驗光師法於2015年12月18日通過法案，低視力服務現已將視光學專業納入，包括低視力評估及屈光矯正。研究者在執業期間及發現許多低視力患者的屈光異常狀態常常沒有受到良好的照護，使得低視力患者無法善用殘餘視力，進而影響其它光學輔具的選擇及光學處置。因此，本研究旨在於探討致低視力患者視覺障礙眼疾、視覺症狀，以及低視力患者的屈光異常狀況，並且研究屈光矯正後視力的變化，最後探討屈光異常矯正與等校視度及其它光學輔具選擇狀況。
本研究共有221名參與者，年齡介於7至99歲(51.41±18.51)，均來自衛生福利部輔具資源中心之個案。共有120名男性（54.3％）和101名 女性（45.7％）; 42名（19.0％）輕度視覺障礙，76名（34.4％）為中度，103名（46.6％）為重度。以五名經驗豐富且有執照的驗光師負責全面的低視力檢查。使用SPSS 22軟體（IBM），描述性統計，Pearson X2，勝算比和相依樣本t檢驗進行統計學分析。
本研究最常見的眼疾是視網膜相關疾病、視神經相關疾病及青光眼，一些參與者甚至同時有兩種以上的眼疾。毫無疑問，除了造成視力問題，眼疾會導致多種視覺症狀，例如視網膜色素變性會導致畏光與眩光、對比敏感度異常、辨色能力異常、明暗適應困難或者視野缺損。屈光異常方面，本研究有186位(84.2%)屈光異常，但有配戴慣用眼鏡的只有80位(43.0%)、106位(67.4%)沒配戴慣用眼鏡。屈光異常矯正後有139位(74.7%)參與者視力可提升，其中有43位(61.4%)的參與者屈光異常矯正後視力優於原慣用眼鏡，且視力屈光異常矯正前後在統計上有顯著差異(t=7.29, p<.001)。此外，即使屈光異常矯正後視力無法提升(N=47, 25.3%)，依然有超過3成5的參與者需要複合特殊功能的特製眼鏡。視力的提升導致等校視度的降低(+17.0D降至+10.0D)，使得第二光學輔具有更多的處置選擇。
錯誤或不足的屈光異常矯正不僅常見於低視力患者，甚至被低視力患者本身或評估人員給忽略，本研究即發現有高比例的低視力患者沒有受到良善的視光照護。正確的屈光異常矯正不僅可提升視力，更可以降低等校視度、獲得更大視野、或者更舒適的工作距離，可以說是低視力生活重建的基礎。因此，屈光矯正不僅在視力提升上扮演絕對重要的角色，同樣也能正面影響著低視力光學輔具的處置。

Since optometric license had just been legislated on 18th Dec, 2015 in Taiwan, low-vision service, including refractive correction and low vision assessment, are now included in optometric profession. During the practice period, the researchers found that the refractive error of many low vision patients are often not well cared for, making it impossible for low vision patients to make good use of residual vision, which in turn affects the choice of other optical aids and optical prescriptions.This study aims to understand the prevalence of ophthalmologic eye diseases and visual symptoms, and to study the refractive correction efficiency of patients with low vision, and equivalent viewing power, and optical devices use for patients with low vision.
There were totally 220 participants aged from 7 to 99 (51.41±18.51) who were all referred from Taiwan Resource Portal of Assistive Technology, the Ministry of Health and Welfare. There were 120males (54.3%) and 101 females (45.7%); 42(19.0%) participants were identified as mild visual impairment, 76(34.4%) were moderate, and 103(46.6%) were severe. Five experienced and licensed optometrists were responsible for comprehensive eye examination. Statistical analyses were performed by using the SPSS 22 package (IBM), descriptive statistic, Pearson X², odds ratio, and paired sample t test.
The most common eye diseases in this study are retinal-related diseases, optic nerve-related diseases, and glaucoma. Some of participants even suffered more than two kinds of eye diseases. Unquestionably, except visual acuity decrease, eye diseases can cause a variety of visual symptoms, such as retinitis pigmentosa, which can lead to photophobia and glare disability, contrast sensitivity problems, color vision deficit, difficulty in adapting to light and dark, or visual field loss. In terms of refractive error, there were 186 (84.2%) refractive errors in this study, but only 80 (43.0%) participants wearing glasses and 106 (67.4%) participants did not wear glasses. After refractive errors correction, 139 (74.7%) participants had improved visual acuity, and 43 (61.4%) had better visual acuity after refractive correction than the original glasses. There was a statistically significant difference between before and after refractive errors correction of visual acuity (t =7.29, p<.001). In addition, even if the visual acuity is not improved after refractive error correction (N = 47, 25.3%), there are still more than 36.2% of the participants need special glasses for special functions. The visual acuity improvement leads to a decrease in the equivalent viewing power (+17.0D to +10.0D), which makes the second optical aid have more disposal options.
Incorrect or insufficient refractive errors correction are not only often found in patients with low vision, but are often overlooked by patients themselves or evaluator. This study found that a high proportion of patients with low vision were not well visually cared for. Visual acuity improvement through refractive correction might also apply lower equivalent viewing power needs, lager field of view, or more ergonomics working distance at the same time. Refractive correction not only plays an absolutely important role in vision improvement, but also positively affects the disposal of low vision optical aids.

第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的與待答問題 2
第三節 名詞解釋 3
第二章 文獻探討 7
第一節 低視力之定義與低視力患者的生活 7
第二節 常見致視覺障礙之眼疾 12
第三節 低視力患者常見之視覺症狀 28
第四節 低視力患者的視覺功能與相關檢查 34
第五節 光學輔具 43
第三章 研究方法 51
第一節 研究設計與架構 51
第二節 研究對象 53
第二節 研究工具與檢查項目 54
第三節 資料處理與分析 61
第四章 研究結果 63
第一節 致視覺障礙眼疾與視覺症狀 63
第二節 屈光狀態、屈光矯正、視力與視覺症狀 78
第三節 屈光異常矯正與等效度視數及其它光學輔具選擇 93
第五章 結論與建議 99
第一節 研究結論 99
第二節 研究限制 105
第三節 研究建議 104
參考文獻 107
一、中文部分 107
二、英文部分 108
附錄一 133

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