目的：比较不同类型间歇性外斜视使用注视6m示标三棱镜检查、注视30m示标、注视户外示标、1h遮盖试验四种测量方法测量斜视角结果的差别。

方法：前瞻性研究。收集2013-06/2014-06在青岛大学医学院附属医院被确诊为间歇性外斜视的患者65例，其中男37例，女28例，平均年龄12.5±6.2岁。分别对患者行注视6m示标斜视度测量、注视30m示标斜视度测量、注视户外示标斜视度测量、1h遮盖试验斜视度测量。根据测量远近斜视角差值大小，将患者分为基本型、集合不足型、分开过强型。对各型中测量的视远斜视度进行单因素方差分析，采用LSD-t方法进行两两比较。

结果：注视6m示标、注视30m示标、注视户外示标、1h遮盖试验四种检测方法测得的视远斜视度在三型中分别为：基本型45.4±21.0，55.0±15.0，64.68±17.7，68.75±16.6PD； 集合不足型33.3±14.0，44.9±12.9，43.6±11.8，54.6±11.2PD； 分离过强型55.6±17.4，66.3±18.8，76.9±16.4，78.1±15.6PD，三型中四种方法测得的视远斜视度进行比较，结果均有统计学意义(F_基本型=9.649，P=0.00； F_{集合不足型}=6.886，P=0.001； F_{分离过强型}=7.989，P=0.00)。两两比较，注视户外示标(P_基本型=0.044，P_{分离过强型}=0.048)及1h遮盖试验(P_基本型=0.04，P_{分离过强型}=0.027)与注视30m示标检查比较时，在基本型与分离过强型两型中差异均有统计学意义； 注视户外示标检查与1h遮盖试验(P_基本型=0.353，P_{分离过强型}=0.815)在基本型与分离过强型两型中的比较差异无统计学意义。而在集合不足型中，与其它三种检查方法相比，1h遮盖试验检查结果明显更大，差异有统计学意义。

结论：注视户外示标与1h遮盖试验可以测出基本型与分离过强型更大的斜视角，在集合不足型1h遮盖试验可以测出更大斜视角。

AIM: To compare the results of 4 methods for measuring angle of exodeviation in the three types of intermittent exotropia, including when looking at indoor distance target of 6m, looking at indoor distance target of 30m, looking at outdoor far distance target, after 1h diagnostic occlusion test.

METHODS: Prospective case series study. Sixty-five patients with intermittent exotropia between June 2013 and June 2014 were enrolled in the Department of Ophthalmology, Affiliated Hospital to Qingdao University, included 37 males and 28 females with average age(12.5±6.2)years. All the patients were measured when looking at indoor distance target of 6m, looking at indoor distance target of 30m, looking at outdoor far distance target, after 1h diagnostic occlusion test. Intermittent exotropia was divided into basic type, convergence insufficiency type and divergence excess type, which was based on the different result of between the distance and near measurements. The One-way test was applied to analyze the four methods of measuring angle of exodeviation in the three types of intermittent exotropia. LSD-t test was applied to compare the differences between each two methods in each type.

RESULTS: The distance exodeviations tested with looking at indoor distance target of 6m, looking at indoor distance target of 30m, looking at outdoor far distance target, after 1h diagnostic occlusion test were basic type(45.4±21.0, 55.0±15.0, 64.68±17.7, 68.75±16.6PD), convergence insufficiency type(33.3±14.0, 44.9±12.9, 43.6±11.8, 54.6±11.2PD), divergence excess type(55.6±17.4, 66.3±18.8, 76.9±16.4, 78.1±15.6PD). There were obviously differences between each two methods in each type(basic type F=9.649, P=0.00; convergence insufficiency type F=6.886, P=0.001; divergence excess type F=7.989, P=0.00). Compared with looking at indoor distance target of 30m, looking at outdoor far distance target(basic type P=0.044, divergence excess type P=0.048)and after 1h diagnostic occlusion test(basic type P=0.04, divergence excess type P=0.027)had the statistical difference in the basic type and divergence excess type, and there was no obviously difference between looking at outdoor far distance target and after 1h diagnostic occlusion test(basic type P=0.353, divergence excess type P=0.815). Compared with the other three measurements, 1h diagnostic occlusion test can elicit larger angle of deviation in the convergence insufficiency type.

CONCLUSION: Both measurement with looking at outdoor far distance target and after 1h diagnostic occlusion test can elicit the larger angle of deviation in the basic type and divergence excess type; The measurement with after 1 hour diagnostic occlusion test can elicit the larger angle of deviation in the convergence insufficiency type.