學院

醫學院

系所

職能治療學系

題名

Clinical manifestations in children with congenital epiblepharon with inverted eyelashes = 下眼瞼贅皮併睫毛內翻兒童之臨床表現

作者

謝靜茹 ( HSIEH CHING-JU ) ; 劉秀雯 ( LIOU SHIOW-WEN ) ; 林克忠 ( LIN KEH-CHUNG )

期刊名稱

北市醫學雜誌 v.1 n.2 pp.171-178

發表日期

2004

著作性質

原始論著

語文

英文

關鍵字

眼瞼贅皮(epiblepharon)睫毛內翻(inverted lashes)屈光不正( refractive errors)

系統號

00019844

摘要

目的：下眼瞼贅皮併睫毛內翻常見於東方種怒族的兒童，過去的觀念是此疾病不會有嚴重的症狀，且患童隨著年齡增長、顏面發育，此疾病會日漸改善，此一異常因而易被忽略。本研究探討下眼瞼贅皮併睫毛內翻兒童的臨床表現及屈光變化。方法：研究對象包括四十八名下眼瞼贅皮睫毛內翻的兒童，以及六十名年齡與性別佈配對的正常小學一年級的兒童。臨床組受試的症狀與家族史等資料的收集係以個案的父母或主要照顧者為受訪者。每位臨床受試在角膜螢光染色後，接受裂隙燈顯微照相，以紀錄其角膜傷害的程度。屈光檢查方面，受試者在點以睫狀肌鬆弛劑後，接受自動驗光儀的屈光檢查。組間屈光參數的差異，係以獨立ｔ檢定來進行。結果：臨床組個案中25%有家族史，40%呈現下列臨床症狀：揉眼睛、分泌物、眼痛、畏光等。角膜螢光染色檢查呈陽性反應者佔89.58%。臨床組雙眼近視（-0.5屈光度），對照組雙眼正視眼（0.1屈光度），兩組間差異達統計學上顯著水平（右眼p=0.37；左眼p=.050）。平均雙眼不等視（p=.48）與散光（右眼p=.19;左眼p=41）上，兩組差異未達統計學上顯著水平。結論：雖然大部分下眼瞼贅皮併睫毛內翻的兒童就診時未呈現臨床症狀，但是大多數有角膜傷害徵兆，?B有屈光不正的問題。手術矯正對此類兒童屈光狀態的影響值得進一步的追蹤評估，文末也討論本研究之發現對兒童眼科之意涵。 Epiblepharon is a congenital lid anomaly in which a fold of skin and underlying orbicularis muscle pushes the lashes against the eyeball. Despite reports of surgical correction for amblyopia in patients with epiblepharon, it remains unclear how refractive errors may develop due to this anomaly and the extent to which surgical correction may reduce such errors. In order to investigate the clinical manifestations including refractive errors in children with congenital epiblepharon, we retrospectively reviewed the medical charts of 48 children ( 21 boys and 27 girls) with epiblepharon who visited our clinic between January 2001 and November 2003. The average age of the children was 6.99 years. A group of 60 normal age -and gender-matched group of children (27 boys and 33 girls ) was recuited from a local primary school to provide a normative basis of refractive function for comparison. Major clinical manifestations of the patients included eye rubbing, tearing, eye pain, eye discharge, photophobia and refractive error change. Compared to the control group, the epibleparon group showed significantly myopic shift in right -eye and left-eye mean spherical equivalents (-0.49 diopters vs. 0.10 diopters for the right eye; -0.38diopters vs. 0.09 diopters for the left eye). There was a trend toward incressed astigmatism especially in the right eye and increased anisometropia in the epiblepharon group. Further study is needed to determine the extent of refractive improvement following surgical correction in children with epiblepharon. (Full text in Chinese)