五所特殊教育学校视障学生视觉损伤及康复情况

doi:10.3760/cma.j.cn115909-20210119-00024

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摘要目的：分析国内5所特殊教育学校视障学生的视觉损伤及康复现状，了解这些学校视障学生的眼健康状况，探讨影响视障学生视觉康复相关因素及今后工作重点。方法：横断面调查研究。采用WHO 盲及低视力眼检查记录表，对5所特殊教育学校视障班学生进行病史采集、视力检查、裂隙灯显微镜检查、医学验光及助视器验配。采用2003年世界卫生组织制定的视觉损伤分级诊断标准。采用 Wilcoxon符号秩和检验对数据进行分析。结果：共筛查视障学生330例（660眼），其中可避免盲及低视力有170例（51.5%），难避免盲及低视力有115例（34.8%），因筛查条件受限不能确定45例（13.7%）。 324例视障学生中（除去6例不配合视力检查），93例（28.7%）学生屈光矫正后视力有所提高，双眼中较好眼的最佳矫正视力（LogMAR）由1.44升至1.19，屈光矫正前后差异有统计学意义（Z=-3.523， P<0.001）。17例（5.2%）屈光矫正后视觉损伤等级有所下降。122例（37.7%）可验配使用中远助视器提高远视力，128例（39.5%）可验配使用近用助视器提高近视力。在1级、2级及3级视觉损伤的视障学生中，远用助视器验配比例分别达到83.7%、83.3%、65.3%，脱盲率达到17.8%，脱残率达到72.2%；近用助视器验配比例分别达到77.6%、81.3%、77.6%，脱盲率达到22.8%，脱残率达到 81.4%。结论：部分特殊教育学校视障学生尚缺乏系统的眼健康筛查及视觉康复服务，部分视障学生通过屈光矫正及助视器的使用即可有效脱盲、脱残。在特殊教育学校中普及眼健康筛查及助视器的康复使用，可作为今后开展视障学生康复工作的重点内容之一。

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关键词 ： , 特殊教育学校, 视障学生, 视觉损伤, 康复

Abstract： Objective: To analyze the status of the visual impairment and rehabilitation of visually impaired students in five special education schools, and to explore the related factors affecting the visual rehabilitation of visually impaired students. Methods: This was a cross-sectional study. The World Health Organization/problem based learning (WHO/PBL) eye exam record was used to collect the medical history, visual acuity, slit lamp exams, refraction, low vision aid fitting, etc. The classification criteria of visual impairment developed by the WHO in 2003 was adopted. The Wilcoxon signed rank sum test was used to analyze the results. Results: A total of 330 students (660 eyes) were screened in the five special education schools. Of these, 170 students (51.5%) were diagnosed with avoidable blindness or low vision, 115 students (34.8%) had inevitable blindness or low vision, and there was uncertainty about 45 students (13.7%) due to limited screening conditions. Among the 324 visually impaired students screened (six of them refused to undergo a visual test), 93(28.7%) had improvement in presenting distance vision (PDVA) after refraction. The mean LogMAR visual acuity in the better eye increased from 1.44 to 1.19, and the difference was statistically significant based on the Wilcoxon signed rank test (Z=-3.523, P<0.001). The level of visual impairment in 17(5.2%) students could be improved. The distance visual acuity of 122(37.7%) visually impaired students could be improved with far/middle range visual aids. Near visual acuity could be improved in 128(39.5%)visually impaired students with near range visual aids. Among the visually impaired students (category 1-3), the proportion for matching them with distant low vision aids reached 83.7%, 83.3% and 65.3% respectively, and 17.8% of them were no longer considered blind, and 72.2% were no longer considered to have a visual disability. The proportion for matching them with near low vision aids reached 77.6%, 81.3%, 77.6%, respectively, and 22.8% were no longer considered blind and 81.4% were no longer considered to have a visual disability. Conclusions: There is still a lack of systematic eye health screening and visual rehabilitation services for visually impaired students in some special education schools. Some visually impaired students can be treated effectively for blindness and visual disability with refractive correction and the use of low vision aids. Promotion of eye health screening and the use of low vision aids in special education schools can be one of the key parts of rehabilitation work for visually impaired students in the future.

Key words： special education schools visually impaired students visual impairment rehabilitation

收稿日期: 2021-01-19

PACS:

基金资助: 温州医科大学附属眼视光医院2020年护理专项课题（YNHL1202002）

通讯作者: 邓如芝（ORCID：0000-0002-4587-7223），Email：drz@eye.ac.cn

引用本文:

倪灵芝陈洁江龙飞胡炯炯林娜李小曼邓如芝. 五所特殊教育学校视障学生视觉损伤及康复情况[J]. 中华眼视光学与视觉科学杂志, 2021, 23(5): 374-379. Lingzhi Ni, Jie Chen, Longfei Jiang, Jiongjiong Hu, Na Lin, Xiaoman Li, Ruzhi Deng. An Analysis of Visual Impairment and Rehabilitation Status of Visually Impaired Students in Five Special Education Schools in China. Chinese Journal of Optometry Ophthalmology and Visual science, 2021, 23(5): 374-379. DOI: 10.3760/cma.j.cn115909-20210119-00024

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https://www.cjoovs.com/CN/10.3760/cma.j.cn115909-20210119-00024 或 https://www.cjoovs.com/CN/Y2021/V23/I5/374

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