臺灣非老花成人雙眼視覺功能與視覺行為表現之相關研究

Correlation between Binocular Vision and Visual Behavioral Performance in Taiwan Non-Presbyopic Adults

鍾翔印(Xiang-Yin Zhong)

指導教授 ： 鄭靜瑩

中山醫學大學/醫學科技學院/視光學系/碩士(2020年)

https://doi.org/10.6834/csmu202000139

摘要

 目的
隨著近年來用眼習慣與用眼需求的改變，雙眼視覺機能的標準值可能也會有所改變，本研究將針對雙眼視覺機能檢測以及視覺行為量表的評估，調查兩者之間的關聯性，並企圖透過本量表初步篩檢，提供臨床工作者挑選較精簡的檢測方式，以縮短患者受檢及等待的時間。
 方法
本研究對象收納年齡為18至35歲之臺灣成年人，研究場所在中山學大學、亞洲大學、康寧大學及馬偕醫護管理專科學校，分別四所學校之驗光實驗室執行，而研究所使用的研究工具與檢查人員均經過信度與效度的考驗。研究對象先填寫基本資料及視覺行為表現量表之後，接著進行驗光與非常規之雙眼視覺檢查，項目包含他覺式驗光、自覺式驗光、遠（近）距離之眼位測量、遠（近）距離之注視偏差、雙眼聚散能力測驗、單（雙）眼調節能力測驗、立體視覺、近點調節能力測驗與聚合近點測驗等。研究將所有研究對象之檢測結果、基本資料、及視覺行為表現量表得分，以SPSS V22.0進行統計分析。
 結果
研究結果顯示臺灣成人的雙眼視覺機能與臨床常用的Scheiman標準值、Morgan標準值和OEP期望值，有多項達到統計學上的顯著差異，而性別與屈光度數組間的差異亦是值得注意的變項。在相關與迴歸分析中，近方注視偏差量、近方基底朝內稜鏡模糊點、破裂點及回復點、近方基底朝外稜鏡破裂點及回復點和雙眼調節靈敏度，與視覺行為表現量表中的各個向度（近距離工作、知覺、舒適度與肢體烤衡）均具有顯著的相關，其中以遠方基礎眼位、遠方基底朝外稜鏡至模糊點、破裂點及回復點、近方基底朝外至破裂點、聚合近點、單眼及雙眼調節靈敏度和調節幅度九項雙眼視覺機能具有較強的視覺行為表現預測能力。
 討論
雙眼視覺機能的標準值隨著時代的演變而有很大的不同，建立臺灣不同年齡層的標準值是必要的。且雙眼視覺和視覺行為表現存在著一定的相關性，本研究提供九項具有預測力的雙眼視覺機能，未來的基礎檢查或許可以考慮優先施行上述九項機能，甚至能夠透過視覺訓練增進這九項機能的能力，進而提升患者的視覺行為表現並解決其抱怨。

關鍵字

雙眼視覺機能 ； 視覺行為表現 ； 近距離工作 ； 視知覺 ； 肢體平衡

並列摘要

Purpose
In recent years, with the change of eye habits and visual needs, the binocular visual function norms may also have change. The purpose of this study was to investigate the correlation between binocular visual function and visual behavioral performance. In addition, we attempted to provide clinical optometrists more convenient approach to select suitable examination for patients by our questionnaire.
Methods
In this study, clinical examination, including objective refraction, subjective refraction, dissociated phoria test at both distance and near, associated phoria test at both distance and near, distance and near vergence test, monocular and binocular accommodation test, stereopsis, NPC and NPA test were performed in Chung Shan Medical University, Asia University, University of Kang Ning and MacKay Junior College of Medicine, Nursing and Management. All subjects were distributed into three groups by CSMU-VBP questionnaire and this questionnaire was organized with good reliability and validation. Furthermore, SPSS v22.0 software was to analysis the results.
Results
Most binocular visual functions in Taiwan non-presbyopic adults do not meet Scheiman’s, Morgan’s, and OEP expected findings. It is noteworthy that these visual functions are significant different between each group of gender and refractive errors. In addition, associated phoria at near, base-in prism to blur point, break point and recovery point at near, base-out prism to recovery point at near and binocular accommodative facility were significantly correlated with all types of visual behavioral performance. Dissociated phoria at distance, base-out prism to blur, break and recovery points at distance, base-out prism to break point at near, break point of NPC and amplitude of accommodation showed better prediction of visual behavioral performance.
Discussion
The normative values of binocular visual functions vary greatly with times. It is necessary to establish the normative values for different age groups in Taiwan. There is a certain correlation between binocular vision and visual behavior. This study suggests the following nine binocular visual functions to be the priorty in testing: phoria at distance, base-out prism to blur, break and recovery points at distance, base-out prism to break point at near, break point of NPC and amplitude of accommodation. Designing binocular visual training methods to improve these visual functions may enhance visual performance and reduce binocular vision symptoms.

並列關鍵字

Binocular vision ； Visual behavioral performance ； Near works ； Visual perception ； Physiological balance

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