低調節性輻輳過剰

Hypoaccommodative convergence excess

　調節力が低下しているために近見時に異常に努力して調節し，そのため過剰の輻輳が生じ，遠見での斜視角はわずかであるが，近見では強い内斜視になるhypoaccommodative convergenceexcessと思われる2例について報告した．

　調節力低下の原因として弱視の既往が関与していることが示唆された．治療としては，近用の凸レンズ付加の二重焦点眼鏡装用により症状の改善が認められた．

We diagnosed and treated two cases with hypoaccom-modative convergence during the foregoing 3 years. Both were aged 10 years when first seen by us. Intermit-tent binocular diplopia and blurring of vision during near work were the cardinal complaints. They solved their problems by removing everything that can he seen from their vicinity. As common clinical features, both cases manifested slight degrees of amblyopia in one eye, remoteness of near point of accommodation, minimal refractive error and esodeviation which is larger at near than at far distance. A high AC/A ratio was the logical consequence.

We treated both cases by prescribing bifocal lenses and regular instillation of miotics to reduce the high AC/A ratio. The esodeviation was treated by surgicalmeans. The deviations were completely corrected. In our present cases, the presence of amblyopia seemed to have triggered the convergence excess. Excessive convergence seemed to be a response to compensate for defective accommodation in the amb-lyopic eye.

Rinsho Ganka (Jpn J Clin Ophthalmol) 40(9) : 1039-1042, 1986