周期性要素のある調節性内斜視に外斜視を合併した1例

A case of exotropia following periodic and intermittent accommodative esotropia

要約　目的：周期性で間欠性の要素がある調節性内斜視が外斜視に移行した症例を報告する。症例：3歳7か月の女児が，初診から2年間は，2～5か月の周期での間欠性内斜視を呈した。右眼に＋5.0D，左眼に＋6.5Dの遠視があり，眼鏡を装用させた。その3年後から外斜位になる傾向が生じ，さらに4か月後には眼鏡装用中は外斜位，非装用時には内斜位になった。初診から8年後の現在，右眼に＋1.25D，左眼に＋3.5Dの眼鏡装用で，近方視と遠方視ともに正位を保っている。結論：調節性内斜視は，遠視の減少に伴い外斜視になることがある。

Abstract.　Purpose：To report a case who became exotropic after initial accommodative esotropia with periodic and intermittent factor. Case：A girl was seen by us at the age of 3 years 7 months. During the following 2 years, she showed intermittent esotropia with an interval of 2 to 5 months. She was found hypertropic and was prescribed eyeglasses of ＋5 diopters right and ＋6.5 diopters left. She showed a tendency to become exotropic 3 years later. Another 4 months later, she became exotropic while wearing eyeglasses and esotropic when not. She was prescribed eyeglasses of ＋1.25 diopters right and ＋3.5 diopters left 8 years after her initial visit. She is currently orthophoric both for near and far when wearing the eyeglasses. Conclusion：Patients with accommodative esotropia may become exotropic along with reduction in the amount of hyperopia.