目的 探讨缓解视疲劳在干眼治疗中的作用.方法 选取具有显著症状的干眼患者且年龄30~50岁患者为观察对象,对其进行干眼常规检查和干眼症状评分.进行详细的病史询问,并进行医学验光确定其屈光状态,分析患者临床症状明显的原因,并分析视疲劳对干眼症状的影响,将视疲劳合并干眼患者随机分成两组:一组接受单纯干眼治疗;另一组在接受干眼治疗同时每晚睡前点用复方托吡卡胺眼水一次,用药3d和1周进行随访,再次进行上述检查,并将结果进行统计学分析.结果 284眼中符合视疲劳诊断者245眼,眼部手术后23眼,精神因素者11眼,其他5眼.从眼部自觉症状分布情况看,眼部干涩是干眼的主要症状.其次为眼异物感、烧灼感、视物模糊、眼部粘液及瘙痒,眼红等.其中大部分干眼患者同时有>2种眼部不适症状.导致视疲劳的主要原因有:调节功能异常,双眼视功能异常,屈光不正,高度屈光参差,老视等.干眼、视疲劳联合治疗,患者干眼症状有明显好转.结论 视疲劳是导致干眼患者症状和体征分离的主要原因,通过诊断性治疗,明确视疲劳会使干眼的症状明显加重,临床治疗中应该重视缓解视疲劳在干眼治疗中的作用.%Objective To evaluate the role of relieving visual fatigue on the treatment of dry eye in middle-aged patients. Methods A protocol was adopted for the management of dry eye in patients aged 30-50 years presented to an ophthalmology department. Schirmer's I test,tear break-up time (BUT),superficial punctate keratopathy and the refractive state were evaluated. Patients were divided into two groups:one group received simple treatment of dry eye;another group receiving both dry eye treatment and compound tropicamide eyedrops once each night. The impact of the refractive status on the treatment of dry eye was evaluated by t-test. Results A total of 52 cases of 104 patients completed the observation. Twenty-five patients accepted the artificial tears treatment and twenty-seven patients accept both artificial tears and compound tropicamide eyedrops. Low refractive errors significantly increased the symptoms of patients with dry eye. Refractive correction significant improved the symptoms of dry eyes with refractive errors. Conclusion The diagnosis of treatment shows that visual fatigue may significantly increase the symptoms of dry eye. We should pay more attention to the possible visual fatigue on the effect of dry eyes.
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