先天緑内障術後の視能訓練

Orthoptic training after surgery for congenital glaucoma

　先天緑内障の術後管理では，視能訓練が必要である。眼圧コントロールが良好でも，適切な視能訓練がされないままに放置された症例では機能弱視に陥る傾向が強く，視力予後が不良になる場合が多い。我々は先天緑内障術後患者の視力を早期より測定し，視力に左右差が認められた症例に対し視能訓練を施行し，弱視化の予防に有効であった。

We evaluated the course of visual acuity in 13cases operated for congenital glaucoma. The condi-tion was unilateral in 6 cases and bilateral in 7. Thepatients were aged between 3 days and 32 monthsafter birth when diagnosed. We employed the pref-erential method among others in assessing thevisual acuity.

We noted a definite tendency for the patients tobecome functionally amblyopic even after surgeryand normalization of intraocular pressure when nofurther proper measures were taken. We treated 5patients in the series by conventional amblyopiatherapy including occlusion. All the treated 5 casesresponded favorably to the treatment as regardsthe final visual acuity.

We postulate that functional amblyopia can be acause for visual handicap after surgery for congeni-tal glaucoma. In the postoperative follow-up ofcongenital glaucoma, therefore, it is essential tocheck the visual acuity even in children under oneyear of age. Treatment for amblyopia is to bepromptly instituted whenever seemed necessary.