조절과 눈모음 및 눈모음이상
Accommodation and Convergence, Anomalies of Convergence
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목적: 조절과 눈모음은 동공수축과 더불어 근거리 주시 시 일어나는 근거리주시 복합운동의 중요한 요소로서 편안하고 완벽한 양안시를 위해서 필수적이며 중요한 눈운동이다. 이에 조절과 눈모음 이상 질환의 적절한 치료법을 알아보고자 한다. 대상과 방법: 조절과 눈모음의 기본이론을 알아보고 눈모음 이상질환의 종류 및 다양한 치료법에 대해 살펴보았다. 결과: 눈모음이상은 단순 눈모음부족, 조절기능이상과 동반된 눈모음부족, 눈모음 마비, 눈모음연축과 눈모음 과다 등으로 구분된다. 치료방법으로는 정확한 굴절검사를 통한 안경처방과 시기능 훈련 및 프리즘 처방 등의 비 수술적 치료법과 외직근에 대한 수술치료법등이 있다. 결론: 조절과 눈모음이상의 치료를 위해서는 완전한 안검사를 통한 다양한 원인에 따른 효과적인 치료법의 선택이 필수이다. 따라서단순한 굴절검사와 시력교정용 안경처방이 아니라 다양한 원인질환을 찾는 것이 매우 중요하다. 이에 조절과 눈운동이상이 의심되는경우에는 안과검사는 물론 타과와의 협진을 통한 전체적이고 전문적인 진료와 그에 따른 적극적인 치료가 필요하다는 올바른 인식이절실하다.
Abstract
Purpose: Accommodation and convergence, the main factors of near vision complex on near vision associated with miosis are essential ocular movements for binocularity. Therefore, we attempted to find appropriate treatments for anomalies of accommodation and convergence. Methods: The basic theories and anomalies of accommodation and convergence were reviewed. Various treatment modalities for anomalies of convergence were discussed and treatment guidelines were proposed. Results: Anomalies of convergence were classified into convergence insufficiency, convergence insufficiency associated with accommodative insufficiency, convergence paralysis, convergence spasm, and convergence excess. Treatment was divided into non-surgical and surgical methods which include not only vision therapy and optical treatment using a prism after cycloplegic refraction, but also rectus muscle surgery. Conclusions: The choice of effective treatments according to various causes is necessary for anomalies of accommodation and convergence through complete eye examinations. Thus, not only simple refractive error measurement and glasses prescription for best corrected visual acuity are necessary, but also active treatment by fundamental ophthalmic and neurologic evaluation in hospitals.
참고문헌 (23)
- Mays LE, "Neuronal circuitry controlling the near response", Cur Opin Neurobiol, 5, pp.763~768 (1995)
- Morgan MW Jr, "Relationship between accommodation and convergence", Arch Ophthalmol, 47, pp.745~759 (1952)
- von Noorden GK, "Efficacy of bifocals in the treatment of accommodative esotropia", Am J Ophthalmol, 85, pp.830~834 (1978)
- Fry GA, "Further experiments on the accommodation convergence relationship", Am J Optom, 16, pp.325~336 (1939)
- Fry GA, "Tait’s analysis of the accommodative-convergence relationship", Am J Optom, 17, pp.383~389 (1940)
- von Noorden GK, "Binocular vision and ocular motility: theory and management of strabismus. 6th ed", pp.92~ (2002), CVMosby
- Ogle KN, "Oculomotor imbalance in binocular vision and fixation disparity", pp.87~88 (1967), Lea & Febiger
- Thompson DA, "Measurements with cover test vs. troposcope", Am Orthopt J, 2, pp.47~52 (1952)
- Jackson JH, "The gradient AC", A ratio: what's really normal?, 2004, pp.54, 125~132
- Alpern M, "Vergence and accommodation. III. Proposed definitions of the AC", A ratios, 1959, pp.48, 141~148
- von Noorden GK, "Binocular vision and ocular motility: theory and management of strabismus. 6th ed", pp.500~507 (2002), CVMosby
- von Graefe A, "Über musculäe Asthenopie", Graefes Arch Clin Exp Ophthalmol, 8, pp.314~367 (1862)
- Nemet P, "Stolovitch C. Biased resection of the medial recti: A new surgical approach to convergence insufficiency", Binocul Vis Strabismus Q, 4, pp.213~ (1990)
- von Graefe A, "Über Myopie in distans nebst Betrachtungen Über Sehen jenseits der Grenzen unserer Accommodation", Graefes Arch Clin Exp Ophthalmol, 8, pp.314~367 (1862)
- Duke-Elder S, "System of Ophthalmology: Ocular Motility and Strabismus", pp.570~ (1973), CV Mosby
- Grisham JD, "Visual therapy results for convergence insufficiency: a literature review", Am J Optom Physiol Opt, 65, pp.448~454 (1988)
- von Noorden GK, "Resection of both medial rectus muscles in organic convergence insufficiency", Am J Ophthalmol, 81, pp.223~226 (1976)
- Jampolsky A, "Ocular divergence mechanisms", Trans Am Ophthalmol Soc, 68, pp.730~822 (1970)
- Alexander Duane, "Anomalies of the accommodation clinically considered", Trans Am Ophthalmol Soc, 14(Pt 1), pp.386~402 (1915)
- Brown HW, "Strabismus in the adult. Symposium of the New Orleans Academy of Ophthalmology", pp.351~ (1950), Mosby-Year Book
- Parinaud H, "Clinical nerveuse: Paralysie des mouvements associës des yeux", Arch Neurol (Paris), 5, pp.145~ (1883)
- Walsh FB, "Clinical neuro-ophthalmology, 3rd ed", pp.1208~ (1969), Williams & Wilkins
- Gilad E, "Paralysis of convergence caused by mushroom poisoning", Am J Ophthalmol, 102, pp.124~125 (1986)