Kubota N, Usui C
Department of Ophthalmology Teikyo University School of Medicine, Itabashi-ku, Japan.
Nippon Ganka Gakkai Zasshi. 1993 Jun;97(6):763-8.
For the treatment of strabismic amblyopia the authors have used atropine in the sound eye under usual optical correction as soon as central fixation of the amblyopic eye is secured by means of proceeding occlusion therapy. Although there may be little effect of occlusion in atropine therapy, six children under five years of age developed amblyopia in their sound eyes. In every case, the first sign of developing amblyopia was the decrease of fixation ability in the sound eye in a binocular fixation test prior to the reduction of visual acuity. On the other hand, fixation ability of the originally amblyopic eye was reinforced more and more not only during atropinization but after its finish until deep amblyopia developed in the sound eye. In three cases, eccentric fixation occurred at 7, 9, and 17 weeks after atropinization. These facts suggest that occlusion amblyopia following atropine therapy is not the result of deprivation but is due to the reversal of the eye used for fixation. Strabismic amblyopia may have the tendency toward an alternation between fixation abilities of the two eyes and such a binocular sensory anomaly may cause strabismic amblyopia itself.
为治疗斜视性弱视,一旦通过进行遮盖疗法确保弱视眼的中心注视,作者就在常规光学矫正下对健眼使用阿托品。尽管在阿托品治疗中遮盖可能作用不大,但6名5岁以下儿童的健眼出现了弱视。在每一例中,弱视发展的首个迹象都是在视力下降之前,健眼在双眼注视测试中的注视能力下降。另一方面,最初弱视眼的注视能力不仅在使用阿托品期间而且在停药后都越来越强,直到健眼发展为重度弱视。3例在使用阿托品后7周、9周和17周出现偏心注视。这些事实表明,阿托品治疗后的遮盖性弱视不是剥夺的结果,而是由于用于注视的眼发生了反转。斜视性弱视可能有双眼注视能力交替的倾向,这种双眼感觉异常可能本身就会导致斜视性弱视。