驗光室燈光設置對視機能檢查影響之研究

視力檢查的重要性為可衡量視覺機能的參考依據，影響視力的因素有許多，如：屈光狀態、屈光介質的清晰度、環境照度，可透過視力的量測來判斷有無視覺表現的變化。測量視力時有許多參數都已被標準化，包括視標大小、視力表距離、檢查程序、視力紀錄方式，對於驗光室的環境照度對視力表現量測則較少被探討。常規驗光室之環境亮度僅適用於標準視覺功能測量，無法推估在不同環境照度下之功能性視覺，本研究依照中華民國國家標準之室內環境照度規範，分別模擬300、200、150、100及30 ~ 50 lux五種環境照度，隨機挑選30位年滿20歲受試者，排除患有眼疾、使用散瞳劑以及斜弱視者。測量其客觀屈光度、慣用處方度數、角膜曲率、眼軸長度及角膜厚度。分別使用投影及紙本視力表，在五種照度下測量遠距離( 6 m )視力及瞳孔直徑，再以SPSS統計軟體分析其結果。參與本研究的受試者皆無任何眼部疾病，透過模擬不同環境照度並測量其視力值，在150 lux以下的照度兩者視力表所測視力值無顯著差異，可將之照度定義為環境亮度，且兩種視力表之間的視力值均為線性變化，投影視力表在較低的環境照度有較佳的視力表現，而紙本視力表則以較高的環境照度下視力表現較佳，推論與視標之對比度有關。視力值會因照度而有所改變，本研究提供不同的環境照度範圍（300、200、150、100、30 ~ 50 lux），透過不一樣的照度來觀測受測者是否有其他視覺障礙情形。本研究建立不同環境照度下視力表現之標準，提供驗光人員評估患者在日常生活是否具有功能性視覺障礙之依據。

關鍵字

照度；驗光室；視力；視機能

並列摘要

The importance of visual measuring is a reference for measurable visual function, there are many factors that effects visual acuity, such as refractive status, definition of refractive medium and environmental illumination, the visual acuity measurement can be used to determine whether there is a change in visual performance. Many parameters of measuring visual acuity have been standardized, including the size of optotypes, chart distance, instructions on testing procedures and the record of visual acuity, however, for the illumination of the optometric room, the measurement of visual acuity is less discussed. The environmental illumination of a common optometric room is only suitable for standard visual function measurements and cannot be used to estimate functional vision under different environmental illumination levels. This study establishes the standard of visual performance under different environmental illumination as the basis for optometric personnel to evaluate visual function. This study simulates five environmental illumination of 300, 200, 150, 100 and 30 ~ 50 lux according to the indoor environmental illumination specifications of the Chinese National Standards. The study included 30 subjects over the age of 20, and exclude who has eye diseases, using atropine, strabismus and amblyopia. We measured the objective diopter, corneal curvature, axial length and corneal thickness. The long-distance ( 6m ) visual acuity and pupil size were measured under five illuminations using a projector chart and visual acuity card, and the results were analyzed by SPSS statistical software. None of the subjects participating in the study had any eye diseases, by simulating different environmental illumination and measuring their visual acuity. It was found that there was no significant difference in visual acuity between the two visual acuity charts under 150 lux illumination, the illumination can be defined as environmental brightness and the visual acuity between the two eye charts is linear. The projector chart has better visual performance in lower environmental illumination, while the visual acuity card is better in visual acuity with higher environmental illumination, and the inference is related to the contrast of the visual standard. The visual acuity will change due to illumination, this study provides different environmental illumination ranges (300, 200, 150, 100, 30 ~ 50 lux), observe whether the subject has other visual impairments through different illumination. This study establishes the standard of visual performance under different environmental illumination, and provides the basis for optometric personnel to assess whether patients have functional visual impairment in daily life.