視覺疲勞與眼睛調節系統之相關研究

The correlation between visual fatigue and accommodation system

10.6834/CSMU.2015.00126

林書慨

視覺疲勞 ； 調節系統 ； 視覺機能 ； 用眼行為 ； visual fatigue ； accommodation ； binocular function ； use eye behavior

中山醫學大學生物醫學科學學系碩士班學位論文

2015年

碩士

陳賢堂

繁體中文

目的：視覺疲勞症狀在現今社會成為一個廣泛而常見的公共衛生議題，因此本研究所要探討的目的是視覺疲勞對於雙眼視覺機能的調節系統之影響，研究設計分為兩部份，先以問卷調查的研究方法進行，接著針對參與者施行雙眼視覺機能檢查獲得數據資料。 方法與結果：本研究參與的人數為49人，使用Conlon(1999)所設計的問卷測量，發現未達視覺疲勞的人佔所有人數的67.3％，有視覺疲勞的人佔所有人數的32.7％。視覺疲勞在背景變項沒有顯著的差異，但可以從敘述統計分析知道參與者大多數處於工作與生活中需要長時間且近距離使用眼睛的情境之下。在分析視覺疲勞是否影響雙眼視覺機能的調節方面，使用獨立樣本T檢定分析的結果，在調節幅度與調節靈活度兩項有顯著影響差異。而在使用Spearman相關統計分析用眼習慣行為與視覺疲勞的相關時，發現達到顯著正相關的選項有「工作中平均近距離用眼時間」、「工作中平均使用電腦時間」、「每天使用電腦時間」、「每天觀看電視時間」以及「感受到眼睛疲勞的頻率次數」。 接著進一步將視覺疲勞對雙眼視覺機能異常交集分組進行風險評估，分析參與者的視覺疲勞與否對於雙眼視覺機能是否存在風險上的差異，視覺疲勞組在雙眼視覺機能檢查項目：NPC破裂點、調節近點、調節幅度與調節靈活性，功能異常風險機率比正常組顯著較高。未達顯著差異的有：遠方眼位、近方眼位、NPC回復點、負相對調節、正相對調節與調節反應。 討論：因此現在生活型態的改變，所以視覺疲勞是非常普遍的現象，因此對於日常生活中的用眼行為及可能造成視覺疲勞的風險因子要更加注意，同時也可以進行一些舒緩眼睛疲勞的活動與視力訓練，可以有效的降低視覺疲勞的症狀減少對眼睛的損害。

Purpose：Symptoms of visual fatigue are associated with prolonged near work. This study investigates the effects of visual fatigue on accommodation system, to find a correlation between visual fatigue and the use eye. We perform clinical measures of binocular functions and accommodation function. Methods：49 visually normal, young-adult subjects without presbyopia and eye diseases participated in the study. Ocular examination included visual acuity, autorefraction, subjective refraction for best corrected vision, Von Graefe test for phoria, test in near point of convergence, near point of accommodation, minus and plus lens to blur, fused crossed cylinder, negative relative accommodation, positive relative accommodative and accommodation facility. A survey of visual discomfort developed by Conlon et al. (1999), were administered to subjects before the clinical assessments. Results：32.7％ of the subjects have asthenopia, While 67.3％ of the subjects do not. Comparing to the ones with no visual fatigue, Subjects that with asthenopia have significant difference in accommodative amplitude(t＝-4.575，p＜0.05) and accommodative facility t＝4.016，p＞0.05). Statistically significant correlation was noted between visual fatigue and near work time(r＝0.311, p＝0.029＜0.05), computer usage time(r＝0.312, p＝0.029＜0.05), Smartphone usage time(r＝0.384, p＝0.006＜0.05), TV watching time(r＝0.283, p＝0.049＜0.05), and visual discomfort frequency(r＝0.656, p＝0.000＜0.05). Statistically significant risk for asthenopia included NPC break point(OR＝3.850, CI＝1.078~13.751), NPA(OR＝3.833, CI＝1.093~13.450), accommodative amplitude(OR＝1.941, CI＝1.394~2.703), and accommodative facility(OR＝5.60, CI＝1.429~21.949). Discussion：Our results show that visual fatigue is associated with near work time, 3C electronic products usage, frequency asthenopia. The accommodative system exhibited fatigue with decreasing accommodation amplitude and accommodative facility. Near visual functions are affected by asthenopia. It is essential for government to mandate public health policy for in the protection eye health general public is necessary.

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