複視を訴え眼科を受診する患者の原因と特徴

Causes and characteristics of patients who visit ophthalmologists for diplopia

要約　目的：複視があり，眼科をまず受診する患者の原因と特徴の報告。対象と方法：過去3年間に複視を訴え，当眼科を受診した174例を対象とした。最初に受診した医療施設が眼科であるか否かで2群に分け，眼球運動障害，複視の原因疾患，全身随伴症状を調査した。結果：全身随伴症状を伴う複視患者では，15％が眼科を初診し，50％がその他の科を受診していた。外転神経麻痺の患者では71％が眼科を初診した。非外傷性外眼筋麻痺の67％と脳動脈瘤の100％が眼科を初診した。脳梗塞では21％，外傷性眼運動神経麻痺では15％が眼科を初診した。脳腫瘍患者の56％と脳動脈瘤患者の57％に外転神経麻痺があった。結論：複視を訴えて眼科を受診する患者，とくに外転神経麻痺では，悪性疾患または緊急疾患が含まれていることがあるので，注意を要する。

Abstract.　Purpose：To report the causes and characteristics of patients who visit ophthalmologists for diplopia. Cases and Method：This retrospective study was made on 174 cases who complained of diplopia and who were seen by us during the past 3 years. They were divided into two groups：those who first visited an eye clinic and those who visited other medical institutions. They were evaluated regarding oculomotor disturbances,causes for diplopia,and systemic lesions. Results：Out of patients with systemic lesions,15％ initially visited an eye clinic and 50％ visited other institutions. Out of patients with abducens palsy,71％ initially visited an eye clinic. An eye clinic was first visited by 67％ of patients with nontraumatic oculomotor palsy,100％ of cerebral aneurysm,21％ of cerebral infarction,and 15％ of traumatic oculomotor palsy. Abducens palsy was present in 56％ of patients with brain tumor and in 57％ of cerebral aneurysm. Conclusion：Due attention is needed as malignancy or emergency may be present in patients who visit ophthalmologists for diplopia.