발달지연 소아환자에서 안과검진의 의의
Ophthalmologic Evaluation in Pediatric Developmental Delay
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목적: 발달지연 소아환자들을 대상으로 안과검진을 시행하여 안과질환 및 굴절이상의 빈도를 살펴보고 그 의의를 고찰해 보고자 하였다. 대상과 방법: 2008년 4월부터 2009년 4월까지 발달지연 클리닉에 내원하는 소아환자를 대상으로 1차 검진에서는 국소광원을 이용한 외안부검사, 동공반응검사 및 안구운동검사를 시행하였으며 2차 검진에서는 세극등현미경검사, 안저검사, 조절마비굴절검사, 눈물소 관관류술 등을 시행하였다. 결과: 89명의 대상 환자 중 61.8%에서 굴절이상을 제외한 안과질환이 관찰되었으며, 사시와 덧눈꺼풀이 각각 24.7%, 22.5%로 가장 많았다. 조절마비굴절검사를 시행한 60명 중 굴절이상을 보인 56.6%의 환자 중에는 난시가 30.0%로 가장 높은 빈도를 보였다. 치료를 시작한 환자는 24명으로, 4명은 수술적 치료를 받았고, 20명은 안경착용을 시작하였다. 결론: 우리나라의 발달지연 소아환자에서 안과질환의 높은 유병률을 확인할 수 있었으며, 이들 환자들에 대한 체계적인 안과검진이 필요할 것으로 사료된다.
Abstract
Purpose: To evaluate the ocular results and refractive errors in children with developmental delay and to determine the significance of ophthalmologic screening in children. Methods: The present study was conducted with children who visited the development delay clinic of National Health Insurance Corporation Ilsan hospital in Goyang, Korea. Primary evaluation included external eye examination, pupil reflex, and ocular movement test with focal light, and secondary evaluation included slit-lamp examination, fundus examination, cycloplegic refraction, and lacrimal drainage test if necessary. Results: Out of 89 subjects included in the study, 61.8% had ocular abnormalities other than refractive errors, and the two most common results included strabismus and epiblepharon, with occurrence rates of 24.7% and 22.5%, respectively. Among the 60 subjects who underwent cycloplegic refraction, 56.6% had refractive errors, with astigmatism (30%) being the most common. Among the 24 subjects who received treatment, four underwent surgical treatment and 20 started wearing glasses. Conclusions: The present study revealed a high prevalence of ophthalmologic abnormalities in pediatric developmental delay patients, indicating that systemic and comprehensive ophthalmic examination is necessary for these patients.
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