ABSTRACT

Purpose

Binocular balancing is an important component of refractive correction to avoid asthenopic complaints. Polaroid filters are commonly used for binocular balancing; they rely on subjective examination and cannot represent daily visual activities. We describe a new examination approach to evaluate binocular balance with retinoscopy, which is an objective examination method and does not require strict patient cooperation.

Methods

Healthy young individuals with refractive errors (under the age of 40) were included in this study. Each patient was examined by three different ophthalmologists in the same room at 20-min intervals. The first ophthalmologist performed refractive examination separately for each eye, the second physician used binocular balance tests with polaroid glasses, and the third physician practiced binocular balance test with retinoscopy. After completion of clinical examinations, autorefractometry was repeated with cycloplegia. The difference between the spherical equivalents (SE) of the eyes was calculated for each method and compared with the SE difference obtained by cycloplegic autorefractometry. The SPSS 21.0 software was used for the statistical tests.

Results

The study included 30 patients (16 males, 14 females) and the mean age of the patients was 21 ± 8.5 years (range 10–37 years). There was no significant difference between the four groups for the interocular difference of SE (Greenhouse–Geisser F = 1.390, p = 0.257). The highest correlation was found between the retinoscopic binocular balance technique and cycloplegic autorefractometry (r = 0.878, p < 0.001). In addition, the intraclass correlation coefficient and the 95% limits of agreement supported strong agreement.

Conclusion

Currently used binocular examination tests are subjective and some patients give inconsistent answers impairing the reliability of the outcome. These tests cannot be performed on patients with limited ability to cooperate. This study demonstrates that the use of retinoscopy in the evaluation of binocular balance delivers reliable results and is a low-cost, practical approach to address the above-mentioned problems.

中文翻译：

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一种新的使用检影镜来评估球面屈光不正的双眼平衡

摘要

目的

双眼平衡是屈光矫正的重要组成部分，以避免出现视疲劳。宝丽来滤镜通常用于双目平衡；它们依赖于主观检查，不能代表日常视觉活动。我们描述了一种用检影镜评估双眼平衡的新检查方法，这是一种客观的检查方法，不需要严格的患者合作。

方法

本研究包括患有屈光不正的健康年轻人（40 岁以下）。每位患者在同一房间内由三位不同的眼科医生每隔 20 分钟进行一次检查。第一位眼科医生分别对每只眼睛进行屈光检查，第二位医生使用宝丽来眼镜进行双眼平衡测试，第三位医生使用检影镜进行双眼平衡测试。完成临床检查后，用睫状肌麻痹重复自动验光。计算每种方法的眼睛球面当量（SE）之间的差异，并与通过散瞳自动验光法获得的 SE 差异进行比较。统计检验采用SPSS 21.0软件。

结果

该研究包括 30 名患者（16 名男性，14 名女性），患者的平均年龄为 21 ± 8.5 岁（范围 10-37 岁）。SE的眼间差异在四组之间没有显着差异（Greenhouse-Geisser F = 1.390，p = 0.257）。视网膜镜双目平衡技术与睫状体麻痹自动验光术之间的相关性最高（r = 0.878，p < 0.001）。此外，组内相关系数和 95% 的一致性限制支持强一致性。

结论

目前使用的双目检查测试是主观的，一些患者给出的答案不一致，从而损害了结果的可靠性。这些测试不能对合作能力有限的患者进行。本研究表明，在评估双眼平衡时使用检影镜可提供可靠的结果，是解决上述问题的一种低成本、实用的方法。