Matsuo Toshihiko, Matsuo Chie
Department of Ophthalmology, Okayama University Graduate School of Medicine & Dentistry, Okayama City, Japan.
Ophthalmic Epidemiol. 2005 Feb;12(1):31-6. doi: 10.1080/09286580490907805.
The purpose of this study is to elucidate the prevalence of strabismus and amblyopia in a large population of Japanese elementary school children, from Grade 1 to Grade 6, ages ranging from 6 to 12 years. The School Health Law requires that all pupils in Grade 1 to Grade 6 be examined for vision and eye problems. Visual acuity testing is done by school teachers and eye disease screening by school ophthalmologists. Pupils with suspected ocular diseases are further examined by extramural ophthalmologists and the results reported back to the schools. The schools then summarize and send uncorrected visual acuity and ocular disease incidence, together with other health statistics, to the municipal education committees. The data are forwarded to the Prefecture Governments and finally submitted to the Education Ministry of the Central Government. Both the Prefecture Governments and the Education Ministry publicize the school health statistics on their websites. The prevalence of strabismus and amblyopia remains unknown from these data because both diagnoses are included under the heading, eye diseases.
Questionnaires asking about the numbers of children with different types of strabismus and amblyopia were sent to all elementary schools in Okayama Prefecture and the results were summarized.
The number of children covered by the return of questionnaires was 86,531 (76.4%) of 113,254 total pupils in Grade 1 to Grade 6 in Okayama Prefecture in the year 2003. The total numbers of children with strabismus and amblyopia were 1,112 (1.28%) and 125 (0.14%), respectively. The numbers of children with any type of exotropia and any type of esotropia were 602 (0.69%) and 245 (0.28%), respectively. The major types of strabismus and amblyopia were intermittent exotropia in 109 children (0.12%), accommodative esotropia in 19 children (0.02%), anisometropic amblyopia in 23 children (0.03%), and ametropic amblyopia in 12 children (0.01%). The number of children with strabismus of unknown type was 245 (0.28%) while the number of children with amblyopia of unknown type was 81 (0.09%).
The prevalence rates of strabismus and amblyopia in this population of Japanese elementary school children were lower than those reported in Western countries. The exotropia/esotropia ratio were increased in comparison with past studies in Japan. The school eye doctors need to be more diligent in identifying and diagnosing various types of strabismus and amblyopia in order to contribute to the school vision screening program already in place in Japan
本研究旨在阐明日本1至6年级、年龄在6至12岁的大量小学生中斜视和弱视的患病率。《学校卫生法》要求对1至6年级的所有学生进行视力和眼部问题检查。视力测试由学校教师进行，眼病筛查由学校眼科医生进行。疑似患有眼部疾病的学生由校外眼科医生进一步检查，结果反馈给学校。学校随后汇总并将未矫正视力和眼病发病率以及其他健康统计数据发送给市教育委员会。这些数据被转发给县政府，最终提交给中央政府教育部。县政府和教育部都在其网站上公布学校健康统计数据。由于斜视和弱视这两种诊断都包含在“眼病”这一标题下，因此从这些数据中仍不清楚它们的患病率。
向冈山县的所有小学发送了关于不同类型斜视和弱视儿童数量的问卷，并对结果进行了汇总。
2003年，冈山县1至6年级的113254名学生中，问卷回复覆盖的儿童数量为86531名（76.4%）。斜视和弱视儿童的总数分别为1112名（1.28%）和125名（0.14%）。任何类型外斜视和任何类型内斜视的儿童数量分别为602名（0.69%）和245名（0.28%）。斜视和弱视的主要类型为间歇性外斜视109名儿童（0.12%）、调节性内斜视19名儿童（0.02%）、屈光参差性弱视23名儿童（0.03%）和屈光不正性弱视12名儿童（0.01%）。类型不明的斜视儿童数量为245名（0.28%），类型不明的弱视儿童数量为81名（0.09%）。
这群日本小学生中斜视和弱视的患病率低于西方国家报告的患病率。与日本过去的研究相比，外斜视/内斜视比例有所增加。学校眼科医生需要更加勤勉地识别和诊断各种类型的斜视和弱视，以便为日本现有的学校视力筛查计划做出贡献。
