啓明學校兒童視障程度與其原因探討

The Degrees and Causes of Visual Impairment in Children in the School for Visual Handicap

10.7023/TJFM.200506.0077

羅道澤(Tao-Che Lo)；張翠巖(Tsui-Yen Chang)；陳仲達(Jong-Dar Chen)

visual impairment ； retinopathy ； International Blind Sports Federation ； perinatal ； premature

台灣家庭醫學雜誌

15卷2期（2005 / 06 / 01）

77 - 86

繁體中文

由本研究描述啓明學校之學童視障的程度和原因，並探討過去與現在，國內與國外的差異性。根據啓明學校89名學童之包含診斷證明書的學籍資料為基礎，蒐集開學時視力篩檢的結果，以國際盲人運動員的醫學分級搭配世界衛生組織眼科檢查的格式來紀錄視障的程度，並就解剖學位置和病因學分析之。 共46%的學童為B1級（雙眼無光感或有光感，但不能辨別手的形狀），B2級（視力在0.03以下）佔19%，B3（視力介於0.03至0.1）佔28%，而0.1至0.3之間的視力缺損佔7%。受影響的解剖位置以視網膜最多，包括中樞神經因素的其他類別其次。病因學以不明原因為主，產褥期因素居次。在時間軸或各年齡層間，產褥期因素尤其是早產兒視網膜病變都有增加的趨勢。 與西方工業化國家相比，本研究中視障兒童的解剖學位置以視網膜最多，高於含中樞神經等在內的其他類別。產褥期因素大都為早產兒視網膜病變，比例較歐美稍高。本研究中產褥期尤其是早產兒視網膜病變有增加的趨勢，其原因值得進一步流行病學研究來探討。

To describe the degrees and causes of visual impairment in children in the school for the visual handicap, and compare the differences between the past with the present, as well as domestic situations with international situations. Based on the entrance registration data including certified diagnosis of 89 students attending the school for the visual handicap, visual exam result given during school admission and degree of visual impairment according to the International Blind Sports Federation medical classification combined with a modified WHO/PBL eye examination record were analyzed. The affected anatomical parts and etiology were also analyzed. A total of 41 (46%) students were graded B1 (from no light perception in either eye to light perception, but inability to recognize the shape of a hand), 17 cases (19%) were graded B2 (from ability to recognize the shape of a hand to a visual acuity of 2/60), 25 cases (28%) were graded B3 (from visual acuity above 2/60 to 6/60), and 6 students (7%) had visual acuity of 6/60 to 6/18. Anatomically, the most affected sites were the retina (31 cases, 35%) followed by other parts (19 cases, 21%) including CNS. The most common causes were undetermined, followed by perinatal reasons. We found that perinatal reasons, particularly retinopathy of prematurity, are increasing in every age group. In comparison to the industrialized western countries, most of the students in this study had anatomic impairment of the retina rather than other parts, including CNS. Perinatal reasons as cause of impairment were mostly due to retinopathy of prematurity, with rates somewhat higher than that of western countries. In contrast to highly industrialized countries, perinatal causes, particularly retinopathy of prematurity, are increasing. But further investigation may be needed to confirm this finding.

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