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背景为培养交流技巧,更好的认识自己周围的世界,聋儿需要更多的倚重于视觉功能的正常存在。因此,任何眼部疾病都会对这个过程产生负面的影响,尤其是没能在发病早期发现,影响更大。一些能够纠正和治疗的疾病,如近视和白内障,早期确认将有助于完善语言的发育和培养社会认知能力;还有一些无法纠正和治疗的疾病,如Usher综合征的视网膜色素变性,就需要多方面的适应环境,给予适当的照顾和康复治疗。目的回顾长久以来累积形成的聋儿眼病的科学知识,并评价这些文献的质量,从而更好的诊断和治疗疾病。材料和方法本研究审阅了超过1000篇的文章,其中191篇文章符合本研究的目的,因而被本文引用。总结这些研究,其中95%为描述性研究或个案报道(Ⅲ型或Ⅳ型证据),只有3%是Ⅱ型证据,2%为Ⅰ型证据。结果和结论本研究主要的结论包括以下几点:a)关于聋儿伴发眼病的研究及文献报道总体上循证医学证据的质量不高;b)聋儿眼病的发生率非常高(大约40%～60%),尽管这些疾病可能严重影响儿童交流技能的培养,但往往很多年不被发现;c)聋儿眼病筛查应得到鼓励,一旦耳聋的诊断成立,无论年龄大小,应立即展开专业的眼科检查,而且可能需要在以后的随访中经常复查;d)患儿家属应该通过与相关的专业医师讨论,被告知筛查过程的实质,并通过不同形式、不同语言给予正确的信息指导;e)进行检查的专业医师应该熟悉患眼病的聋儿的需要,并且要敏感地觉察到儿童交流的需要,尤其是进行行为测听检查需要患儿配合时;f)尽管视轴纠正师能够开展绝大多数心理物理学检测(视力和立体视觉检查,眼球运动检查等等),全面的眼科检查仍然需要开展,包括:裂隙灯显微镜检查,带状视网膜检影法,直接和间接检眼镜检查,眼内压测定等等。视网膜电流描记也经常被用来确认Usher综合征的存在;g)对于双重感觉缺陷的儿童,需要进行连续的听力检测以监测听力阈值,完善助听器的使用,对有需要的患儿进行人工耳蜗植入。
Background In order to develop communication skills and better understand the world around them, deaf children need to rely more on the normal existence of visual function. Therefore, any ocular disease will have a negative impact on the process, especially if it can not be found early in the disease and the impact is even greater. Some diseases that can be corrected and treated, such as myopia and cataracts, early confirmation will help to improve language development and develop social cognition; there are some diseases that can not be corrected and treated, such as retinitis pigmentosa of Usher syndrome Need to adapt to many aspects of the environment, giving appropriate care and rehabilitation. OBJECTIVE: To review the scientific knowledge accumulated over the years in the deaf eye diseases and to evaluate the quality of the literature to better diagnose and treat the disease. Materials and Methods This study reviewed over 1,000 articles, 191 of which were for the purpose of this study and are therefore cited here. Of these studies, 95% were descriptive or case-based (type III or IV evidence) and only 3% were type II and 2% were type I. RESULTS AND CONCLUSION The main conclusions of this study include the following: a) The studies and literature reports on eye diseases associated with deaf children generally show low quality of EBM evidence; b) The incidence of eye diseases in deaf children is very high (about 40 % ~ 60%). Although these diseases may seriously affect the cultivation of children’s communication skills, they are often not discovered for many years. C) Eye disease screening should be encouraged in deaf children. Once deafness diagnosis is established, regardless of age, Professional eye examination, and may need to be reviewed at frequent follow-up visits; d) The relatives of children should be informed of the substance of the screening process and given correct information guidance in different forms and languages by discussing with relevant professional physicians ; e) the professional physician performing the examination should be familiar with the needs of the deaf child with eye disease and sensitively aware of the need for children’s communication, especially if behavioral audiometry is required for children; f) For the vast majority of psychophysical tests (visual acuity and stereovision, eye movement examinations, etc.), a comprehensive ophthalmologic examination is still required, including: slit lamp microscopy, tape visualization Retinal retinoscopy, direct and indirect ophthalmoscopy, intraocular pressure measurement and so on. Retinal electrocardiography is often used to confirm the presence of Usher’s syndrome. G) For children with double-perceived deficits, continuous hearing testing is required to monitor hearing thresholds and improve the use of hearing aids. Cochlear implant Into.