不同类型视觉显示终端对视觉功能的影响

doi:10.3760/cma.j.cn115909-20210327-00121

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摘要目的：探讨不同类型视觉显示终端（VDT）引起受检者视觉疲劳的差异和对视觉健康的影响。方法：前瞻性自身对照研究。纳入30名受检者，男7名，女23名，年龄23（23，25）岁，等效球镜度（-3.86±2.71）D，受检者按照随机数字表法分配的顺序先后观看类纸护眼屏及电视屏幕的视频，所有受检者在相同环境相同视角下观看视频30 min，观看前后分别填写视疲劳量表，测量调节、集合、融合等视觉功能指标并记录瞬目次数。观看视频前后各观测指标数据的比较根据数据正态性选择重复测量方差分析或Friedman检验及Wilconxon秩和检验进行统计。结果：观看2种屏幕后所有受检者的瞬目频率增加，看近的单眼、双眼正相对调节能力提高。观看类纸屏及电视屏前受检者的瞬目频率分别为15.7（11.8， 17.3）、 16.9（13.1，19.4）次/min，观看2种屏幕后分别为18.9（12.7，20.1）、20.4（15.3，21.9）次/min， 2种屏幕观看后都较观看前瞬目频率明显增加（Z=2.82，P=0.01；Z=-2.27，P=0.02），但2种屏幕间无差异；观看类纸屏后视疲劳量表评分较观看前明显降低（P=0.02）且明显低于观看电视屏后（χ2 =5.57， P=0.01），而观看电视屏前后量表评分无显著变化；观看类纸屏后看近水平外隐斜度数较看屏幕前增长明显（F=2.87，P=0.049），且明显大于观看电视屏后（P=0.049）；观看类纸屏后调节性集合/调节比值（AC/A）相较观看电视屏后更低（χ2 =2.99，P=0.03），但观看2种屏幕前后无明显差异；观看2种屏幕后，受检者右眼、左眼及双眼的正相对调节能力（PRA）都较观看前增加（F=11.01、5.01、10.00，均P<0.05），同时观看类纸屏后的双眼PRA较观看电视屏更高（P=0.02）。观看类纸屏后近眼位负融像破裂点，远眼位正融像恢复点较看屏幕前均有增加（P=0.02、0.04），观看电视屏后各融像性功能参数无明显改变。结论：短时间、中等距离观看VDT可引起视疲劳感受及部分双眼视觉功能指标变化；不同类型的VDT可对人眼的视觉功能产生不同影响，观看电视屏比观看低蓝光、无频闪的类纸护眼屏可能更容易引起视疲劳。

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关键词 ： , 视觉显示终端, 视觉功能, 视疲劳, 对比研究

Abstract： Objective: To investigate the differences in visual fatigue caused by different types of visual display terminals (VDT) and their impact on visual health. Methods: This was a self-controlled study that enrolled 30 subjects, 7 males, 23 females, age 23(23, 25) years old, with an equivalent spherical lens of -3.86±2.71 D. The subjects used the digital table method to watch either a paper screen or TV screen video, one after the other, in random order. All subjects watched the video in the same environment for 30 minutes. Before and after watching the video, they filled in the Asthenopia Scale, and adjustment, aggregation, fusion and other visual function indicators were measured and the number of blinks was recorded. The comparison of the observation indicators and the data between the viewing modes was statistically analyzed by Friedman test and Wilconxon rank sum test. Results: After viewing the two screens, the blink frequency of all subjects increased, and the relative adjustment ability of the single eye and both eyes improved for those who looked closer at the screen. The score on the visual fatigue scale after watching the paper screen was significantly lower than that before watching (P=0.02) and was significantly lower than that after watching TV (χ2 =5.57, P=0.01), but there was no significant change in the scale score before and after watching the TV screen. When watching either the paper screen or TV, the median blink frequencies of subjects in front of the screen were 15.7(11.8, 17.3) and 16.9(13.1, 19.4) times/min. Median frequencies were 18.9(12.7, 20.1) and 20.4(15.3, 21.9) times/min after watching the two screens. Both screens elicited a significant increase in blinking frequency compared to before viewing (Z=2.82, P=0.01; Z=-2.27, P=0.02), but there was no significant difference between the two screens. After viewing paper-like screens, the horizontal heterophoria degree increased significantly compared to the amount before watching the screen (F=2.87, P=0.049), and was significantly greater than the amount after watching the TV screen (P=0.049). The AC/A value after watching the paper screen was lower than that after watching the TV screen (χ2 =2.99, P=0.03), but there was no significant difference from before and after watching the two screens. After watching the two screens, the positive relative accommodation ability (PRA) of the right eye, left eye and both eyes of the subjects increased compared with before viewing (F=11.01, 5.01, 10.00, P<0.05). The PRA of both eyes after watching paper-like screens at the same time was higher than watching TV screens (P=0.02). After watching a paper screen, the break point of the near-eye negative fusion (BI) and the recovery point of the far-eye positive fusion increased compared to before watching the screen (P=0.02, 0.04), but there was no obvious change in the functional parameters of fusion after watching the TV screen. Conclusions: Watching a VDT for a short time and at a medium distance can cause some visual fatigue-related index changes; different types of VDTs can have different effects on the visual function of the human eye. Watching a TV screen has less effect than watching a paper projection screen with low blue light and no flicker. The screen may be more likely to cause visual fatigue.

Key words： visual display terminal visual function visual fatigue comparative study

收稿日期: 2021-03-27

PACS:

基金资助: 北京市卫生和计划生育委员会首都卫生发展科研专项重点攻关（首发2018-1-2051）；首都临床特色应用研究专项课题（Z171100001017066）

通讯作者: 付晶（ORCID：0000-0002-2939-9479），Email：fu_jing@126.com

引用本文:

姚瑶付晶. 不同类型视觉显示终端对视觉功能的影响[J]. 中华眼视光学与视觉科学杂志, 2021, 23(8): 570-575. Yao Yao, Jing Fu. Comparative Study on the Influence of Different Types of Visual Display Terminals on Visual Function. Chinese Journal of Optometry Ophthalmology and Visual science, 2021, 23(8): 570-575. DOI: 10.3760/cma.j.cn115909-20210327-00121

链接本文:

https://www.cjoovs.com/CN/10.3760/cma.j.cn115909-20210327-00121 或 https://www.cjoovs.com/CN/Y2021/V23/I8/570

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