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育兒攻略

小兒外斜視,有“假”可打

2022-11-24 16:40:39

外斜視是兒童斜視中較為常見的類型,多與近視、散光有關,但是如果遠視度數很高,也會出現外斜視。如果斜視低于15度,一般人不會察覺。但是只要細心觀察,外斜視還是能夠被檢查出來的:如果寶寶與你面對而坐時,總是有一只眼斜看著旁邊,好像心不在焉似的,很可能就是外斜視。

兒童時期易發生斜視的主要原因有發育未完善、先天異常、遺傳因素等。從外觀來分辨,斜視最常見的是眼球向內偏斜的“斗雞眼”,以及眼球向外偏斜的“外斜視”。外斜視若不及早治療,后果較之“斗雞眼”更嚴重。因此一定要盡早發現治療。

斜視的人因為眼位不正,物體的影像落在黃斑中心以外的位置,視物就會出現復視。

此外,由于斜視患者長期靠一只眼注視,另一眼的影像受到抑制而停止發育,導致廢用性視力下降,造成弱視,甚至損害單眼視功能和立體視覺。

據專家介紹,外斜視治療要達到最佳效果,需區分外斜視的性質、年齡段、合并癥等。

外斜視尤其是大角度外斜視的治療,手術是最主要手段,且手術時機的選擇很重要。其他治療方法還包括戴鏡、弱視治療等。

一般來說,與屈光不正有關的斜視,最理想的治療方案是先矯正視力,矯治明顯的屈光不正、弱視后,再考慮手術。配合適的眼鏡矯正屈光不正是治療兒童斜視、弱視的重要方法,小兒配鏡一定要散瞳驗光,弱視明顯者還要配合用弱視治療儀,只有視力提高,手術效果才能鞏固。一般可先戴眼鏡矯治約半年,如果經過戴鏡、弱視治療仍無法改善、治愈斜視,應考慮做手術。如果視力正常,散瞳驗光無明顯屈光不正,證明戴鏡治療無效,應盡早手術。

斜視有真也有假。寶寶在出生最初幾個月內,由于視功能未發育好,眼肌調節力發育未完善,雙眼的共同協調運動能力較差,有時會出現短暫的“斜視”,面對這樣的“斜視”,應該細心觀察,只要是足月順產,沒有初生吸氧史,經過眼科醫生檢查確認,多數不必治療。隨著寶寶的發育成長,這種癥狀多數會逐漸消失,但需每半年復查一次。如果孩子到兩三歲了,家長發現其眼珠偏斜則需盡早治療。

有些細心的家長還發現,孩子的外斜視不是總會出現,這稱為間歇性外斜視。兒童的外斜視發病開始時往往是間歇性的,而且間歇時期比較長,有的孩子直到頻繁或大部分時間能看出外斜視時才被發現,這類患兒較容易被忽視。間歇性外斜視通常3歲左右發病,日久會變為恒定性外斜視,導致雙眼立體視覺喪失。如果發病時間很短,斜視較不穩定者可密切觀察,間歇性外斜視伴有視力差者需配戴合適的眼鏡,并做弱視治療,對控制、減輕外斜視有幫助。經過觀察、治療仍存有外斜視者,則需盡早手術治療。


▍來源:中國人口報


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