Das Meghomala, Bennett David M, Dutton Gordon N
Department of Ophthalmology, Hairmyres Hospital, Eaglesham Road, East Kilbride G75 8RG, Scotland, UK.
Br J Ophthalmol. 2007 Nov;91(11):1556-60. doi: 10.1136/bjo.2006.104844. Epub 2007 Feb 14.
Impaired visual attention is a common manifestation of cerebral dysfunction. In adults, closed head trauma, cerebral microvascular ischaemia and dementia are common causes. In children, aetiologies include periventricular leukomalacia, hydrocephalus, hypoxic ischaemic encephalopathy and brain damage caused by hypoglycaemia. The resultant visual disability can be profound even when visual acuities are unaffected, and can cause significant disability in the execution of daily activities. This can prompt consultation with an eye care specialist. Patients complain of poor vision, difficulty in identifying someone in a group, or finding an object on a patterned background or among other objects, but a thorough examination often does not reveal the clinical basis for these complaints. The diagnosis of attentional dysfunction is also easily missed because at present it can only be recognised on the basis of adequate history taking from both the patient and close relatives and friends. The Useful Field of View test facilitates the detection and quantification of this disorder. Management includes the implementation of strategies that diminish background pattern and foreground clutter.
视觉注意力受损是脑功能障碍的常见表现。在成年人中，闭合性颅脑损伤、脑微血管缺血和痴呆是常见原因。在儿童中，病因包括脑室周围白质软化、脑积水、缺氧缺血性脑病以及低血糖所致脑损伤。即使视力未受影响，由此导致的视觉残疾也可能很严重，并会在日常活动的执行中造成显著障碍。这可能促使患者咨询眼科专科医生。患者抱怨视力差、在人群中辨认他人困难、在有图案的背景或其他物体中找到某个物体困难，但全面检查往往无法揭示这些主诉的临床依据。注意力功能障碍的诊断也很容易被漏诊，因为目前只能通过从患者及其近亲好友处获取充分病史来识别。有用视野测试有助于检测和量化这种障碍。管理措施包括实施减少背景图案和前景杂乱的策略。
