Tomlins P J, Benskin S, Tahhan M, Tyagi A K
Birmingham and Midlands Eye Centre, City Hospital, Birmingham, West Midlands, UK.
Eye (Lond). 2007 Jul;21(7):941-2. doi: 10.1038/sj.eye.6702348. Epub 2006 Apr 28.
To evaluate whether dilated fundus examination is necessary on patients presenting to clinic with lid complaints and normal vision.
Patients with lid complaints were recruited from general and emergency clinics. Patients with visual symptoms or previous ophthalmic history were excluded. Subjects were examined by a junior ophthalmologist with slit-lamp biomicroscopy and Goldmann tonometry. Dilated posterior segment examination was performed with a Volk lens and the peripheral retina was examined with a three-mirror contact lens.
A total of 100 patients (200 eyes) were recruited, 63 females and 37 males with an average age of 45 years (SD of 19 years). The majority of lid abnormalities were chalazia (66) and papilloma (21). Posterior segment findings were early cataracts in five cases (eight eyes), macular drusen in three cases (five eyes), peripheral retinal lattice degeneration in two cases (three eyes), retinal pigment epithelial changes in one case (two eyes), a choroidal naevus in one eye, choroidal atrophy in one eye, and one case with asymmetric disc cupping. Six patients were seen by senior ophthalmologists and all were discharged after the first visit.
In our sample of 100 patients presenting with lid complaints and normal visual acuity, dilated examination revealed no sight-threatening conditions that required further treatment or regular follow-up. Therefore, a single episode of screening for nonspecified retinal disease in a group with no particular risk factors is an inefficient screening method.
评估对于视力正常但因眼睑问题前来就诊的患者，是否有必要进行散瞳眼底检查。
从普通门诊和急诊室招募有眼睑问题的患者。排除有视觉症状或既往眼科病史的患者。由一名初级眼科医生使用裂隙灯生物显微镜和Goldmann眼压计对受试者进行检查。使用Volk透镜进行散瞳后段检查，并用三面镜接触镜检查周边视网膜。
共招募了100例患者（200只眼），其中女性63例，男性37例，平均年龄45岁（标准差19岁）。大多数眼睑异常为睑板腺囊肿（66例）和乳头状瘤（21例）。后段检查结果为5例（8只眼）早期白内障，3例（5只眼）黄斑玻璃膜疣，2例（3只眼）周边视网膜格子样变性，1例（2只眼）视网膜色素上皮改变，1只眼脉络膜痣，1只眼脉络膜萎缩，以及1例视盘杯盘不对称。6例患者由高级眼科医生会诊，所有患者首次就诊后均出院。
在我们的100例因眼睑问题就诊且视力正常的患者样本中，散瞳检查未发现需要进一步治疗或定期随访的威胁视力的情况。因此，在无特定危险因素的人群中单次筛查非特异性视网膜疾病是一种低效的筛查方法。
