Department of Ophthalmology, Beijing Aerospace General Hospital , Beijing.
Department of Ophthalmology, PLA Navy General Hospital , Beijing.
Strabismus. 2020 Sep;28(3):136-141. doi: 10.1080/09273972.2020.1789676. Epub 2020 Jul 10.
The purpose of this study is to explore the relationships between excessive near work and divergence insufficiency esotropia in young adults. A prospective study described a series of young patients with divergence insufficiency esotropia related to excessive near work between 2012 and 2017. The medical records of twelve young patients with divergence insufficiency esotropia and a history of excessive near work were reviewed, and the duration of near work, angle of primary position deviations at distance and at near, and angle of primary position deviations after refraining from near work for 3 months were analyzed. All patients with divergence insufficiency esotropia (age range: 21-35 years) showed an initial esodeviation ranging from 18 to 35 prism diopters for distance fixation and ranging from 8 to 20 prism diopters for near. Neurological evaluation in all cases was normal. Myopic refractive errors were detected in twelve patients. Every patient persisted near work for more than 6 h a day over a period of several months (minimum 4 months). Reductions in esodeviation were noted in twelve patients after refraining from near work for more than 3 months. Only one patient was diplopia free in all positions of gaze. The remaining eleven patients were treated successfully, six with prisms and five with surgery. They were all orthophoric and demonstrated restored binocularity at the post-treatment examinations. Our findings suggested that excessive near work might influence the development of divergence insufficiency esotropia in young adults. Refraining from excessive near work could decrease the degree of esodeviation in these patients.
本研究旨在探讨年轻人过度近距离工作与发散不足性内斜视之间的关系。一项前瞻性研究描述了 2012 年至 2017 年间一系列与过度近距离工作相关的发散不足性内斜视的年轻患者。回顾了 12 例有过度近距离工作史的发散不足性内斜视年轻患者的病历，分析了近距离工作持续时间、远距和近距第一眼位偏斜角以及停止近距离工作 3 个月后第一眼位偏斜角。所有发散不足性内斜视患者（年龄范围：21-35 岁）均表现为初始的内斜视，远距注视时斜视度为 18-35 棱镜度，近距注视时斜视度为 8-20 棱镜度。所有病例的神经学评估均正常。12 例患者均存在近视屈光不正。每位患者每天持续近距离工作超过 6 小时，持续数月（最短 4 个月）。12 例患者停止近距离工作 3 个月以上后，内斜视度均有下降。仅有 1 例患者在所有注视位均无复视。其余 11 例患者成功治疗，6 例使用棱镜，5 例接受手术。他们在治疗后检查时均为正位，双眼视功能恢复。我们的研究结果表明，过度近距离工作可能影响年轻人发散不足性内斜视的发展。停止过度近距离工作可以降低这些患者的内斜视度。
