Scott Lorna, McWhinnie Hazel, Taylor Lynette, Stevenson Nicola, Irons Peter, Lewis Elizabeth, Evans Marylyn, Evans Bruce, Wilkins Arnold
Orthoptic Department, Ayr Hospital, UK.
Ophthalmic Physiol Opt. 2002 Mar;22(2):156-65. doi: 10.1046/j.1475-1313.2002.00009.x.
In two studies, the first in a school in Peterborough and the second in a school in Norwich, more than 233 children aged 8-12 years received either an orthoptic examination, or an optometric examination, together with an examination using coloured overlays and a test of reading fluency. In both studies more than one-third of the children reported visual symptoms. More than one-third of the children chose to use an overlay, and they read more quickly with it than without. The colour of the overlay chosen was weakly related to the binocular amplitude of accommodation: overlays reflecting greater energy at long wavelengths were chosen more frequently by children with a higher amplitude of accommodation. Although the visual symptoms were strongly related to the use of an overlay, in neither study was the benefit from an overlay strongly related to the orthoptic or optometric findings. Nevertheless, children who used an overlay had slightly, but significantly, reduced mean binocular amplitude of accommodation and fusional reserves. On average, children with 'sensory' or 'motor' instability of the nonius strips of the Mallett unit read more slowly than others, as did those with poor stereopsis. However, 60% of those demonstrating sustained overlay use gave a normal response on the Mallett aligning prism test, compared with 80% of those who did not use an overlay for a sustained period. Another indicator of decompensated heterophoria, Sheard's criterion, did not differentiate subjects who used overlays from those who did not. Although binocular and accommodative anomalies do not appear to be the underlying mechanism for the benefit from coloured filters in most cases, there may be some individuals who respond to coloured filters and in whom these ocular motor factors require treatment. Children with visually precipitated symptoms and/or reading difficulties need both a careful evaluation of their accommodative and binocular status, and an investigation of the effect of coloured filters.
在两项研究中，第一项在彼得伯勒的一所学校进行，第二项在诺维奇的一所学校进行，233 多名 8 至 12 岁的儿童接受了斜视检查或验光检查，同时还接受了使用彩色叠加物的检查和阅读流畅性测试。在两项研究中，超过三分之一的儿童报告有视觉症状。超过三分之一的儿童选择使用叠加物，使用叠加物时他们的阅读速度比不使用时更快。所选择的叠加物颜色与双眼调节幅度有微弱关联：调节幅度较高的儿童更频繁地选择在长波长处反射更多能量的叠加物。尽管视觉症状与叠加物的使用密切相关，但在两项研究中，叠加物带来的益处与斜视或验光检查结果均无强烈关联。然而，使用叠加物的儿童双眼平均调节幅度和融合储备略有但显著降低。平均而言，马利特单位的努内斯条带存在“感觉”或“运动”不稳定的儿童以及立体视觉较差的儿童阅读速度比其他儿童慢。然而，在持续使用叠加物的儿童中，60% 在马利特对齐棱镜测试中给出了正常反应，而持续不使用叠加物的儿童这一比例为 80%。斜视失代偿的另一个指标，即谢尔德准则，并未区分使用叠加物和未使用叠加物的受试者。尽管在大多数情况下，双眼和调节异常似乎不是彩色滤光片产生益处的潜在机制，但可能有一些个体对彩色滤光片有反应，并且这些眼动因素需要治疗。有视觉诱发症状和/或阅读困难的儿童既需要仔细评估其调节和双眼状态，也需要研究彩色滤光片的效果。
