Chiu N N, Rosenfield M, Wong L C
State University of New York, State College of Optometry, New York 10010, USA.
J Am Optom Assoc. 1997 May;68(5):305-8.
When assessing refractive error using static retinoscopy, it is conventional to fog the contralateral eye by approximately 2.00 D to prevent a blur-driven accommodative response stimulating consensual accommodation in the tested eye. However, the effect of higher amounts of contralateral fog (e.g., in a moderate-to-high uncorrected myopic individual) during refractive error assessment is unclear.
We assessed the refractive state in 16 visually normal myopic subjects while fogging the contralateral eye between zero and 6.00 D, in 1.00 D increments. Retinoscopy was simulated by shining a streak retinoscope light into the right eye, while simultaneously measuring the refractive state of this eye objectively.
No significant change in mean refractive state was observed for up to 5.00 D of contralateral fog. But, 6.00 D of contralateral fog produced a significant mean increase in the myopic direction of 0.13 D. Also, in three subjects, a myopic shift of approximately 0.60 D was recorded after the introduction of 6.00 D of contralateral fog. Nevertheless, the magnitude of these largest shifts in refractive error are still smaller than the previously reported degree of repeatability of static retinoscopy.
Since large amounts of contralateral fog produced only small and clinically insignificant changes in the refractive state, the practitioner merely needs to ensure that the nontested eye is indeed fogged. The magnitude of fog present will have only a minimal effect on the final result.
在使用静态检影法评估屈光不正时，传统做法是将对侧眼雾视约2.00 D，以防止模糊驱动的调节反应刺激被检眼的双眼同视性调节。然而，在屈光不正评估过程中，较高程度的对侧眼雾视（例如，在中度至高度未矫正近视个体中）的影响尚不清楚。
我们对16名视力正常的近视受试者进行了屈光状态评估，同时将对侧眼雾视0至6.00 D，以1.00 D为增量。通过将带状检影镜光线投射到右眼来模拟检影，同时客观测量该眼的屈光状态。
对侧眼雾视达至5.00 D时，平均屈光状态未观察到显著变化。但是，对侧眼雾视6.00 D会使近视方向的平均度数显著增加0.13 D。此外，在三名受试者中，引入6.00 D对侧眼雾视后记录到近视偏移约0.60 D。然而，这些最大屈光不正偏移的幅度仍小于先前报道的静态检影法的可重复性程度。
由于大量对侧眼雾视仅在屈光状态上产生微小且临床上无显著意义的变化，从业者只需确保未被检查的眼确实被雾视即可。雾视的程度对最终结果只会产生极小的影响。
