The investigation of amblyopic patients detected no abnormalities in 3-years-old health check program

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  • ３歳児健診で視力異常を指摘されなかった弱視症例

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Abstract

We studied patients with amblyopia who were not detected any abnormalities in their eyes in 3-years-old health check program.<br>The subjects were 24 eyes, 15 cases (4-11 years old) treated for amblyopia in Iwate Prefectural Ichinohe Hospital and Iwate Prefectural Central Hospital between January, 1990 and May, 2003. We investigated the age and chief complaint at the initial visit, type of amblyopia, visual acuity, refractive error after cycloplegia, and prognosis of visual acuity. The patients were divided into 18 eyes, 9 cases of refractive amblyopia and 6 eyes, 6 cases of anisometropic amblyopia. Out of 15 patients, health check programs in primary schools detected 10 patients and these results suggested its importance. Visual acuity less than 0.5 without correction at the initial visit was recognized in 17 eyes of 24 eyes (70.8%). Moderate or severe hyperopic astigmatism was most frequent and mixed astigmatism was second under cycloplegia. In 7 eyes with visual acuity more than 0.5 without correction, mild hyperopic or mixed astigmatisms were recognized. Twenty-two eyes showed rule astigmatism and astigmatism more than -2.0 diopters was seen in most of cases. In 13 cases, corrected visual acuities improved beyond 1.0 after treatment.<br>We thought that failure in detection of visual disturbance in 3-years-old health check program is not due to kinds of astigmatism and refractive error but the system itself. Applying objective examination of refractive error and improving the measurement of visual acuity are needed to make 3-years-old health check program more useful.

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