눈의 조절부족이 있는 어린이를 대상으로 한 시치료의 효과
The Effectiveness of Vision Therapy for Accommodative Insufficiency in Children
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이 연구는 증상을 호소하는 조절부족이 있는 9~13세의 초등학교 어린이 13명을 치료군 6명과 대조군 7명으로 나누어 치료군을 대상으로 12주 동안의 시치료를 실시한 후 다음과 같은 치료효과를 확인하였다. 1) COVD-QOL 점수로 평가한 눈증상은 치료 후에 29.17±6.37에서 9.83±5.42로 통계적(p<0.01) 으로나 임상적인 기준인 20점 미만으로 유의하게 감소하여 증상이 향상된 것을 볼 수 있었다. 2) 조절력(우안) 측정값은 치료 후에 7.33±2.25 D에서 13.17±2.02D로 통계적(p<0.01)으로 뿐만 아니라 Hofstetter의 최소 조절력(15-0.25×나이)을 만족하여 임상적으로도 유의하게 향상되었다. 3)조절용이(우안) 측정값도 치료 후에 1.92±1.63 cpm에서 19.50±4.22 cpm으로 통계적(p=0.001)으로는 물론 조절용이의 정상 값인 7 cpm 이상을 만족하여 임상적으로도 유의하게 향상되었다. 4)조절부족에 대한 시치료의 치료율은 83%이었고 향상율은 100%를 보였다. 이와 같이, 조절부족에 대한 시치료는 증상을 제거하고 저하된 조절기능을 향상시키는데 효과적인 방법임을 확인하였고 이를 통해 어린이의 눈건강을 증진시키는데 기여할 것으로 생각된다.
Abstract
Objectives:The purpose of this controlled study was to determine the effectiveness of vision therapy for accommodative insufficiency in children. Methods:Thirteen children 9 to 13 years of age with symptomatic accommodative insufficiency were divided into a treatment group (n=6) and a contol group (n=7). The treatment group received 12 weeks of vision therapy while the control group received nothing. Results:The COVD-QOL score for the treatment group showed both statistically and clinically significant reduction from 29.17±6.37 to 9.83±5.42 (p<0.001). Also, there were statistically and clinically significant improvements in the clinical measures of accommodative amplitude (p<0.01) and accommodative facility (p<0.001). In contrast, there were no significant improvement in symptoms and in the clinical measures of accommodative amplitude and facility for the control group (p>0.05). Conclusion:Vision therapy is an effective mode of treatment in eliminating symptoms and improving accommodative amplitude and facility in children with accommodative insufficiency.
참고문헌 (30)
- 손성은, "조절 부족과 조절 용이성 환자의 임상 사례", 대한시과학회지, 2, pp.169~175 (2000)
- American Optometry Association, "Optometric clinical practise guideline: Care of the patient with accommodative and vergence dysfunction", American Optometry Association, ~ (1998)
- American Optometry Association, "Optometric clinical practise guideline: Care of the patient with learning related vision problems", American Optometry Association, ~ (2000)
- Borsting E, "Association of symptoms and convergence and accommodative insufficiency in school-age children", Optometry, 74, pp.25~34 (2003)
- Ciuffreda KJ, "The scientific basis for and efficacy of optometric vision therapy in nonstrabismic accommodative and vergence disorders", Optometry, 73, pp.735~762 (2002)
- Cooper J, "Reduction of asthenopia after accommodative facility training", Am J Optom Physiol Opt, 64, pp.430~436 (1987)
- Daum KM, "Accommodative dysfunction", Doc Ophthalmol, 55, pp.177~198 (1983)
- Duckman RH, "Accommodation in cerebral palsy: Function and remediation", J Am Optom Assoc, (55), pp.281~283 (1984)
- Evans BJW, "Pickwell's binocular vision anomalies: Investigation and treatment, 4th ed", Butterworth- Heinemann, ~ (2002)
- Griffin JR, "Binocular anomalies: Procedures for vision therapy, 2nd ed", Butterworth-Heinemann, ~ (1984)
- Grisham JD, "Visual skills of poor readers in high school", Optometry, 78, pp.542~549 (2007)
- Harris P, "Changes in scores on the COVD quality of life assesment before and after vision therapy", J Behav Optom, 18, pp.43~47 (2007)
- Helveston EM, "Visual training: Current status in ophthalmology", Am J Ophthalmol, 140, pp.903~910 (2005)
- Hoffman L, "Effectiveness of non-strabismic optometric vision training in a private practice", Am J Optom & Arch Am Acad Optom, (50), pp.813~816 (1973)
- Hokoda SC, , J Am Optom Assoc, 56, pp.560~562 (1985)
- Jimnez R, "Statistical normal values of visual parameters that characterize binocular function in children", Ophthal Physiol Opt, 24, pp.528~542 (2004)
- Lara F, "General binocular disorders: Prevalence in a clinic population", Ophthal Physiol Opt, 21, pp.70~74 (2001)
- Maples WC, "Test-retest reliability of the College of Optometrists in Vision Development quality of life outcomes assessment", Optometry, 71, pp.579~584 (2000)
- Maples WC, "Test-retest reliability of the College of Optometrists in Vision Development quality of life outcomes assessment short form", J Optom Vis Dev, 33, pp.126~134 (2002)
- Maples WC, "Efficacy of vision therapy as assessed by the COVD Quality of Life checklist", Optometry, 73, pp.492~497 (2002)
- Marran LF, "Accommodative insufficiency is the primary source of symptoms in children diagnosed with convergence insufficiency", Optom. Vis Sci, 83, pp.281~289 (2006)
- Rawstron JA, "A systematic review of the applicability and efficacy of eye exercises", J Pediatr Ophthalmol Strabismus, 42, pp.82~88 (2005)
- Rutstein RP, "Anomalies of binocular vision: Diagnosis and management", pp.68~75 (1998), Mosby
- Scheiman M, "et al. Prevalence of vision and ocular disease conditions in a clinical pediatric population", J Am Optom Assoc, 67, pp.193~202 (1996)
- Scheiman M, "Clinical management of binocular vision: Heterophoric, accommodative and eye movement disorder, 2nd ed", pp.199~210 (2002), Lippincott Williams and Wilkins
- Shin HS, "Relationship between accommodative and vergence dysfunctions and academic achievement for primary school children", Ophthal Physiol Opt, 29, pp.615~624 (2009)
- Sterner B, "Accommodative facility training with a long term follow up in a sample of school aged children showing accommodative dysfunction", Doc Ophthalmol, 99, pp.93~101 (1999)
- Sterner B, "The effects of accommodative facility training on a group of children with impaired relative accommodation: A comparison between dioptric treatment and sham treatment", Ophthal Physiol Opt, 21, pp.470~476 (2001)
- Vaughn W, "The association between vision quality of life and academics as measured by the College of Optometrists in Vision Development quality of life questionnaire", Optometry, 77, pp.116~123 (2006)
- Wold RM, "Effectiveness of optometric vision therapy", J Am Optom Assoc, 49, pp.1047~1054 (1978)