目的：观察双眼视觉训练对功能性视力不良的疗效。

方法：回顾性系列病例研究。选取2018-01/06我科就诊的患儿22例(男12例，女10例)，平均年龄7.5±0.8岁，完善眼部常规检查及屈光、双眼视觉功能检查。对屈光度数为球镜在±1.00D以内之间、伴有低于1.00D散光或不伴散光者，根据结果行针对性视觉功能训练。观察训练前后视力、屈光度及双眼视功能。

结果：训练后22例患儿视力均有提升， 训练前后平均屈光度分别为-0.011±0.573、-0.057±0.338D(P=0.633)。远距离水平隐斜量训练前后的平均值分别为-3^△±2.97^△和-1.18^△±1.6^△(P=0.089)。训练前后近距离水平隐斜量平均值分别为-6.27^△±4.56^△及-2.82^△±2.56^△； 集合近点平均值分别为7.73±2.15、3.05±0.69cm； 调节性集合与调节比率平均值分别为2.00±1.55、3.64±0.5(均P<0.05)。训练前双眼视觉的负相对调节及正相对调节的平均值分别为1.61±0.41、-1.98±0.71D，训练后为2.09±0.23、-3.89±0.71 D； 训练前后调节反应由0.09±0.38D提升至0.39±0.13D； 调节幅度由9.55±2.54D到 11.55±1.13D； 双眼调节灵敏度由3.36±2.73cpm到 9.64±1.5cpm(均P<0.05)。

结论：儿童功能性视力不良者，在屈光检查的前提下，进行双眼视觉功能检查是必要的； 针对性视觉训练治疗，可以提高视力及改善双眼调节及集合功能。

METHODS: Totally 22 children with functional vision loss were enrolled in our department between January 2018 and June 2018, including 12 males and 10 females, the mean age 7.5±0.8 years old. All patients had routine eye examinations, refraction and binocular visual function examinations. Children with or without astigmatism whose diopter spherical mirror was between±1.00D and were accompanied by astigmatism less than ±1.00D participated in personalized vision therapy. Paired t test was used to analyze the binocular visual function before and after vision therapy.

RESULTS: The average visual acuity of the 22 children were improved, but the diopters before and after vision therapy were -0.011±0.573D and -0.057 ±0.338D drespectively, without statistical significance(P=0.633). The average of the distant level phoria(DLP)before and after vision therapy were -3^△ ±2.97^△ and -1.18^△ ±1.6^△, which was not statistically significant(P=0.089). The near level phoria(NLP)were -6.27^△ ±4.56^△ and -2.82^△ ±2.56^△; the near point of convergene(NPC)were 7.73±2.15 and 3.05±0.69cm; the accommodation convergence/accommodation(AC/A)were 2.00±1.55, 3.64±0.5 before and after the training respectively(P<0.05); The negative relative accommodation(NRA)and positive relative accommodation(PRA)before vision therapy were 1.61±0.41 and -1.98±0.71D; after training they were 2.09±0.23 and -3.89±0.71D respectively; binocular crossed-cylinder(BCC)was 0.09±0.38D, which improved to 0.39±0.13D after therapy; the average of amplitude of accommodation(AMP)were 9.55±2.54 and 11.55±1.13D; binocular accommodation facility(BAF)were 3.36±2.73 and 9.64±1.5cpm respectively before and after therapy.

CONCLUSION:It is necessary to perform binocular visual function examination base on the refractive examination for children with functional vision loss. Visual therapy can improve visual acuity and binocular vision function.