先天性眼瞼下垂と視機能

Visual function in congenital blepharoptosis

　先天性眼瞼下垂96例192眼に対し視力，屈折，眼位などにつきretrospectivestudyを行い以下の知見を得た．

1）健眼遮閉は96例中24例（30％）に行った．最終受診時に0.5以下の視力障害を示したものは192眼中21眼（11％）であった．

2）顕性斜視は96例中17例（18％），不同視は96例中37例（39％）に認めた．

3）視力と下垂の程度手術時期に関係はなかった．

4）0.5以下の視力障害は不同視弱視，屈折性弱視，斜視弱視によるものが多かったが視性刺激遮断弱視はなかった．

5）以上の結果より，視性刺激遮断弱視の発生をおそれて手術を急ぐ必要はないと考えた．屈折異常，斜視を高率に合併するので，それらを可能な限り早期に診断・治療する必要があると考えた．

We evaluated a consecutive series of 96 cases with blepharoptosis. Blepharoptosis was bilateral in 17 and unilateral in 79 cases.

Amblyopia, or visual acuity of 0.5 or less at the last visit, was present in 21 eyes (11%). Occlusion therapy of the healthy eye had been performed in 24 eyes. The visual acuity was not dependent on the severity of ptosis nor on the time of surgery.

Anisometropia was present in 37 cases (39%). Strabismus was present in 17 cases (18%).

While anisometropia, hypermetropia and strabis-mus were the main causes of amblypia, we observed no case of form vision deprivation amblyopia. Early surgery is, therefore, not necessary for congenital blepharoptosis. Refractive erros and strabismus, on the other hand, should be checked at an early age because of their high incidence and visual implica-tions.