Abstract: Objective To  detect the refractive status of the 40 to 49 years old outpatients by cycloplegic refraction and the correction and to explore the method to improve the visual fatigue and symptoms of dry eye. Methods 30 visual  fatigue outpatients (60 eyes) with complaints of sore eye,dry eye,blurred vision，aged  40 to 49 years old  (average 44.43 years) were selected,11 patients were male and 19 patients were female;the other diseases such  as glaucoma,cataract,ocular fundus were ruled out after routine eye examination. The patients had no surgical and wearing myopia,hyperopia and astigmatism glasses history. Mydriasis refraction was porformed after conventional optometry,and the SchirmerⅠtest,tear film break-up time(BUT) detection and corneal fluorescent staining were performed simultaneously. 43 eyes of 30 patients had a visual acuity of ≥ 0.8,and 17 eyes were between 0.4 and 0.6. Results Among all patients,37 eyes presented －0.25DS to －1.25DS with conventional refraction,36 eyes showed +0.50DS to +1.50DS after dilation;22 eyes presented 0.00DS to +1.25DS before dilation and 21 eyes showed+0.50DS to +1.50DS after dilation;27 eyes were diagnosed as moderately dry eye and 33 eyes were slightly dry eye. Conclusion Patients aged 40-49 years old with normal or close to normal results in conventional inspection still have considerable accommodation ability. There may exist hyperopia or hyperopic astigmatism in the patients with visual fatigue,dry eye and even a special face (frown). The examination results often exist error that is easily overlooked before dilation. The sore eye,dry eye,blurred vision and other visual fatigue symptoms in 30 patients (60 eyes) are significantly improved after optometry and optician. Therefore optometry after mydriasis and wearing glasses should be noted in the treatment of dry eye,that is the fundamental solution to relieve the symptoms of ocular discomfort completely.

Key words: refractive errors, visual fatigue, accommodation ability, dry eye