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[斜视中的调节]

[Accommodation in strabismus].

作者信息

Pigassou-Albouy R

出版信息

J Fr Ophtalmol. 1984;7(3):237-44.

PMID:6747217
Abstract

This paper describes clinical observations of optico-sensori-motor symptomatology prior to and during treatment for strabismus. These findings were compared with theoretical data of the binocular visual function. We consider that binocular function has the structure and the working of a "set" in cybernetic sense. In this psycho-physiological set, the accommodative system constitutes a "sub-set". The classification of accommodative disturbances as "pure or impure" and "typical or atypical" arises from the fact that a rebuilding of the visual function has occurred. Thus in "pure" accommodative strabismus the disturbances of accommodation results from "peripheral" accommodation and is easily reversible. In this situation ocular deviation has been perfectly corrected for and binocular vision normally built up since there is enough compensation of the whole optical correction. In "impure" accommodative strabismus the perturbation of accommodation affects the whole accommodation system and also the sensorial motor system. Thus there is a restructuring of the optico-sensori-motor set that is more or less reversible due to a variety of factors. From these investigations we conclude: every strabismus is accommodative in the sens that in every strabismus there is a disturbance of accommodative mechanism. Furthermore, we oppose believers of "all sensorial" and "all motor" mechanisms. Considering that strabismus is a disturbance of optico-sensori-motor binocularity, nothing can be only "accommodative", only "sensorial" and only "motor". From this it follows that treatment should not be only "motor", only "accommodative" or only "sensorial".

摘要

本文描述了斜视治疗前及治疗过程中的视-感觉-运动症状学的临床观察结果。这些发现与双眼视觉功能的理论数据进行了比较。我们认为,双眼功能具有控制论意义上“装置”的结构和运作方式。在这种心理-生理装置中,调节系统构成一个“子装置”。调节障碍分为“单纯性或非单纯性”以及“典型性或非典型性”,这是因为视觉功能发生了重建。因此,在“单纯性”调节性斜视中,调节障碍源于“周边”调节,且易于逆转。在这种情况下,眼位偏斜已得到完美矫正,双眼视觉也正常建立,因为整个光学矫正有足够的代偿。在“非单纯性”调节性斜视中,调节紊乱会影响整个调节系统以及感觉运动系统。因此,视-感觉-运动装置会或多或少因各种因素而发生可逆性重组。从这些研究中我们得出结论:每一种斜视在某种意义上都是调节性的,即每一种斜视都存在调节机制的紊乱。此外,我们反对“全是感觉性”和“全是运动性”机制的支持者。鉴于斜视是视-感觉-运动双眼性的紊乱,不存在仅为“调节性”、仅为“感觉性 ”或仅为“运动性”的情况。由此可见,治疗不应仅为“运动性”、仅为“调节性”或仅为“感觉性”。

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