微小斜视弱视的诊断和治疗

Diagnosis and treatment of microtropie amblyopia

47例4～15岁儿童微小斜视性弱视是从常规遮盖治疗的单眼弱视效果不好的患者中筛选的。双眼单视时，中心抑制性暗点的存在是诊斯本病的要点。比较四种检查暗点的方法，以4^△棱镜穆位试验法阳性率高，且设备简单、操作容易而快速，优于其他三种方法，是筛选儿童弱视的一种理想手段。应用棱镜检查，本组病例的微小斜视的水平范围在2^△～12^△，平均5．7^△±3．6^△。采用同视机闪烁脱抑制消除暗点加遮盖法治疗弱视，治愈率为53．2％，治疗有效率为77％。影响顶后的关键问题是暗点的抑制程度及时间，因此早期脱抑制治疗，尤其早期矫正屈光参差是治疗和预防这类弱视的关键环节。

47 cases of mierotropia 4～15 years of age were selected from monocular amblyopia cases that did not respond to the occlusion treatment. The presence of central suppression scotoma was the basis for diagnosis. The 4-diopter prism test, though simple and quick, yielded the highest positive rate (100%) in allexaminations. Hence it was an ideal means for screening amblyopia in children. The magnitude of microtropia detected by the prism test was 5.7~△±3.6~△. The efficacy of treatment with amblyoscope plus occlusion was 77%. The discovery and treatment for anisometropia and microtropia should be as early as possible for better prognosis. The measures for the prevention of microtropia were discussed.