Wong, TY; Saw, SM. The age-specific prevalence of myopia in Asia: a meta-analysis.. Optometry and vision science : official publication of the American Academy of Optometry. March 2015, 92 (3): 258–66. PMID 25611765. doi:10.1097/opx.0000000000000516. 
  • 徐广第. 《眼科屈光学》. 北京: 军事医学科学出版社. 2005-06. ISBN 9787801216830. 
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屈光不正
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