Wesson M D, Masin L C, Boyles S T
School of Optometry, University of Alabama at Birmingham 35294, USA.
J Am Optom Assoc. 1995 Jun;66(6):338-42.
Testing of vergence ranges is a routine clinical procedure providing valuable information about the patient's binocular status. Unfortunately, obtaining this information from non-verbal or very young patients has proven difficult or impossible in many situations, due to lack of subjective response. This study explored a new prism bar technique for obtaining vergence ranges using an objective procedure in a randomized, modified examiner-masked routine that allows for vergence measurement without a verbal response.
In the first of two experiments, subjective and objective vergence ranges at 40 cm were obtained using a nonluminous target (printed picture of dog's head) from 29 adult subjects. The second experiment compared a self-illuminated target (transilluminator) to that of the nonluminous target in subjective and objective vergence range measurements using nine subjects from the first experiment.
The results of both of these experiments suggest that, at least in the adult population, the vergence range values obtained objectively compare favorably with those obtained subjectively. However, the transilluminator yielded greater variance for all measures and, for one variable, base-out to break, did yield statistically different results between objective and subjective findings.
Objective and subjective vergence range measurements appear to yield consistently comparable results in the adult population. The use of a non-luminous target appears to yield more consistent results, most likely due to the poor accommodative nature of a self-illuminated target (transilluminator).
融合范围测试是一项常规临床检查,能提供有关患者双眼状态的有价值信息。遗憾的是,在许多情况下,由于缺乏主观反应,从非言语或非常年幼的患者那里获取这些信息已被证明困难重重甚至无法实现。本研究探索了一种新的棱镜杆技术,通过客观程序在随机、改良的检查者盲法常规中获取融合范围,该方法允许在无需言语反应的情况下进行融合测量。
在两项实验的第一项中,使用非发光目标(狗头的印刷图片)从29名成年受试者那里获得了40厘米处的主观和客观融合范围。第二项实验在主观和客观融合范围测量中,将自发光目标(透照器)与第一项实验中的9名受试者的非发光目标进行了比较。
这两项实验的结果均表明,至少在成年人群中,客观获得的融合范围值与主观获得的值相比具有优势。然而,透照器在所有测量中产生了更大的方差,并且对于一个变量,即外展至破裂,客观和主观结果之间确实产生了统计学上不同的结果。
在成年人群中,客观和主观融合范围测量似乎能产生始终可比的结果。使用非发光目标似乎能产生更一致的结果,这很可能是由于自发光目标(透照器)的调节特性较差。