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
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
危险因素
- 年龄小于9岁
- 斜视（眼位的偏斜）
- 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
- 早产
- 弱视或斜视的家族史
- 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
- 发育延迟
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）
新兴检查
- 视觉诱发电位
治疗流程
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）
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 declares that she has no competing interests. IG is an author of references cited in this topic.
Gail Maconachie, PhD, BMedSci
Lecturer
School of Allied Health Professions, Nursing and Midwifery,
Faculty of Health
University of Sheffield
UK
利益声明
GM declares that she has no competing interests. GM is an author of a reference cited in this topic.
Eleni Papageorgiou, MD, PhD
Consultant in Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology
Department of Ophthalmology
University Hospital of Larissa
Larissa
Greece
利益声明
EP declares that she has no competing interests.
鸣谢
Dr Irene Gottlob, Dr Gail Maconachie, and Dr Eleni Papageorgiou 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.
鉴别诊断
- 没有弱视的屈光不正
- 功能视觉损伤
- 累及视觉通路的中枢神经系统异常
更多 鉴别诊断指南
- 视力康复的首选实践模式
- 婴幼儿视力筛查
更多 指南
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