Grant Simon, Moseley Merrick J
Department of Optometry & Visual Science, City University London, London, UK.
Strabismus. 2011 Sep;19(3):119-28. doi: 10.3109/09273972.2011.600423.
A question of increasing interest to the basic science and clinical management communities during the past decade is whether children and adults with amblyopia and associated binocular visual abnormalities experience difficulties in executing real-world actions, to which vision normally makes an important functional contribution. Here we provide objective evidence that they do, by reviewing quantitative data from a number of studies comparing their performance with that of matched normally sighted subjects on a range of everyday visuomotor tasks. Because in real life, these tasks (grasping objects, walking, driving, reading) are habitually performed with both eyes open, our focus is on their binocular skill deficits, rather than those with their amblyopic eye alone. General findings are that individuals with abnormal binocularity show impairments in critical aspects of motor control--movement speed, accuracy or both--on every one of these activities, the extent of which correlates with their loss of stereoacuity, but not the severity of their amblyopia. Impairments were especially marked when the task was time-limited or novel. Implications are that children and adults with severely reduced or absent binocularity may be accident-prone when required to respond rapidly to unexpected situations and that amblyopia management should focus more attention on evaluating and restoring stereoacuity and stereomotion processing.
在过去十年中，基础科学和临床管理领域越来越关注的一个问题是，患有弱视及相关双眼视觉异常的儿童和成人在执行现实世界中的行动时是否会遇到困难，而视觉通常会对这些行动做出重要的功能贡献。在此，我们通过回顾多项研究的定量数据来提供客观证据，这些研究将他们在一系列日常视觉运动任务中的表现与匹配的正常视力受试者的表现进行了比较。因为在现实生活中，这些任务（抓取物体、行走、驾驶、阅读）通常是在双眼睁开的情况下习惯性地执行的，所以我们关注的是他们的双眼技能缺陷，而不仅仅是弱视眼的缺陷。总体研究结果表明，双眼视力异常的个体在这些活动中的每一项中，在运动控制的关键方面——运动速度、准确性或两者——都存在损害，其损害程度与他们立体视锐度的丧失相关，但与弱视的严重程度无关。当任务有时间限制或新颖时，损害尤为明显。这意味着，双眼视力严重下降或丧失的儿童和成人在需要对意外情况迅速做出反应时可能容易发生事故，并且弱视治疗应更加关注评估和恢复立体视锐度以及立体运动处理能力。
