| 目的：卡洞法在以往的研究中被认为是测量优势眼的金标准，但在最近国内大力推倡的医学验光中则主张采用习惯屈光矫正下的Worth 四点法测量优势眼眼别。对这两种方法以及在不同屈光状态下测量的优势眼眼别的关系尚罕有明确报道。本实验通过分析性横断面研究Worth四点法测量优势眼与卡洞法测量优势眼的相关性，并分别研究屈光度的矫正与否对这两种方法在视远5米距离优势眼眼别测量的影响。方法：在2004年7月与12月间，共428个来本院经过眼前后段检查均为正常的屈光门诊验光者，双眼矫正视力均≥1.0，并且两眼的最佳矫正视力差别均小于2行；年龄平均：16.00±8.49岁；双眼中右眼等效球镜平均-2.32±1.88D，左眼等效球镜平均屈光度-2.20±1.93D。分别测量两种方法（卡洞法与Worth四点法）及在两种条件下（习惯矫正方式与屈光全矫下）的优势眼眼别，使用SPSS11.5统计软件包的卡方检验各组数据的差异与相关性。 结果：Worth四点法和卡洞法两种方法测得优势眼在习惯屈光矫正下无显著差异（n=61，P>0.05），也无显著相关性（P>0.05）；在屈光全矫下两种方法存在显著差别（n=140， P=0.001），但无显著相关（P>0.05）; 而卡动法在两种条件下测量的优势眼眼别差异显著（n=61，P<0.0001），并且存在显著相关（r=0.782，P<0.0001）;Worth 四点法在两种条件下测量的优势眼眼别存在显著差异（n=62， P<0.0001），并且两者显著相关（n=62，r=0.517，P<0.0001）。 结论：屈光矫正方式显著影响优势眼的测量结果；Worth四点法与卡动法测量的优势眼别无关；医学验光采用何种方法测量优势眼尚需进一步研究。
[Abstract:] Objective: Hole-in-the-Card test is thought the golden standard to exam ocular dominance in previous study. However, recent study suggest it’s Worth 4 dot test under habitual correction that may be used more benefit for the medical refraction in optometry routine clinic and before laser surgery. Since seldom has done such as comparing these two methods under two corrected correction, we evaluated the agreement of ocular dominance tested by Worth 4 dot method and hole-in-the-Card method, under habitual correction and full correction. Methods: 429 subjects were recruited from our eye center clinic during July to December of 2004. And all of them were screen resulting as healthy , none of them having amblyopia with every eye’s BCVA ≥1.0, average age 16.00±8.49years old, average sphere equivalent -2.26±1.89D。 Ocular dominance was determined using hole-in-the-card test and Worth 4 dot test, and under habitual correction and full correction. Results: Under habitual correction, there was neither significant difference(P=0.346) nor significant correlation(P=0.718)between the two methods; while under full correction, Worth 4 dot test significantly differed from hole-in-the-card test(P=0.001), but still no significant correlation(P=0.164); Habitual correction and full correction of either test was significant difference(P<0.0001, P<0.0001) and significant correlation (P<0.0001, P<0.0001). Conclusion: Refractive error correction can effect in judging ocular dominance. So does Worth 4 dot test differs to card-in-the-hole test .
[Key words:] ocular dominance︱ Worth 4 dot︱hole-in-the-card
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