ASTIGMATISM AND AMBLYOPIA AMONG NATIVE AMERICAN CHILDREN

高度散光存在于美洲原住民 人民. 虽然散光的流行已经得到了很好的研究， 它的发展过程和视觉后果很差， 明白 这项研究的目标是建立 散光与视力发育关系 美国土著儿童，并确定最佳的 减轻散光的有害影响的策略 人口 提出了一个三态研究方案： 第1阶段：角膜、内部和总体的患病率 散光（以及敏锐度降低的患病率， 弱视）将在学龄前儿童6 6个月至6岁以上的土著人 美国部落（Tohono O 'Odham Nation）， 存在散光的普遍性。 第2阶段：将根据以下情况提供眼镜矫正 根据对334名儿童眼科护理人员的民意调查得出的指南 从业者 所有患有散光，近视， 远视或屈光参差的程度 99%的受访者将被归类为高风险 治疗屈光性弱视，并将配眼镜。 散光矫正50%至98%的儿童 的受访者将在中度风险组;这些 孩子们将被随机分配到眼镜 矫正或不矫正眼镜。 其余儿童 属于低风险组，不戴眼镜。 第3阶段：屈光努力度和视力的随访评估 每隔1、2和3分钟进行一次视力检查 年，以确定眼镜矫正是否减少了 最佳矫正视力低于正常值的患病率。 主 分析将是最佳矫正视力结果的比较 随机接受眼镜矫正的儿童 结果来自那些被随机分配到没有景观的人 纠正一下 据推测，儿童的比例 低于正常敏锐度的患者在以下组中将较小 随机分配到眼镜组的儿童比儿童组 随机分为不戴眼镜组。 这项研究将显示散光对视力的影响 发展，并将确定是否纠正 在学龄前的散光防止 屈光性弱视的发展，或产生改变 在正视化中。

High levels of astigmatism exist among Native American peoples. While the prevalence of astigmatism is well studied, its developmental course and visual consequences are poorly understood. the goal of the proposed research is to establish the relation between astigmatism and visual development in native american children, and to determine the optimum strategy to mitigate detrimental effects of astigmatism in this population. A three-state research protocol is proposed: Stage 1: the prevalence of corneal, internal, and total astigmatism (as well as prevalence of reduced acuity and meridional amblyopia) will be examined in preschool children 6 months to 6 + years of age who are members of a Native American tribe (the Tohono O'Odham Nation) in which a high prevalence of astigmatism is present. Stage 2: spectacle correction will be provided based on guidelines resulting from a poll of 334 pediatric eye care practitioners. All children whose astigmatism, myopia, hyperopia, or anisometropia is of a magnitude that would be corrected by 99% of those polled will be classified as High risk for refractive amblyopia and will have spectacles prescribed. children whose astigmatism would be corrected by 50% to 98% of those polled will be in the Moderate Risk group; these children will be randomly assigned to receive spectacle correction or no spectacle correction. the remaining children will be in the Low Risk group and will not receive spectacles. Stage 3: Follow-up assessment of refractive effort and visual acuity will be performed at intervals of one, two and three years, to determine whether spectacle correction reduces the prevalence of below-normal best-corrected acuity. the primary analysis will be ca comparison of best-corrected acuity results from children who were randomized to spectacle correction with results from those who were randomized to no spectacle correction. It is hypothesized that the proportion of children with below normal acuity will be smaller in the group of children randomized to spectacles than in the group of children randomized to no spectacles. This study will show the effect of astigmatism on visual development and will determine whether correction of astigmatism during the preschool years prevents the development of refractive amblyopia, or produces an alteration in emmetropization.