摘要
目的:分析探讨老年人麻痹性斜视的病因诊断及治疗预后。方法:检查斜视患者的33cm和5m眼位、九个方位的眼肌运动情况;对有限制因素者行牵拉试验排查;采用复视像、Hess屏、同视机分析复视性质及受累肌;根据病史采用影像学检查、血生化实验室检查;全身病进行相关科室会诊。结果:本组414例单眼发病399例,双眼发病15例。单一神经麻痹417眼,滑车神经居首位153眼,其后为外展神经135眼,动眼神经129眼;复合神经麻痹12眼。发病原因主要是血管性疾病,其次为眼科手术后斜视,其后有外伤、感染炎症、肿瘤等,此外原因不明者35例。结论:年龄相关的血管性疾病是老年人复视斜视的主要原因或高危险因素,通常治疗预后较好。眼科手术后的斜视应引起眼科医师的重视。影像学诊断和实验室检查可有助临床诊断治疗。
AIM： To analyze and investigate the etiologic diagnosis, treatment and prognosis in the elderly with paralytic strabismus.
METHODS： The eye position in 33cm and 5m and the movement of eye muscles in nine directions of patients who acquired strabismus were examined. Cases with restricted factors by applying traction test were excluded. The diplopia figure, Hess＇ screen and synoptophore were used to analyze the character of diplopia and the involved muscles of strabismus. According to the medical history, image examinations, blood biochemical laboratorial examinations were taken. The consultations were done with related clinics in patients with systemic disease.
RESULTS： In 414 cases, the disturbance occurred in monocular of 399 cases and in binoculus of the other 15 cases. Single nerve was involved in 417 eyes, including trochlear nerve in 153 cases ranking the first. The next involved were abducens nerve in 135 cases, oculomotorius in 129 cases, the combined nerve paralysis in 12 cases. The main causes were vascular diseases, the strabismus after eye operation, trauma, infective inflammation and tumor. In addition, the reasons of 35 cases were unknown.
CONCLUSION： Age-related vascular diseases were the main cause and high risk factor of the elderly with diplopia and strabismus, Strabismus caused by eye operation should be considered seriously by ophthalmologists. Image examinations and laboratorial tests may be helpful for the clinical diagnosis and the treatment of paralytic strabismus,
出处
《国际眼科杂志》
CAS
2006年第5期1190-1191,共2页
International Eye Science
