方法：回顾性病例研究。收集2011-01/2014-12在我院就诊的视疲劳患者3 502例，年龄7～50岁。按年龄分为4组：(1)7～20岁组712例；(2)21～30岁组603例；(3)31～40岁组694例；(4)41～50岁组1 493例。检查其眼前后节、泪液分泌试验、泪膜破裂时间、电脑验光、主觉验光、水平聚散力、远近隐斜、集合近点、调节性辐辏/调节值、调节灵敏度、相对调节、调节幅度、调节反应，分析视疲劳的原因。将视疲劳患者病因先进行Kruskal-wallis H检验，再采用Nemenyi法进行检验组间比较。

结果：视疲劳患者3 502例其病因依次是：眼部相关疾病(49.37%)，屈光不正(23.36%)、调节与辐辏功能障碍(21.70%)、眼外肌功能障碍(5.57%)。将4组不同病因患病率进行Kruskal-wallis H检验，总体差异有统计学意义(P<0.05)。将各组间患病率进行Nemenyi组间比较，眼外肌功能与眼部相关疾病有统计学意义(P<0.05)。

结论：视疲劳常见病因依次是眼部相关疾病、屈光不正、调节与辐辏功能障碍、眼外肌功能与障碍。

METHODS:This was a retrospective case-controlled study. From January 2011 to December 2014, all the clinical data of 3 502 patients who were diagnosed as asthenopia aged 7～50 was analyzed. The subjects were divided into 4 groups according to the age:(1)7～20 years old: 712 cases;(2)21～30 years old: 603 cases;(3)31～40 years old:694 cases;(4)41～50 years old:1 493 cases. The patients were examed for the conditions of anterior and posterior segment, Schirmer Ⅰ test, break-up time, computer optometry, subjective refraction, horizontal convergence and divergence, distance and near phoria, near point of convergence, accommodative convergence/accommodation ratio, accommodative facility, relative accommodation, amplitude of accommodation and accommodative response. The causes for asthenopia were analyzed by Kruskal-wallis H test first, then comparisons among groups were conducted by Nemenyi test.

RESULTS:The causes for asthenopia were eye-related diseases(49.37%), ametropia(23.36%), accommodation and convergence function problem(21.70%), disorders of extraocular muscles function(5.57%). Kruskal-wallis H test showed significant differences on the prevalence of asthenopia caused by different reasons of the four groups(P<0.05). Nemenyi test showed that the difference was significant on disorders of extraocular muscles function and eye-related diseases among the four groups(P<0.05).

CONCLUSION: The causes of asthenopia are eye-related diseases, ametropia, accommodation and convergence function problem and disorders of extraocular muscles function.