因弱視的遮蓋療法引起的嚴重視覺喪失

上一篇

散瞳劑使用造成之屈光反轉性弱視-個案報告

http://jim0423.blogspot.com/2011/03/blog-post_26.html

有人問到傳統遮蓋療法是否也會引起類似的效果，我找到了這一篇。

同樣是案例報告，兩個斜視性弱視的幼童因全時遮蓋而造成長期視覺喪失。

第一個在一歲半時，遮蓋了13天，好眼的視力在反向遮蓋弱視眼40天後才恢復。第二個在九個月大時，遮蓋了一個月，之後採取了反向遮蓋弱視眼3年，且此後雙眼皆成為弱視。

雖然因遮蓋形成的弱視並不常見，但仍建議避免全時遮蓋並且須定期監測患者視力。
還有一點，雙眼視覺的發育也很重要，在對抗弱視的同時，也一定要讓雙眼有同時視的機會，雙眼視覺的功能與技巧才有得到發展的機會。

J Pediatr Ophthalmol Strabismus. 1987 Sep-Oct;24(5):244-6.

Severe visual loss resulting from occlusion therapy for amblyopia.

Simon JW, Parks MM, Price EC.

Department of Ophthalmology, Albany Medical Center, New York 12208.

Abstract

Two children developed profound visual loss in the eye being patched full time because of strabismic amblyopia in the fellow eye. The first had been patched for 13 days at age 18 months. Complete resolution was noted on the 40th day of reverse occlusion. The second had been patched for 1 month at age 9 months. After 3 months without treatment, reverse occlusion was instituted and was continued for 3 years. Mild amblyopia persists in both eyes of the second child. Although rare, occlusion amblyopia can occur in young children being patched full time. We usually avoid full-time occlusion and monitor patients at intervals at least as frequent as 1 week per year of age.