对自发性眨眼的新视角。

A new perspective on spontaneous blinks.

机构信息

Dr. Heiko Pult-Optometry and Vision Research, Weinheim, Germany.

出版信息

Ophthalmology. 2013 May;120(5):1086-91. doi: 10.1016/j.ophtha.2012.11.010. Epub 2013 Feb 8.

DOI:10.1016/j.ophtha.2012.11.010

PMID:23399377

Abstract

PURPOSE

To investigate whether the central portions of the upper and lower eyelid margins make complete contact during spontaneous blinks.

DESIGN

A prospective case series of subjects located in Weinheim, Germany.

PARTICIPANTS

Data were analyzed from 30 subjects (14 women; mean age, 42.4 ± 12.3 years).

METHODS

A small drop of lissamine green (LG; 0.15 μl) was placed on the keratinized portion of the central lower lid. Spontaneous blinks were recorded by video from a frontal view and simultaneously from a temporal-inferior view (high-speed video). Blinks were analyzed as being complete or incomplete, and the number of blinks necessary to remove the LG was counted. The upper eyelid was observed to grade the extent of misalignment of the lids in the z-axis. This so-called overblinking of the lids was classified using a 5-grade scale (0 = aligned; 1 = less than one-third overblink; 2 = more than one-third to two-thirds overblink; 3 = more than two-thirds to three-thirds overblink; and 4 = more than three-thirds overblink). Correlations were calculated by Pearson correlation (or Spearman rank in nonparametric data), and differences between groups were calculated by unpaired t test (or Mann-Whitney U test in nonparametric data).

MAIN OUTCOME MEASURES

Contact between lids in spontaneous blinks and lid alignment.

RESULTS

Mean blink rate was 14.9 ± 14.1 blinks/minute, and 58.8 ± 22.6% of blinks were incomplete. Blink rate was significantly higher in women than in men (P = 0.007, unpaired t test; female, 22.0 ± 16.8 blinks/minute; male, 8.6 ± 7.2 blinks/minute). Incomplete blinking occurred significantly less often in women (51.2 ± 18.5%) than in men (67.4 ± 24.5%; P = 0.029) but was not related to age (Pearson r = 0.108; P = 0.285). Lissamine green stayed unaltered in spontaneous blinks and, on average, 1.5 ± 0.8 forced blinks were needed to remove the LG. Mean grade of upper lid overblink was 3.0 ± 0.9. Lid overblink was correlated significantly with age (r = 0.456; P = 0.006).

CONCLUSIONS

Central lid margins do not touch in spontaneous blinks because the lids are not aligned.

FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

摘要

目的

研究在自发性眨眼过程中，上下眼睑缘的中央部分是否完全接触。

设计

位于德国魏恩海姆的前瞻性病例系列研究。

参与者

分析了 30 名受试者的数据（14 名女性；平均年龄 42.4±12.3 岁）。

方法

在中央下眼睑的角化部分滴一滴 Lissamine Green（LG；0.15μl）。从正面和颞下侧（高速视频）同时记录自发性眨眼。将眨眼分析为完全或不完全，并计算去除 LG 所需的眨眼次数。观察上眼睑以评估眼睑在 z 轴上的错位程度。这种所谓的眼睑过度眨眼使用 5 级量表进行分类（0=对齐；1=不到三分之一的过度眨眼；2=三分之一到三分之二的过度眨眼；3=三分之二到三分之三的过度眨眼；4=超过三分之三的过度眨眼）。通过 Pearson 相关（或非参数数据中的 Spearman 秩）计算相关性，通过未配对 t 检验（或非参数数据中的 Mann-Whitney U 检验）计算组间差异。

主要观察指标

自发性眨眼时眼睑的接触和眼睑对齐情况。

结果

平均眨眼率为 14.9±14.1 次/分钟，58.8±22.6%的眨眼为不完全眨眼。女性的眨眼率明显高于男性（P=0.007，未配对 t 检验；女性，22.0±16.8 次/分钟；男性，8.6±7.2 次/分钟）。女性不完全眨眼的发生率明显低于男性（51.2±18.5%比 67.4±24.5%；P=0.029），但与年龄无关（Pearson r=0.108；P=0.285）。Lissamine Green 在自发性眨眼过程中保持不变，平均需要 1.5±0.8 次强制眨眼才能去除 LG。上眼睑过度眨眼的平均等级为 3.0±0.9。眼睑过度眨眼与年龄显著相关（r=0.456；P=0.006）。