Departmental Bulletin Paper 弱視を早期発見するための効果的な幼児眼科健康診断プログラム策定準備の基礎調査
Basic Research on the Development of Infant Ophthalmological Examination Program for Early Amblyopia Detection

石井, 雅子  ,  谷, 佳子  ,  進藤, 真紀  ,  阿部, 春樹  ,  Ishii, Masako  ,  Tani, Yoshiko  ,  Shindo, Maki  ,  Abe, Haruki

130 ( 3 )  , pp.184 - 190 , 2016-03 , 新潟医学会
弱視は, 早期発見が重要で小学校に入学してから発見されても, よい治療効果が期待できない. 視力不良の発見が早ければ, 弱視の発生を未然に防止でき, 治療効果は高くなる. 幼児期の眼科健診は重要である. 幼児期の視機能の管理の徹底を目指すことを目的とした. 新潟市北区の幼稚園および保育園(保育所)27園を対象とした. 視力検査の実態調査から検査環境の設営, カード式ランドルト環の破損や汚れ, 視標の呈示方法, 視力値の判定に改善が必要と判断された. 眼科健診のアンケート調査から視力検査は幼稚園では5園中3園(60.0%), 保育園では22園全園(100%)が実施していた. 園内における視力検査では検者の技術面, コミュニケーション面, 物理的・時間的な面, 被検児の理解力や集中力の面での困難が挙げられた. 幼児眼科健診のプログラムには視力検査の実施が不可欠であり, 全園児に対して視力検査が実施されることが望まれる. 園内の視力検査の精度を向上させることが最も重要であると考えられた.
Good effective treatment of amblyopia cannot be expected even when discovered after joining elementary school, early detection is important. If poor visual acuity is discovered early, amblyopia can be prevented and effectiveness of treatment increases. Ophthalmological examination in early childhood is important. The purpose of this study was to aim at thorough management of visual function in early childhood. 27 kindergartens and nursery schools in Kita ward of Niigata city were considered. Visual acuity examination had been conducted in 3 out of the 5 kindergartens (60%) and all the 22 nursery schools (100%) from the questionnaire survey of ophthalmological examination. For the visual acuity test, problems on the aspects of communication, physical and temporal, technical skills of the examiner, understanding of the person under examination and ability to concentrate were mentioned. From the fact finding mission, it was determined that improvements were required in the preparation of the visual acuity test environment, damage or soiling of the card type Landolt ring, and presentation method of the vision chart. Implementation of visual acuity test is essential for the infant opthalmological examination program, so visual acuity test should be enforced to all infants. It is most important to improve the accuracy of visual acuity test.

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