弱视当代分类与其研究分组设计的探讨

Study of Contemporary Amblyopia Categorisation and Further Grouping Research

摘要: 为了提高对弱视分类的深入认识，完善对弱视研究分组的系统化。笔者观察弱视概念有双眼矫正视力相差为2行以上，国际上当对弱视屈光参差而有认可为双眼屈光力、等效球镜相差 ≥ 0.50 D时，分析当其单眼斜视、屈光参差、形觉剥夺或双眼高度屈光不正等分别逐步相遇时的结果得出其唯有三个主要分类：即屈光参差性弱视、单眼注视综合征性弱视以及斜视联合屈光参差性弱视，结合其临床研究做出可分为36个小组，并提醒要注意规避严重影响同质、齐同、均衡的可能性因素，如重度性、近视性、非立体视性弱视等，笔者提出“视力康复弹簧效应现象”的假说；对其三个分类性质比喻为“三个阶梯”，治疗需经历“三级跳”；并预测未来人们对屈光不正性弱视、斜视性弱视的印象将会逐渐地淡化。

Abstract: The aim of this article is to further investigate the categorization of Amblyopia, in order to form a systematic, comprehensive grouping for future Amblyopia researches. The author observed cases for vision correction with more than 2 lines, as well as Anisometropia with 0.5 D or more discrepancies between both eyes spherical equivalent. The author further studied the result and effect of different combination among Single Eye Strabismus, Anisometropia, Dep- rivation, Refractive Error etc., and came to a conclusion that there should be only 3 major categories. They are Ani- sometropic Amblyopia, Monofixation Syndrome Amblyopia and Strabismus combining with Anisometropic Amblyopia, of which can be classified into 36 groups for clinical research. It is important for researchers to be careful and avoid the potential source which will jeopardise the “equivalent”, “same nature” and “balance” between cases, such as severe case of Amblyopia, Non-stereo acuity, just to name a few. The author then raises the “Spring-like Effect of Vision Re- habilitation” hypothesis, to describe the 3 categories as “3 steps” of treatments. Furthermore, the author also predicts that Anisometropia and Strabismus will no longer be a major concern for public.