国府台病院眼科における知的障害者専門外来：開設後10年の状況

Ten-year review of clinic for intellectual developmental disorders at the Department of Ophthalmology, Kohnodai Hopital

要約　目的：知的障害者の眼科専門外来開設後10年の診療状況を報告する。

方法：受診時年齢，知的障害の原疾患，眼科的主訴，眼科的診断，治療とその結果を検討した。

結果：総数は239名で，初診時16歳以上が半数を占めた。原因不明例が多く，ダウン症，脳性麻痺，自閉症などが続いた。主訴は視力低下，眼位異常，眼瞼下垂，外眼部の異常で，白内障（63例），網膜剝離（17例），斜視（67例）の診断が確定した。27例の白内障術後には8割以上で視力が改善した。

結論：知的障害者が受診しやすい環境作りと丁寧な検査により確定診断や適切な治療法選択につながった。視力向上がみられる症例も多く，眼科専門外来は知的障害者のQOL向上に貢献していると考えた。

Abstract　Purpose: To present a review of the clinic specialized in intellectual developmental disorders that was opened 10 years ago at the Department of Ophthalmology, Kohnodai Hospital.

Method: Data were evaluated regarding the age at the first visit, diseases underlying developmental disorders, chief complaints, ophthalmological findings, diagnoses and outcome of treatment. The review was based on medical records.

Result: A total of 239 patients visited the clinic over the past 10 years. More than half were over 16 years of age. Intellectual disorders of unidentified causes were present in 73 cases（30％）, followed by Down syndrome in 67 cases（28％）, sequelae of trauma or infection in 51 cases（21％）, pervasive developmental disorders including autism in 48 cases（20％）among others. Chief complaints included impaired vision, strabismus, blepharoptosis, and disorders of conjunctiva or eyelid. Cataract was present in 63 cases, strabismus in 67, and retinal detachment in 17. Visual acuity improved in 80％ of cases after cataract surgery.

Conclusion: Careful examination in comfortable environment was essential in the correct diagnosis and therapeutic regimen in patients with intellectual disorders. Our clinic for intellectual developmental disorders made significant contributions to improve the quality of life in persons with intellectual disorders.