Visual Assessment of the Multiply Handicapped Patient
Visual Assessment of the Multiply Handicapped Patient
复制标题
多重残疾患者的视觉评估
DOI：
10.1097/00006324-198908000-00007
复制
发表时间：
1989
影响因子：
1.4
通讯作者：
Amanda Hall
中科院分区：
文献类型：
--
作者：
D. Orel;G. Haegerstrom‐Portnoy;Amanda Hall
多重残疾和/或发育迟缓患者的视觉能力很难用依赖于患者主观反应的方法来评估。本文采用改进的眼科检查方法，对59例患有多种神经功能障碍和视力未知的患者进行了检查，其中包括使用视觉诱发电位（VEP）和优先注视（PL）技术测量视力。患者年龄从3岁到33岁不等；中位年龄9岁。严重屈光不正（73%）和斜视（71%）是最常见的眼部疾病。在43名有明显屈光不正的患者中，只有16名（37%）佩戴了适当的矫正眼镜（从-21到+20 D）。在27例患者中，未矫正的屈光不正在- 10 ~ +20 d之间，56例（95%）患者使用空间频率扫描VEP技术，41例（70%）患者使用PL光栅视力卡。在41例患者中，有27例VEP和PL光栅的视力测量值在1倍频内（最小分辨角为2倍）。12例患者VEP敏锐度提高1.1 ~ 2.7个八度。估计12例患者的光栅视力至少为6/12（20/40）。使用VEP和PL技术可以测量“难以检查”的多重残疾患者的残余视力。
The visual capabilities of the multiply handicapped and/or developmentally delayed patient are difficult to assess with methods that depend on the patient's subjective responses. Fifty-nine patients with multiple neurological handicaps and unknown visual capabilities were examined using a modified ophthalmic examination which included visual acuity measures using visual evoked potential (VEP) and preferential looking (PL) techniques. Patients ranged in age from 3 to 33 years; median age 9 years. Significant refractive error (in 73%) and strabismus (in 71%) were the most common ocular disorders. Of the 43 patients with a significant refractive error, only 16 (37%) were wearing their proper correction (ranging from -21 to +20 D). In 27 patients the uncorrected refractive error ranged from - 10 to +20 D. Binocular acuities (with refractive correction) could be obtained from 56 patients (95%) using a spatial frequency sweep VEP technique, and in 41 patients (70%) using PL grating acuity cards. The VEP and PL grating acuity measures agreed to within 1 octave (a factor of 2 in minimum angle of resolution) in 27 of 41 patients. VEP acuity was 1.1 to 2.7 octaves higher in 12 patients. Grating acuity of at least 6/12 (20/40) was estimated in 12 patients. Residual vision can be measured in “difficult to examine” multiply handicapped patients with VEP and PL techniques.