浅前房をきたしたエアーガンによる眼外傷の1例

A case of shallow anterior chamber following blunt trauma by an air gun pellet

　11歳男児の右眼にエアガンの弾丸が命中し，視力低下で救急受診した。右眼視力は手動弁で，眼圧は右7mmHg，左10mmHgであった。右眼に前房出血があった。受傷翌日に右眼視力は回復したが，−5Dの近視があり，右眼圧は5mmHgに低下した。前房深度は右2.24mm，左3.74mmであった。超音波生体顕微鏡（UBM）検査で右眼の隅角に毛様体解離があった。プレドニゾロン内服を行い，受傷から2週後に眼圧は正常化し，前房深度の左右差が消失した。受傷1か月後のUBM検査で毛様体解離は消失していた。隅角検査ができない外傷性浅前房にはUBM検査が有用であることを示ず症例である。

A 11-year-old boy was hit in his right eye by an air gun pellet. Immediately after the accident, the affected eye showed hyphema and visual acuity of hand motion. The intraocular pressure (IOP) was 7mmHg right and 10mmHg left. The next day, his visual acuity recovered to 1.0 corrected by -5 diopters. The IOP in the right eye was 5mmHg. The depth of the anterior chamber was 2.24mm right and 3.74mm left. Ultrasound biomicroscopy (UBM) showed cyclodialysis in the affected eye. Treatment with systemic prednisolone resulted in normalization of IOP and anterior chamber depth 2 weeks later. Cyclodialysis had disappeared when examined by UBM 1 month after the injury. This case illustrates that UBM may be effective in posttraumatic shallow anterior chamber as an alternative to gonioscopy.