弱视

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最后审阅： 29 八月 2022
最后更新： 14 十二月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 婴儿不追踪父母的脸
  • 异常红光反射
更多 关键诊断因素

其他诊断因素

  • 无症状
  • 单眼或双眼的视力低于同龄儿童正常水平
  • 非对称的角膜光反射
  • 对交替遮盖双眼出现的不相同的行为反应
  • 遮盖/去遮盖检查异常
  • 视力模糊
  • 视疲劳
  • 先天性眼球震颤
  • 瞳孔检查异常
  • 外眼检查异常
其他诊断因素

危险因素

  • 年龄小于9岁
  • 早产
  • 弱视或斜视的家族史
  • 斜视（眼位的偏斜）
  • 远视性大于+1.50D的屈光参差（远视并且双眼屈光不正不相等）
  • 近视性屈光参差
  • 散光（柱镜而不是球镜导致的眼睛离焦）大于2.0D
  • 远视大于+4.5D
  • 近视大于-3.00D
  • 角膜、前房、晶状体、玻璃体腔或视网膜表面的混浊
  • 重度上睑下垂或者单眼或双眼长期闭合
  • 发育延迟
更多 危险因素
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诊断性检查

首要检查

  • 视力检查（专科）
  • 立体视觉（深度觉或三维空间觉）和双眼视觉检查
  • 注视、眼位和眼球运动的检查
  • 用裂隙灯显微镜进行的眼前节检查
  • 散瞳眼底检查
  • 散瞳验光
  • 双眼红光反射检查（Brückner检查）
更多 首要检查

新兴检查

  • 视觉诱发电位
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治疗流程

持续性治疗

在没有形觉剥夺的弱视中

形觉剥夺性弱视

难治性弱视（依从性差的患者）

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撰稿人

作者

Irene Gottlob, MD

Professor of Ophthalmology

Department of Neuroscience, Psychology and Behaviour

University of Leicester

Ulverscroft Eye Unit

Leicester Royal Infirmary

UK

利益声明

IG has undertaken amblyopia research supported by the National Eye Research Centre, the Ulverscroft Foundation, the National Institute of Health Research, and Action Medical Research. An employer of IG, The University of Leicester, holds a European patent for glass dose monitors. IG is an author of references cited in this topic.

Gail Maconachie, PhD, BMedSci

Research Orthoptist

Department of Neuroscience, Psychology and Behaviour

University of Leicester

UK

利益声明

GM declares that she has no competing interests. GM is an author of a reference cited in this topic.

鸣谢

Dr Irene Gottlob and Dr Gail Maconachie would like to gratefully acknowledge Dr Tina Rutar, the previous contributor to this topic.

利益声明

TR declared that she had no competing interests.

同行评议者

David Robbins Tien, MD

Associate Clinical Professor of Ophthalmology

Alpert Medical School of Brown University

Director of Ophthalmology

Hasbro Children's Hospital

Providence

RI

利益声明

DRT declares that he has no competing interests.

David K. Wallace, MD, MPH

Associate Professor of Ophthalmology and Pediatrics

Duke Eye Center

Durham

NC

利益声明

DKW has received NEI grants of more than 6 figures USD. DKW is an author of a number of references cited in this topic.

Michael Clarke, FRCS, FCOphth

Reader in Ophthalmology

Newcastle University

Newcastle

UK

利益声明

MC has received NHS research grants of more than 6 figures USD. MC is an author of a number of references cited in this topic.

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