三歳児眼科一次健康診査における視機能異常検出に有用な問診項目の検討  [in Japanese] Evaluation of Questionnaire Items Useful for Visual Impairment Detection in a Primary Eye Checkup for 3-year-old Children  [in Japanese]

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Author(s)

    • 田村 省悟 Tamura Shogo
    • 九州保健福祉大学 保健科学部 視機能療法学科 Department of Orthoptics and Visual Science, School of Health Science, Kyushu University of Health and Welfare
    • 内川 義和 Uchikawa Yoshikazu
    • 国際医療福祉大学 保健医療学部 視機能療法学科 Department of Orthoptics and Visual Science, School of Health Science, International University of Health and Welfare
    • 岡野 真弓 Okano Mayumi
    • 国際医療福祉大学 保健医療学部 視機能療法学科 Department of Orthoptics and Visual Science, School of Health Science, International University of Health and Welfare
    • 鬼塚 信 Shin Onituka
    • 九州保健福祉大学 保健科学部 視機能療法学科 Department of Orthoptics and Visual Science, School of Health Science, Kyushu University of Health and Welfare

Abstract

<p><b>【目的】</b>三歳児眼科健診において視機能異常を検出するのに有用となる一次健診での問診項目を明らかにするために、三次健診で検出された視機能異常と問診結果との関連を検討した。</p><p><b>【対象及び方法】</b>対象は2011年4月から2013年3月までに延岡市三歳児眼科健診の一次健診、二次健診を受診した児1223名とした。一次健診では、保護者が家庭にて視力検査、問診票の記入を行った。一次健診の問診結果、三次健診で検出された視機能異常を後ろ向きに調査し、視機能異常を従属変数、問診項目を独立変数としたロジスティック回帰分析を行った。</p><p><b>【結果】</b>問診項目「目が寄ったり、外や上にずれたりすることがありますか。」が眼位異常(p<0.01、オッズ比:191.86、95%信頼区間:41.58-885.22)および屈折異常(p=0.02、オッズ比:6.54、95%信頼区間:1.30-32.78)と有意に関連した。屈折異常が検出された児のうち、本問診項目に該当した児は全て眼位異常を有していた。「極端にテレビなどに近づいて見ますか。」が視力障害と有意に関連した(p<0.01、オッズ比:4.38、95%信頼区間:1.55-12.37)。</p><p><b>【結論】</b>眼位異常の検出には視線のずれに関する問診項目、視力障害の検出にはテレビの視聴距離に関する問診項目が有用であることが明らかとなった。</p>

<p><b>[Purpose] </b>To determine the usefulness of the items of a questionnaire for visual impairment detection in a primary eye checkup for 3-year-old children, we investigated the association between the visual impairments detected in a tertiary checkup and the questionnaire results.</p><p><b>[Subjects and Methods] </b>Subjects included 1223 children who had completed the primary and secondary eye checkups between April 2011 and March 2013. The primary checkup was a visual acuity test conducted at home by the parents who also filled out a questionnaire. We retrospectively analyzed the results of the questionnaire from the primary checkup and the final outcomes of the tertiary checkup. Visual impairments as dependent variables and the questionnaire items as independent variables were analyzed by logistic regression analysis.</p><p><b>[Results] </b>The response to the question "Do you detect any misalignment (inward, outward, or upward) in your child's gaze?" was significantly correlated with eye position abnormality (<i>P </i>< 0.01; odds ratio, 191.86; 95% confidence interval, 41.58-885.22) and refractive error (<i>P</i> = 0.02; odds ratio, 6.54; 95% confidence interval, 1.30-32.78). In the children detected with refractive error, those with corresponding questionnaire responses were all detected with eye position abnormality. The response to the question "Does your child watch television from an extremely close distance?" was significantly correlated with visual loss (<i>P</i> < 0.01; odds ratio, 4.38; 95% confidence interval, 1.55-12.37). </p><p><b>[Conclusion] </b>Our results suggested that questionnaire items regarding misalignment of gaze can be useful for detecting visual impairments related to eye position abnormality, and that the questions on television viewing distance can be useful to detect visual loss.</p>

Journal

  • JAPANESE ORTHOPTIC JOURNAL

    JAPANESE ORTHOPTIC JOURNAL 47(0), 161-166, 2018

    JAPANESE ASSOCIATION OF CERTIFIED ORTHOPTISTS

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