Evans Bruce J W
Institute of Optometry, 56-62 Newington Causeway, London SE1 6DS, UK.
Cont Lens Anterior Eye. 2006 Sep;29(4):175-81; quiz 211. doi: 10.1016/j.clae.2006.03.007. Epub 2006 May 18.
Orthoptic anomalies are prevalent: they are encountered in at least 5% of patients seen in a typical primary eyecare practice. Several cases are reviewed that highlight the role of contact lenses in treating orthoptic anomalies. In particular, contact lenses are the preferred optical approach to the correction of anisometropia, and it is often argued that anisometropia should be corrected as young as possible. However, fitting contact lenses to patients, particularly children, with anisometropic amblyopia has been problematic because there is no immediate binocular acuity improvement when the contact lenses are inserted which reduces patient motivation. Continuous wear with silicone hydrogels represents a breakthrough for these cases and some illustrative case studies are given. The visual deficit in amblyopia can be reduced in some cases solely by fitting contact lenses, without the need for occlusion therapy. Other orthoptic uses of contact lenses are reviewed including: correcting motor deviations, occlusion, and infantile onset nystagmus. It is concluded that there are orthoptic anomalies where contact lenses are the preferred mode of correction. It is in patients' best interest for practitioners to discuss contact lenses in these cases.
在典型的初级眼保健诊所中，至少5%的患者会出现这种情况。本文回顾了几个病例，突出了隐形眼镜在治疗斜视异常中的作用。特别是，隐形眼镜是矫正屈光参差的首选光学方法，并且人们常认为屈光参差应尽早矫正。然而，为患有屈光参差性弱视的患者，尤其是儿童，验配隐形眼镜一直存在问题，因为佩戴隐形眼镜后双眼视力不会立即提高，这会降低患者的积极性。对于这些病例，连续佩戴硅水凝胶隐形眼镜是一个突破，并给出了一些典型案例研究。在某些情况下，仅通过验配隐形眼镜就可以减少弱视患者的视力缺陷，而无需进行遮盖疗法。本文还回顾了隐形眼镜在其他斜视方面的应用，包括：矫正运动性偏差、遮盖以及婴儿期发病的眼球震颤。结论是，在某些斜视异常中，隐形眼镜是首选的矫正方式。对于从业者来说，在这些情况下讨论隐形眼镜符合患者的最佳利益。
