Nilsson U L
Department of Ophthalmology, University of Linköping, Sweden.
Doc Ophthalmol. 1988 Dec;70(4):363-83. doi: 10.1007/BF00157066.
Ninety-six patients with advanced stages of glaucoma, optic atrophy, myopia or retinitis pigmentosa (RP) who could not manage with ordinary spectacles or simple magnifying aids were taken care of at the Low Vision Clinic for rehabilitation and followed for an average of 3.6 years (the glaucoma group) up to an average of 6.0 years (the optic atrophy group). They were given high power optical aids and subjected to educational training in the proper use of these aids for best utilization of residual vision. Many of them (for optic atrophy as high a percentage as 40.7) were taught to use extra macular retina by means of eccentric viewing technique. The mean age of the oldest group, the glaucoma patients, was 69.3 years. The three other groups were about 20 to 25 years younger, on an average. (Another 35 patients were seen for the first series of visits but could not be followed up, the main reasons being death (13 patients) and moving out of the area (9 patients). The mean power of the aids (mainly telescopes) used for distance vision was 2.1 x (RP)-5.3 x (optic atrophy). Increased near addition and hyperocular lenses were the main aids for reading and near vision, the mean power being 17.0 dioptres (glaucoma)-23.5 dioptres (RP)(4.3 x -5.9 x). Aids were also provided for intermediate distance and for "spot use". The mean number of series of visits was 3.1 (myopia)-3.5 (glaucoma) and the average number of 1 h training sessions 2.2 (glaucoma)-2.5 (optic atrophy, RP) per series of visits. With aids and educational training, the mean visual acuity improved on the first series of visits from 0.31 to 0.60 for the glaucoma group, from 0.19 to 0.70 for the optic atrophy group, from 0.12 to 0.68 for the myopes and from 0.35 to 0.52 for the RP group. After the last series of visits acuity was still as good as 0.51, 0.61, 0.73 and 0.45, respectively. The number of individuals able to read newspaper text increased from 16.1% to 100.0% for the glaucoma patients, from 14.8% to 100.0% for the optic atrophy patients, from 75.0% to 100.0% for the myopes, and from 50.0% to 95.5% for the RP patients. The results show clearly that the methods used for rehabilitation of patients with glaucoma, optic atrophy, myopia or RP through optical aids and sessions of educational training are very successful, with substantial improvement of life quality.
96名患有晚期青光眼、视神经萎缩、近视或色素性视网膜炎（RP）的患者，他们无法通过普通眼镜或简单放大镜辅助工具改善视力，在低视力诊所接受康复治疗，随访时间平均为3.6年（青光眼组）至平均6.0年（视神经萎缩组）。为他们配备了高倍光学辅助工具，并接受了如何正确使用这些辅助工具以最佳利用残余视力的教育培训。他们中的许多人（视神经萎缩组的比例高达40.7%）通过偏心注视技术学会了使用黄斑外视网膜。年龄最大的一组患者，即青光眼患者，平均年龄为69.3岁。其他三组患者平均年龄比青光眼组小20至25岁。（另有35名患者参加了首次系列就诊，但未能进行随访，主要原因是死亡（13名患者）和搬离该地区（9名患者）。用于远距离视力的辅助工具（主要是望远镜）的平均放大倍数为2.1倍（RP组）至5.3倍（视神经萎缩组）。增加近附加度数和高眼透镜是阅读和近视力的主要辅助工具，平均度数为17.0屈光度（青光眼组）至23.5屈光度（RP组）（4.3倍至5.9倍）。还提供了用于中间距离和“特定用途”的辅助工具。就诊系列的平均次数为3.1次（近视组）至3.5次（青光眼组），每次就诊系列的平均1小时培训课程次数为2.2次（青光眼组）至2.5次（视神经萎缩组、RP组）。通过辅助工具和教育培训，青光眼组患者在首次就诊系列时平均视力从0.31提高到0.60，视神经萎缩组从0.19提高到0.70，近视患者从0.12提高到0.68，RP组从0.35提高到0.52。在最后一次就诊系列后，视力仍分别高达0.51、0.61、0.73和0.45。能够阅读报纸文字的青光眼患者人数从16.1%增加到100.0%，视神经萎缩患者从14.8%增加到100.0%，近视患者从75.0%增加到100.0%，RP患者从50.0%增加到95.5%。结果清楚地表明，通过光学辅助工具和教育培训课程对青光眼、视神经萎缩、近视或RP患者进行康复治疗的方法非常成功，患者生活质量得到了显著改善。
