von Noorden G K, Avilla C W
Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.
Am J Ophthalmol. 1990 Sep 15;110(3):287-92. doi: 10.1016/s0002-9394(14)76346-9.
We compared the clinical characteristics of esotropic, hypermetropic children whose strabismus was fully corrected with spectacles (refractive accommodative esotropia) with those who remained orthotropic (that is, had no manifest strabismus on the cover test) in the presence of uncorrected hypermetropia. In addition to a standard ophthalmologic and orthoptic examination, we determined the stimulus accommodative convergence/accommodation (AC/A) ratio by using the gradient method over a range of 6 diopters, the near point of accommodation, and random dot stereopsis. Hypermetropic patients without esotropia or significant esophoria were found to have a low AC/A ratio in contrast to those patients with refractive accommodative esotropia. This finding explains why esodeviations may be absent in some hypermetropic patients with uncorrected vision. We found a high prevalence of abnormally low near points of accommodation and defective or absent stereopsis in both groups of patients.
我们比较了患有内斜视、远视的儿童的临床特征，这些儿童的斜视通过眼镜完全矫正（屈光性调节性内斜视），与那些在存在未矫正远视的情况下仍保持正视（即遮盖试验时无明显斜视）的儿童。除了标准的眼科和视光学检查外，我们通过梯度法在6屈光度范围内测定了刺激调节性集合/调节（AC/A）比率、调节近点和随机点立体视。与屈光性调节性内斜视患者相比，未患内斜视或显著内隐斜的远视患者被发现AC/A比率较低。这一发现解释了为什么一些视力未矫正的远视患者可能没有内斜视。我们发现两组患者中调节近点异常低以及立体视缺陷或缺失的患病率都很高。
