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研究生:李欣怡
研究生(外文):LI, SIN-YI
論文名稱:比較不同眼調節測試之研究
論文名稱(外文):A Comparative Study of Different Examination of Ocular Accommodation
指導教授:李建輝李建輝引用關係陳昆祥陳昆祥引用關係
指導教授(外文):LEE, CHIEN-HUICHEN, KUN-SHIANG
口試委員:白宜巧
口試委員(外文):BAI, YI-CIAO
口試日期:2023-06-14
學位類別:碩士
校院名稱:中華醫事科技大學
系所名稱:視光系碩士班
學門:醫藥衛生學門
學類:醫學技術及檢驗學類
論文種類:學術論文
論文出版年:2023
畢業學年度:111
語文別:中文
論文頁數:108
中文關鍵詞:調節調節幅度調節遲滯調節疲勞近視
外文關鍵詞:accommodationamplitude of accommodationlag of accommodationaccommodative fatiguemyopia
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長時間視近是導致近視的主要原因之一。根據衛生福利部2017年國民健康訪問調查,無論是平日或假日,未滿12歲患有近視的兒童在「使用電腦、上網或打電動」及「使用手機、平板或其他3C產品」每日平均使用時間均高於未患有近視的兒童,其中在「使用電腦、上網或打電動」指標中,患有近視的兒童與未患有近視的兒童之人數差距達一倍;此外,患有近視兒童參與「戶外活動」的時間,則較未患有近視之兒童來的少。然而,隨著科技快速進步,在許多工作場域及生活環境中,使人們需要長時間視近,導致眼睛痠澀疲勞的患者日益增加。因此本研究將以檢測調節力為主軸,使用不同的檢測方式探討年滿20歲至39歲青壯年調節能力與期望值以及日常習慣方面之結果是否具有顯著差異。本研究以收40位研究對象的不同眼調節測試之數據,再以SPSS V.25統計分析軟體做資料分析,獲得以下結論:
1. 將年齡分組分別測量調節幅度-移遠法、調節幅度-推近法、調節幅度-負鏡片法,由統計數據顯示右眼、左眼以及雙眼之調節幅度移遠法與年齡達到顯著差異。此結論與Hofstetter(1947)公式換算相呼應,即調節會隨著年齡增加而下降。
2. 南部地區青壯年以不同調節相關之檢測法測量,其中以融合交叉圓柱鏡、負相對性調節以即正相對性調節與Morgan期望值達到顯著差異。推論可能是現今人們和Morgan期望值測試年代(1944)相較更多活動處於室內進行(例如:辦公、課業…等等),進而導致調節測量結果大不相同。
3. 將高度近視與非高度近視分組分別測量相關之調節機能檢測,由統計數據顯示高度近視與非高度近視之融合交叉圓柱鏡有達顯著差異。從數據可得非高度近視平均值為0.295(D),高度近視平均值為0.500(D),其結果推論為高度近視調節較為落後(調節遲滯)。
Long-term close look is one of the main causes of myopia. According to the National Health Interview Survey conducted by the Ministry of Health and Welfare in 2017, children under 12 years old with myopia spend more time on "using computers, surfing the Internet or playing video games" and "using mobile phones, tablets or other electronic products" whether it is weekdays or holidays than children without myopia; among indicators, in the indicator of "using computers, surfing the Internet or playing video games", the gap between the number of children with myopia and those without myopia is doubled.
In addition, children with myopia spend less time participating in "outdoor activities" than children without myopia. However, with the rapid advancement of science and technology, people need to have close looks for a long time in many workplaces and living environments, resulting in an increasing number of patients with sore and tired eyes. Therefore, this Study focuses on the detection of ocular accommodation ability and uses different detection methods to explore whether there are significant differences in the accommodation ability, expectations and daily habits of age 20 to 39. In this study, the data of different ocular accommodation tests of 40 research objects are collected, and the data are analyzed with SPSS V.25 statistical analysis software, and the following conclusions are obtained:
1. Group research objects by age and measure them by pull-away method, push-up method and minus to blur method; and the statistics results indicate that there have significant differences between pull-away method of right eyes, left eyes and both eyes and their ages. This conclusion echoes the Hofstetter (1947) equation conversion, that is, the ocular accommodation will decline with ages.
2.Young and middle-aged adults in the southern region of Taiwan are measured by different accommodation-related detection methods, among which the fusion of fused cross cylindrical, negative relative accommodation, and positive relative accommodation are significantly different from Morgan's (1944) expected value. It is inferred that people nowadays are doing more activities indoors (such as working in offices, study at school…, etc.) which lead the measurement results have big differences.
3.Group high myopia and non-high myopia to measure the relevant accomodation function tests, and the statistical data shows that there is a significant difference between the high myopia and non-high myopia fusional cross cylindrical test. From the data, the average value of non-high myopia is 0.295(D), and the average value of high myopia is 0.500(D). The result is presented that the ocular accommodation of high myopia is relatively behind (lag of accommodation) than non-high myopia.
