先天性外涙囊瘻の小学校健診における発現率

Incidence of congenital external lacrimal fistula in elementary schoolchildren

静岡市の小学校での健康診断で，先天性外涙囊瘻の頻度を調べた。対象は4校の児童1,815名で，同じ眼科医が視診，触診，手持ち細隙灯顕微鏡で診察した。先天性外涙囊瘻を30名（1.65％）に認めた。両眼性3名，片眼性27名で，男子15名，女子15名であった。学校別の頻度は1.25～1.79％の間にあった。先天性外涙囊瘻による症状は皆無であり，皮膚瘻孔の自覚もなかった。耳瘻孔の併発が2名，涙囊圧迫で皮膚瘻孔から透明な涙液が逆流するものが19名あり，膿逆流はなかった。本調査は，日本での先天性外涙囊瘻の発現率のめやすとなる。

A survey was conducted to identify congenital external lacrimal fistula among 1,815 pupils in four elementary schools in Shizuoka City. All the pupils were examined by one ophthalmologist by means of ocular inspection,palpation,and hand-held slitlamp microscope. Congenital external lacrimal fistula was detected in 30 children（1.65％）consisting of 15 boys and 15 girls. It was bilateral in 3 and unilateral in 27 children. Its incidence in 4 schools ranged from 1.25％ to 1.79％. Subjective symptoms due to lacrimal fistula were consistently absent. Congenital auricular fistula was present in 2 children with lacrimal fistula. Pressure to the lacrimal sac induced outflow of transparent lacrimal fluid in 19 cases. This survey is expected to serve as a model regarding the incidence of congenital external lacrimal fistula in Japan.