誌謝 i
摘要 iii
Abstract v
目錄 vii
圖目錄 xi
表目錄 xii
專有名詞中英文對照表 xvii
第一章 緒論 1
1.1研究背景與動機 1
1.2研究目的 2
1.3名詞解釋 2
1.4研究流程 4
第二章 文獻回顧 5
2.1近視相關文獻 5
2.1.1近視世界分布 6
2.1.2國內近視盛行率 8
2.2調節相關文獻 11
2.2.1不同人眼調節測量方式 12
2.2.2兒童調節異常 13
2.3環境造成的近視 14
2.3.1COVID-19爆發期間大陸地區小學生的近視發展率 15
2.3.2 3C環境帶來的視覺疲勞 16
第三章 研究設計與實施 17
3.1研究架構表 17
3.2研究對象及資料來源 18
3.2.1倫理審查 18
3.2.2研究對象 18
3.2.3研究對象篩選標準 18
3.3研究工具 19
3.3.1基本個人資料檢測紀錄表 19
3.3.2研究設備 21
3.4數據蒐集研究地點及時間 26
3.5研究操作流程 26
3.6研究實驗項目及流程 30
3.7研究統計方法 37
3.7.1各參數之描述性統計分析 37
3.7.2各參數之單因子雙異數分析(ANOVA):獨立樣本分析 37
3.7.3各參數之單一樣本t檢定分析 37
3.7.4各參數之獨立樣本t檢定分析 37
第四章 資料分析結果與討論 38
4.1各參數之描述性統計分析 38
4.1.1基本資料數目分布 38
4.2各年齡與不同調節幅度評估方式參數之單因子變異數分析(ANOVA) 43
4.2.1調節幅度參數分析(右眼移遠法) 43
4.2.2調節幅度參數分析(左眼移遠法) 45
4.2.3調節幅度參數分析(雙眼移遠法) 47
4.2.4調節幅度參數分析(右眼推近法) 49
4.2.5調節幅度參數分析(左眼推近法) 51
4.2.6調節幅度參數分析(雙眼推近法) 53
4.2.7調節幅度參數分析(右眼負鏡片法) 55
4.2.8調節幅度參數分析(左眼負鏡片法) 57
4.3各調節相關參數與MORGAN期望值之單一樣本T檢定分析 59
4.3.1調節相關參數分析(融合交叉圓柱鏡) 59
4.3.2調節相關參數分析(負相對性調節) 60
4.3.3調節相關參數分析(正相對性調節) 60
4.4不同用眼習慣與調節幅度機制參數之單因子雙異數分析(ANOVA):獨立樣本分析 61
4.4.1不同用眼習慣(每日近方工作最常看的物品)之調節相關參數分析 61
4.4.2不同用眼習慣(每日工作最常使用的工作距離)之調節相關參數分析 70
4.4.3不同用眼習慣(每日工作需要近距離用眼時間)之調節相關參數分析 79
4.5高度近視與非高度近視者的調節機能參數之獨立樣本T檢定 88
第五章 結論與建議 94
5.1結論 94
5.2研究限制與建議 95
參考文獻 96
附錄一 101
附錄二 103
附錄三 108
中文部分
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英文部分
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Morgan Jr, M. W. (1944).The clinical aspects of accommodation and convergence. Optometry and Vision Science, 21(8), 301-313.
Ramamurthy D, Lin Chua SY, Saw SM. A review of environmental risk factors for myopia during early life, childhood and adolescence. Clin Exp Optom. 2015 Nov;98(6):497-506. doi: 10.1111/cxo.12346. Epub 2015 Oct 25. PMID: 26497977.
Rose KA, French AN, Morgan IG. Environmental Factors and Myopia: Paradoxes and Prospects for Prevention. Asia Pac J Ophthalmol (Phila). 2016 Nov/Dec;5(6):403-410. doi: 10.1097/APO.0000000000000233. PMID: 27898443.
Sankaridurg P, Tahhan N, Kandel H, Naduvilath T, Zou H, Frick KD, Marmamula S, Friedman DS, Lamoureux E, Keeffe J, Walline JJ, Fricke TR, Kovai V, Resnikoff S. IMI Impact of Myopia. Invest Ophthalmol Vis Sci. 2021 Apr 28;62(5):2. doi: 10.1167/iovs.62.5.2. PMID: 33909036; PMCID: PMC8083082.
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Tsai TH, Liu YL, Ma IH, Su CC, Lin CW, Lin LL, Hsiao CK, Wang IJ. Evolution of the Prevalence of Myopia among Taiwanese Schoolchildren: A Review of Survey Data from 1983 through 2017. Ophthalmology. 2021 Feb;128(2):290-301. doi: 10.1016/j.ophtha.2020.07.017. Epub 2020 Jul 15. PMID: 32679159. 
網路部分
1.創市際市場研究顧問(2017)。台灣網路使用概況調查。取自:
https://www.ixresearch.com/reports/cati
2.衛生福利部國民健康署(2018)。近視歷年流行病學調查結果。取自:
https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=609&pid=1084
3.賴裕源(2011)。調節力異常及處理。取自:
https://blog.xuite.net/alphavision/twblog/122906552#
4.諾貝爾醫療集團 / 諾貝爾圖書館。第十三章眼視光學基本概念(2007)取自:
https://www.nobelgroup.com.tw/pastense/page01_2.php?branchnum=BOOK06&sortid=14
5.調節幅度、計算、結果解讀、調節幅度(2020)。取自:
https://hacker1356.wordpress.com/2020/11/27/調節幅度、計算、結果解讀/
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